REPRINT FROM 
MEDICAL and SURGICAL 
REPORTER. 
No. 1850. 
PHILADELPHIA, AUGUST 13, 1892. 
Vol. LXVII—No. 7. 
Satiety fUport#. 
its objectionable features of generally 
inducing constipation, cephalalgia, nau- 
sea and deranged digestion cause us to 
make use of the less harmful remedies 
for the relief of pain in a large class of 
ailments. The dose of antipyrin should 
be ten or fifteen grains, and if the pain is 
not relieved in one or two hours, repeat 
the dose. Antikamnia, acetanilid and 
phenacetine are also useful in hemicrania; 
and all four can be depended upon for 
the certain relief of hyperaemic head- 
aches. The speaker has many patients 
who prevent paroxysms of sick head- 
ache by one or two doses of antifebrin of 
six to eight grains each. Some get 
relief from antipyrin when antifebrin 
fails. He had used phenacetine in a 
number of cases of pertussis, and be- 
lieves it serves a useful purpose in dimi- 
nishing fflhe severity and frequency of the 
paroxyms of coughing. For the relief of 
enteralgia, gastralgia and other nervous 
affections of the bowels, dependence 
cannot be placed upon any of these ; but 
antikamnia has given relief in a number 
of cases of these affections. All of the 
series have a wide range of usefulness in 
the treatment of la grippe, in relieving 
the severe muscular and neuralgic pains 
and in reducing the fever. 
The use of all antipyretic remedies 
must be persisted in until the desired 
end—the reduction of temperature—is 
secured; but the peculiarities of each 
patient must be studied, and these agents 
must be administered in a way to suit 
each individual case. A dose that would 
give the desired result at one period of a 
disease might prove insufficient or ex- 
cessive at another period ; and a dose 
that would lower a temperature to the 
required degree in one individual might 
require double that amount to get the 
same result in another. Many authori- 
ties recommend giving five to ten grains 
regularly every three or four hours. In 
this the writer does not agree, for it is 
well known that in nearly all fevers there 
MITCHELL DISTRICT MEDICAL 
SOCIETY. 
Twenty-second Annual Meeting held at 
West Baden, Indiana, July 7th and 
8th, 1892. 
FIRST DAY—AFTERNOON SESSION. 
The Society convened in the hall of the 
West Baden Hotel, and was called to 
order at 2 P. M., by the President, Hr.' 
E. S. Elder, of Indianapolis. 
After the transaction of some mis- 
cellaneous business, the reading of papers 
was proceeded with. The first paper 
read was by Hr. C. W. Murphy, of Salem, 
Indiana, entitled 
THE COAL TAR DERIVATIVES ; THEIR USE 
AND ABUSE. 
Antipyrin, antikamnia. acetanilid and 
phenacetine being the most frequently 
used and important of the newly discov- 
ered chemical agents, the speaker’s re- 
marks were confined principally to their 
consideration. Antifebrin and acetanilid 
are the same articles under different 
names. When the physician prescribes 
acetanilid he gives its pharmaceutical 
name; when he prescribes antifebrin he 
gives its proprietary name ; the former is 
very cheap, the latter more expensive. 
As there are no restrictions on the 
manufacture of acetanilid it is easy to 
understand how, as in the manufacture of 
other drugs, an impure article is some- 
times placed upon the market. 
All of these agents come under the 
head of anodynes or analgesics, posses- 
sing the property of lessening the sensi- 
bilit}' of the nerve centers or their 
peripheral extremities, but in varying 
degrees. They are also antipyretic in 
action, and it should never be overlooked 
that their effect on the system when fever 
is present is much more powerful than 
when it is absent. While opium will 
always stand at the head of anodynes, is an evening exacerbation ; usually the 
fever rapidly declines after midnight, 
and does not rise again until 10 or 11 a. 
