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increased in the latter, it is probably broken up in the body. .


In one per cent, solution it may be applied as a local anaes-
thetic to ulcers and infected wounds. Internally, its chief use
is as a hypnotic, which is both safe and generally efficient. In
moderate doses it promptly relieves irritability of the stomach.]


CHLORALOSE. Not official. C 8 H U C1 3 O 6 =259. 85. '

SOURCE. By heating together Anhydrous Chloral and Glucose, the soluble
Chloralose is formed which crystallizes. C,HCljO-j-C 6 Hj,O 6 =C 8 H u Cl s O 6 -f-

CHARACTERS. In small crystals, having a bitter and disagreeable, but not
acrid taste. Solubility. Freely in hot, slightly in cold water.

Dose, 2 to 4 gr. ; .12 to .25 gm.



Chloralose on account of its bitter taste is best given in cap-
sules. It will produce sound sleep in which sensibility is not
lost, although the reflex activities are greater than usual, because
as, Richet says, it excites the spinal cord while depressing the
functions of the brain. The awakening is without unpleasant
effects. Ten grains; .60 gm., have produced profound uncon-
sciousness, so that caution should be exercised in prescribing.


AMYLENE HYDRATE. (Not official.) (CH 3 ) 2 C 2 H 5 COH=87.8l.
Synonyms. Dimethylethylcarbinol. Tertiary Amylic Alcohol.

SOURCE. By the action of Sulphuric Acid on Amylene, separation of the
Amylene-sulphuric Acid, dilution, nitration, neutralization with Milk of Lime
or solution of Soda, and fractional distillation.

CHARACTERS. A limpid, colorless, oily liquid, of a peculiar penetrating
odor. Sp. gr., 0.815. Solubility. In 8 parts of water ; readily in Alcohol,
Ether or Chloroform.

Dose, ^ to i fl. dr. ; 2. to 4. c.c.


Amylene hydrate is a hypnotic, about midway in power be-
tween chloral and paraldehyde, having a pleasanter taste than
the latter. The sleep is generally natural, and the awakening
prompt and complete. It is a safe hypnotic, having no action
upon the heart or respiration, and it may have also anodyne pro-
perties. It can be administered in wine, raspberry syrup, or
simply in water. It has been given hypodermatically, with one-
half its volume of alcohol. After continued use it is apt to dis-
agree with the stomach.]

[PARALDEHYDE. C 6 H 12 O 3 =i3i.7.]

SOURCE. A product of the polymerization of [Ethylic] Aldehyde by
means of various Acids or Salts. For example, [Ethylic] Aldehyde may be
acted on by Hydrochloric Acid, [Carbonyl Chloride (COC1 2 ), Sulphur Dioxide]
or Zinc Chloride ; during the action, the temperature of the mixture rises, and
almost complete conversion into Paraldehyde takes place. On cooling to
below 32 F. [o C.], Paraldehyde crystallizes. 3C 2 H 4 O C,H 12 O 3 .

CHARACTERS. A colorless [transparent liquid, having a strong, charac-


teristic, but not unpleasant or pungent odor, and a burning and cooling taste.
Solubility. In 85 parts of water ; freely in Alcohol and Ether.]
Dose, ]^ to i fl. dr. ; [i. to 4. c.c.]


External. It is antiseptic.

Internal. Large doses increase the flow of urine and some-
what strengthen the heart, but they do not affect the gastro-intes-
tinal tract or respiration ; enormous doses of paraldehyde weaken
the action of the heart, and kill by paralysis of the respiratory

Nervous system. It is a powerful hypnotic, without any
unpleasant after-effects. It acts quickly, and the sleep, which
lasts several hours, is quiet, refreshing, and dreamless. Paralde-
hyde in toxic doses paralyzes the anterior cornua of the spinal
cord ; thus it abolishes reflex action and causes paralysis. It does
not affect nerves or muscles.


Internal. It is given solely as an hypnotic in the same class
of cases as chloral, and as it does not act on the heart it may also
be used for patients suffering from cardiac disease. It has been
used largely in asylums to produce quiet in mania, and sleep in
melancholia. It may produce an erythematous rash. Unless
given in capsules, the great objection to its use is its [disagree-
able] taste, which is best covered by prescribing it with syrup
and tincture of orange peel in at least two fluid ounces [60. c.c.]
of water to insure that a usual dose will be dissolved. [It can
also be administered in glycerin in a 25 per cent, solution, which
renders it more palatable.] It gives an extremely offensive and
persistent odor to the breath, which lasts many hours. [In-
stances of the paraldehyde habit have been occasionally reported.
There is great emaciation, cardiac weakness, unsteady gait,
mental confusion and agitation with hallucinations of sight and
hearing and unpleasant delusions. Restraint for several months
is necessary for cure.]



SULPHONAL. [B. P., not official. C 7 H 16 S 2 O 4 =227. 59. Synonym.
Diethylsulphondimethylmethane. ( CH 3 ) 2 C(SO 2 C 2 H 5 ) 2 =227.59.

SOURCE. Mercaptan (Ethyl Hydrosulphide) is combined with Acetone
to form Mercaptol, which by oxidation with Potassium Permanganate yields
Sulphonal. ]

CHARACTERS. Colorless, tabular crystals, inodorous, almost tasteless.
Solubility. In 450 parts of cold ; in 15 parts of boiling water ; in 90 parts
of Alcohol or Ether ; in 3 parts of Chloroform.

Dose, 15 to 40 gr. ; [i.oo to 2.40 gm.] in cachets or suspended in


Sulphonal is an hypnotic. It does not depress the heart.
The drug is given for the same class of cases as chloral, but as it
is so insoluble, it is absorbed with difficulty and very slowly ;
hence it takes two or more hours to act, and its action may be
prolonged into the next day. It produces its effect most rapidly
if the fluid, in which it is suspended, is hot ; but as they are so
much more convenient it is usually given in cachets an hour and
a half before bedtime. Sulphonal rarely leads to a habit or to
any disagreeable after-effects. The symptoms of a sulphonal
habit are general lethargy, mental, moral and muscular weak-
ness, loss of nutrition, and dyspepsia. It has been known to
produce [persistent] eruptions upon the skin and hsematopor-
phyrin in the urine. [Several fatal cases of poisoning by this
drug have been reported from small doses continued for long
periods. Severe general functional disturbances have followed
its use.] Enormous single doses produce, in addition to these
symptoms, prolonged sleep, lasting many days, paralysis of
sphincters, anuria, a fall of temperature, and, late in the case,
depression of respiration.


[TRIONAL. (Not official.) CH 3 C(SO 2 C 2 H 5 ) 2 C 2 H 5 =24I. 56. Syn-
onym. Diethylsulphonmethylethylmethane. This contains three Ethyl groups
instead of two as does Sulphonal.

SOURCE. It is prepared as in Sulphonal, except that Methylethylketone is
used in place of Acetone.


CHARACTERS. Shining, colorless, crystalline plates, tasteless and odorless.
Solubility. In 320 parts of water ; readily in Alcohol and Ether.
Dose, 5 to 30 gr. ; .30 to 2.00 gm.


Trional is a prompt hypnotic, without cumulative action, and
it has no injurious or unpleasant after-effects. Apparently the
patients do not become habituated to its use. It has been used
as a hypnotic and sedative for the insane ; for narcotic habitues,
so far as is known, it is a safe remedy. It is important the daily
action of the bowels be secured, an alkaline water be given daily,
and weekly intermissions be insisted upon, otherwise it may give
rise to disagreeable after-effects. It but rarely gives rise to

Tetronal is of similar chemical composition, containing four
instead of three ethyl groups, and is used for the same purposes,
but in somewhat larger dose.


URETHANE. (Not official.) CO.NH Z .OC !( H..:=88.94. Synonyms.
Ethyl Carbamate. Ethyl Urethane.

SOURCE. By the interaction of Urea Nitrate and Ethyl Alcohol ; and
crystallization on cooling.

CHARACTERS. Colorless, columnar or tabular crystals ; colorless, and
having a pleasant, saline, somewhat cooling taste. Solubility. In I part of
water ; 0.6 part of Alcohol ; I part of Ether ; 3 parts of Glycerin.

Dose, 5 to 30 gr. ; .03 to 2.00 gm.


Urethane is used as a hypnotic, and is believed to provide a
calm, natural sleep without any disagreeable after-effects. It was
formerly more frequently employed.]

CLASS V. Drugs which have an Antipyretic or Analgesic Action.
[The single official representative is Acetanilid.

Antipyrin and Phenacetin (B. P.), Exalgin, Lactophenin, Phenocoll Hy-
drochloride and Thallin Sulphate, none of which are official, belong to this
class. Alpha- and Beta-Eucaine, local anaesthetics are considered here, for



ACETANILID. C 6 H 5 NHC 2 H,O[=i34.73.] Synonyms. Phenyl-
acetamide. Antifebrin. [An Acetyl denvative of Aniline.]

SOURCE. Glacial Acetic Acid and [pure] Aniline are heated together [the
excess of both ingredients is then distilled off, and the congealed residue is
crude Acetanilid, which is purified by repeated crystallization from water.]
C 6 H 5 NH 2 +HC 2 H 3 2 =C 6 H 5 NHC 2 H 3 0+H 2 0.

CHARACTERS. [White, shining micaceous crystalline laminae, or a crys-
talline powder, odorless, having a faintly burning taste, and permanent in the
air. Solubility. In 194 parts of water, and in 5 parts of Alcohol ; also solu-
ble in 1 8 parts of Ether, and easily soluble in Chloroform.

INCOMPATIBLES. Potassium and sodium hydrate, and chloroform.

IMPURITIES. Aniline and its salts.

Dose, 2 to 5 gr. ; .12 to .30 gm.]


External. It is a local haemostatic as it contracts blood-
vessels when applied to them.

Internal. Blood. With ordinary doses of this drug this
fluid is unaffected, but in large doses the color is changed, from
the formation of methaemoglobin. The passage of this in the
urine discolors it. It causes the red corpuscles to break up and
arrests the movements of the white.

Heart. This substance depresses the heart. It is not known
how it does this ; but what little evidence there is appears
to show that it has a directly paralyzing action on the cardiac

Vessels. Acetanilid contracts the smaller vessels from direct
action on their muscular coat. The blood -pressure therefore

Respiration. This is not affected by ordinary doses. After
toxic doses the force of the respiratory act progressively dimin-

Kidneys. This substance is a mild diuretic. The excretion
of urea and uric acid is stated to be increased by it. Large
doses cause the urine to be dark from the passage of altered
blood. Acetanilid is said to be excreted as aniline, but this re-
quires confirmation.

Skin. This may produce an erythematous rash which usually


[resembles that of measles] or is urticarial, and it is occasionally
a mild diaphoretic.

Temperature. This substance is a powerful antipyretic.
It has a very slight action on the temperature of health, but it
reduces it very markedly when it is raised from any cause. It
was introduced into medicine for this property. We have
already seen (see p. 71) how numerous are the ways in which
antipyretics may act. The fall of temperature produced by this
drug is not due to any action on the blood or the circulation,
and it is too marked to be entirely owing to its diaphoretic
action. It decreases heat production, and it is most likely that
it acts directly upon that part of the central nervous system,
probably upon the corpora striata, which presides over heat pro-
duction. It, to a much less extent, increases heat dissipation.
The result of these two actions is that the temperature falls. The
proof of these statements is too long and complicated to give
here, but we may mention that it is easy to show both by a calo-
rimeter, and by the decrease of the products of the febrile de-
struction of tissue, such as urea, that these drugs diminish heat
production. [It also possesses anti -periodic properties.]

Nervous system. The drug is a powerful analgesic. Ace-
tanilid in large doses is said to produce first convulsions, then
coma, and paralysis of motor nerves and muscles ; but all these
statements require further experiments.


External. Acetanilid has been used in form of a dusting
powder [for soft and hard venereal ulcerations, in place of iodo-
form,] or as an ointment (i to 24) for chronic ulcers and eczema.
[It has also been employed as an antiseptic for wounds. Too
large a surface, however, should not be dusted over.]

Internal. Pyrexia. Originally this drug was introduced
into medicine on account of the property which it has of reducing
pyrexia. The opinion is, however, gaining ground that if the
temperature is not dangerously high no attempt should be made
to reduce it, for probably the raised temperature is an endeavor
on the part of the body to defend itself against the micro-organ-


isms which are the cause of the particular fever from which the
patient is suffering ; in other words, the pyrexia is a " defensive
mechanism." Further, this drug is a cardiac depressant, and
therefore unsuitable for patients suffering from fever, and this
last consideration makes many physicians prefer to use cold
water when the temperature is so high that it, of itself, is dan-
gerous to life. In order to gain a rapid effect, when it has been
decided to use an antipyretic this drug is useful. The balance
of evidence is that toxic symptoms are more common after ace-
tanilid, which, however, does not keep the temperature down
quite so long as [other antipyretics. ] It takes about two hours
to reduce the pyrexia to its minimum. [Acetanilid] may be
given per rectum. [It has no action upon the intestinal tract.]

Analgesic action. This drug has the property of relieving
pain [of neuralgia, sciatica, dysmenorrhoea, locomotor ataxia,
migraine, and various headaches.]

[Under the name of Antikamnia a substance has been intro-
duced which is probably a mixture of 20 parts of sodium bicar-
bonate, 70 of acetanilid and 10 of caffeine. Since acetanilid is
a cardiac depressant, the addition of caffeine may be advantageous
in some cases. A case of death has been reported, attributed to
the ingestion of 24 grains [1.50 gm.] of this mixture.] Anti-
nervin contains acetanilid, sodium salicylate and potassium



Symptoms. Acetanilid occasionally produces in man collapse, cyanosis,
very slow respiration, a feeble and irregular pulse, vomiting, profuse sweating,
and profound prostration. [Death has occurred after a dose of 5 gr. ; .30 gm.]
It is not known whether these symptoms are due to impurities in the drug.

Treatment. Stimulation by alcohol and ether, subcutaneously, and by
the mouth. Strychnine subcutaneously to stimulate the heart. Oxygen in-
halations. Warmth to the feet and body.


ANTIPYRIN. (Not official. ) Phenazonum, [B. P.] C 6 H 5 (CH 3 ) 2 C S
HN 2 O=[i87.65.] Synonym. Phenyldimethylpyrazolone.

SOURCE. Aceto-acetic Ether is acted upon by Phenyl-hydrazine, when
Phenylmonomethylpyrazolone, Ethyl Alcohol, and water are formed. CH S
COCH 2 COOC,H 6 + H 2 NNHC 6 H 5 = C 6 H 5 (CH 3 )C 3 H 2 N !i O+C,H 5 OH-f H 2 O.



The Monomethyl compound is treated with Methyl Iodide and Methyl Alcohol.
C 6 H 5 (CH 3 )C 3 H 2 N 2 0+CH S I=C 6 H 5 (CH 3 ) 2 C 3 HN 2 0+HI.

CHARACTERS. Colorless, odorless, scaly crystals [of a somewhat bitter
taste]. Solubility. Freely in water, Alcohol and Chloroform.

INCOMPATIBLE. Iron sulphate, iodide, and chloride, copper sulphate,
iodine, arsenic iodide, carbolic, hydrocyanic, and nitric acids, potassium per-
manganate, salicylates, [corrosive mercuric chloride], spirit of nitrous ether ;
all preparations of tannin give a white precipitate ; chloral hydrate decom-
poses it unless in dilute solution.

Dose, 3 to 20 gr. ; [.20 to 1.20 gin.]


[Antipyrin in small doses may moderately increase arterial
pressure by direct stimulation of the heart (Wood) ; in large
doses it is a cardiac depressant, the final fall of blood-pressure
being certainly due, at least in part, to a direct action upon the
heart.] It also contracts the blood-vessels, being therefore a
local haemostatic. It is a mild diuretic, and is quickly excreted
in the urine as antipyrin. [It may produce an erythematous
rash. It rapidly reduces an elevated temperature by decreasing
heat production, by direct action on the centre which presides
over heat production, and to a much less extent increases heat
dissipation. In large doses it is said to produce convulsions,
later coma, and paralysis of motor nerves and muscles.

Antipyrin is given internally as a powerful antipyretic, in
fevers of various kinds. It is also used as a haemostatic in haem-
orrhoids and epistaxis. It has been used with some success in
diabetes. It is largely employed as an anti-neuralgic, reliev-
ing the pains of locomotor ataxia and other nervous affections,
and as an anti-rheumatic. It has been highly recommended
in chorea and epilepsy. Externally it is supposed to be an anti-
septic, but irritation has followed its hypodermatic use. It is a
local anaesthetic.

Salipyrin is prepared by the action of antipyrin upon sali-
cylic acid in substance. It is a white, coarsely-crystalline pow-
der with a rather sweetish taste, readily soluble in alcohol, but
slightly in water. In chronic articular rheumatism and sciatica
it has been successful, but it does not prevent relapses. It has


been successfully used for spasmodic dysmenorrhoea. The dose
is from 6 to 30 gr. ; .40 to 2.00 gm.

lodopyrin or iodantipyrin is supposed to have a hydrogen
atom in the phenyl group of antipyrin replaced by iodine. It
occurs in colorless, prismatic needles, which are tasteless. It is,
with difficulty, soluble in cold water or alcohol, but readily when
hot. It causes a fall of temperature and perspiration, but with-
out collapse or shivering. It is doubtful if it has any advantage
over antipyrin. The dose is from 2 to 15 gr. ;. .12 to i.oo gm.]


Symptoms. Antipyrin occasionally produces, in man, collapse, cyanosis,
very slow respiration, a feeble and irregular pulse, vomiting and profound pros-
tration. It is not known whether these symptoms have been due to impurities
in the drug, [but it is quite likely that they have arisen from improper dosage.]
Many deaths have been caused by this drug ; it has been stated that during
one epidemic of influenza in Vienna seventeen persons were killed by it.

Treatment. Stimulation by Alcohol and Ether subcutaneously and by the
mouth ; Strychnine subcutaneously to stimulate the heart ; warmth to the feet
and body.


[PHENACETIN.] (Not official.) Ci H 13 NO 2 =[i78.63]. Synonym.
Para-acetphenetidin. C 6 H 4 OC 2 H 5 NHC 2 H 3 O==[i78.63].

SOURCE. Glacial Acetic Acid is made to act upon paraphenetidin, a pro-
duct of Paranitrophenol. [C 6 H 5 OC 2 H 5 NH 2 +HC 2 H 3 O 2 =C 6 H 4 OC 2 H 5 NHC 2
H S 0+H 2 0.]

CHARACTERS. Colorless, tasteless, scaly crystals. Solubility. Very spar-
ingly (i in 1700) in water; in 30 parts of Alcohol ; soluble in Glycerin.

Dose, 5 to 10 gr. ; [.30 to .60 gm.] (as an antipyretic), in cachets,
capsules or suspended.


[Phenacetin has no action externally nor on the gastro-mtes-
tinal tract, and with ordinary doses the blood is unaffected. It
slightly depresses the heart, but does not in ordinary doses affect
the respiration. It is a mild diuretic, but large doses cause the
passage of altered blood. It is a powerful antipyretic by de-
creasing heat production and slightly increasing heat dissipation.
It is a powerful analgesic. It is a valuable remedy for reducing
fever, and because it depresses the heart but little, it is safer


than either antipyrin or acetanilid. It is, however, very insolu-
ble, and slower and less powerful than these remedies, but the
effects last longer. As this drug possesses a marked analgesic
action, it is to be preferred as a remedy for the relief of pain, as,
neuralgia, sciatica, locomotor ataxia, migraine and various head-
aches. For this purpose, the dose of 5 gr.; .30 gm., should be
administered every hour for three or four hours ; this generally
gives relief. This drug has been of service in the treatment of



Symptoms. This drag sometimes produces severe vomiting, sweating,
feeble and rapid pulse, and collapse. Treatment. Alcoholic stimulation.
Strychnine hypodermatically. External warmth.]


EXALGIN. (Not official.) [C 6 H 5 N(CH 3 )CH S CO=I48. 70.] Syno*
nym. Methyl Acetanilid.

[SOURCE. By warming together Monomethylaniline and Acetyl Chloride.

CHARACTERS. Colorless acicular needles, with a slightly] saline taste.
Solubility. In 60 parts of water ; freely in Alcohol.

Dose, ^ to 3 gr. ; [.03 to .20 gm.]


Exalgin is a powerful analgesic and has been given with suc-
cess for neuralgia. Often it relieves when many other drugs
have failed. Medicinal doses hardly ever cause depression, but
very large quantities may be dangerous from their breaking up
the blood like acetanilid. It is best dissolved in Tinctura
Aurantii [Dulcis], but may be made into a pill. [It is used for
migraine, sciatica, the pains of rheumatism, and, of late, for


Several severe cases of poisoning having been reported, the usual dose
should not be exceeded. The symptoms are similar to those of acetanilid.
Treatment. As for acetanilid. (See p. 321.)


LACTOPHENIN. (Not official. ) C n H 15 NO s =2o8. 56. Synonym.
Lactylparaphenetidine. C ft H 4 OC 3 H 6 NHCOCH(OH)CH,==2o8.56.


SOURCE. Lactophenin differs from Phenacetin only by the substitution of
Lactic for Acetic Acid.

CHARACTERS. A white, tasteless powder. Solubility. In 330 parts of

Dose, 10 to 15 gr. ; .60 to i.oo gm.


Lactophenin is an analgesic and antithermic. It is usually
better borne than antipyrin. Although it may, in some instances,
give rise to sweating, it does not cause collapse nor cyanosis. It
produces a considerable and persistent lowering of a febrile
temperature, but without abundant perspiration, and its use is
not followed by chilly sensations. It has been administered in
articular rheumatism, influenza, scarlet fever, septicaemia and
other infectious diseases. Von Jaksch has obtained excellent
results in typhoid fever, with daily doses from 7 to 15 gr.; .50 to
i.oo gm., not only in reducing the fever, but as a sedative when
delirium becomes a prominent symptom.


PHENOCOLL HYDROCHLORIDE. (Not official.) C 10 H M N 2 O,

SOURCE. By the intermixture of Phenetidine with Glycocoll or Amido-
acetic Acid.

CHARACTERS. It is a white micro-crystalline powder. Solubility. In
20 parts of water.

Dose, 5 to 30 gr. ; .30 to 2.00 gm.


It is not poisonous to animals and nor does it injuriously
affect the blood. It is a fairly powerful antipyretic, not followed
by collapse or cyanosis ; the perspiration is not more marked
than after large doses of antipyrin. It has also been used as an
antineuralgic ; in severe acute articular rheumatism it has exer-
cised a beneficial action upon the joints when other remedies
have failed. It is rapidly excreted by the urine, to which it
gives a brownish color, and it probably increases the excretion
of uric acid. The reports, of which there are now a consider-
able number, are favorable to this remedy.


THALLINE SULPHATE. (Not official.) 2C 9 H 10 N(OCH 3 )H 3 SO 4

SOURCE. By heating together Paramidoanisol, Paranitranisol, Glycerin
and Sulphuric Acid.

CHARACTERS. A white or whitish granular crystalline powder having a
slightly Anise-like odor and a nauseous, bitter, saline and pungent taste.
Solubility. In 7 parts of water ; in 100 parts of Alcohol.

Dose, 2 to 10 gr. ; .12 to .60 gm.


This drug was introduced into medicine as an antipyretic, but

Online LibraryWilliam Hale-WhiteMateria medica, pharmacy, pharmacology and therapeutics → online text (page 28 of 67)