m., and sometimes not until 2 or 3 in the 
afternoon. A powder of seven or ten 
grains antikamnia in the morning, when 
the temperature has risen to 103°, will 
generally keep it down below the point 
until 7 or 8 p. m., and occasionally it is 
sufficient for the twenty-four hours ; but 
if it comes up again any time in the 
afternoon or evening another dose is 
given. Should one dose fail to make an 
impression on the fever, which but sel- 
dom occurs, the author gives another 
dose at the expiration of two hours. In 
this manner, with from one to three 
doses, the temperature in almost all 
fevers is easily maintained below 103°; 
and, as already stated, it prevents undue 
tissue waste, lessens nervous irritability, 
promotes sleep, prevents delirium and 
complications, and therefore lessens the 
mortality. 
Dr. J. M. Mathews, of Louisville, 
said he had been a sufferer from periodi- 
cal headaches all his lifetime ; he had 
tried the coal tar derivatives, some of 
them acting fairly well, others doing him 
injury, but antikamnia, in his own case, 
had given entire satisfaction ;• so much 
so, that when he has an attack he can 
stop it almost instantly with antikamnia 
in 15 or 20 grain doses. 
Dr. Dudley S. Reynolds, of Louis- 
ville, said the paper awakened in his mind 
a consideration of the whole subject of 
the treatment of the inflammatory, zy- 
motic fevers, antipyresis, etc. In 1882 
a discussion of Brand’s method of treat- 
ing typhoid fever was extensively in- 
dulged in by the French Society for the 
Advancement of Science. An eminent 
Frenchman had been making experiments 
with salicin, quinine and some of the 
other alkaloids of the cinchona bark. 
All the great clinicians of France took 
part in the discussions. The impression 
was that high temperature means disinte- 
gration of tissue; it means the active pro- 
cesses of fermentation; carefully studied, 
most all the remedial agents employed 
against these processes will convince one 
that they are in the nature of anti-ferments. 
In the chronic inflammations of the so- 
called rheumatic people, especially the 
chronic inflammations of the ciliary bodies 
of the iris, all the different kinds of 
medicine used in the treatment of high 
temperature had been tried—all the elim- 
inating agents, all the depleting agents 
and mercurial drugs, which had so long 
been in high esteem by the profession,, 
had almost entirely passed out of use. 
We now find salol, salicylate of sodium,, 
and more rarely pilocarpine bring about 
not only reduction of pains, discomfort 
and of the general bodily temperature, 
which is always elevated in inflamma- 
tions of the ciliary body, but actually 
dissipate the inflammatory process by 
opening up the lymph channels and tubes 
by destroying the ferment that occludes 
them, whether by dissolving some mor- 
bid effusion or by general diffusion it is 
difficult to say, yet the conviction in the 
minds of Frenchmen was that antipy- 
retics are after all anti-zymotics, those 
agents which arrest fermentation. 
Dr. E. S. Elder, of Indianapolis ex- 
pressed his appreciation of the paper, 
and was glad that the author had taken 
such a bold stand in favor of antipyretic 
medication, as he believed that an un- 
founded prejudice had been created 
against their use by certain members of 
the profession, who claim that antipy- 
retics assist in producing heart failure. 
He believed that the injury charged to 
antipyretic medication resulted fron con- 
tinued high temperature, which meant 
increased metabolism, or a burning up 
of the tissues, which of itself was disin- 
tegrating and weakening. He considers 
it good practice in the use of antipyretic 
remedies to combine with them some 
heart tonic, such as strychnia or digitalis. 
Dr. C. W. Murphy, of Salem, said if 
there was depression of the heart he used 
a cardiac tonic, otherwise not. He some- 
times uses digitalis and nux vomica in 
combination. The principal reason for 
the condemnation of antipyretic medica- 
tion by certain members of the profes- 
sion he thought was due to an improper 
administration of the remedies them- 
selves. 
Dr. S. H. Charlton, of Seymour, 
Indiana, asked Dr. Murphy in what 
doses would he consider it safe to use 
these remedies, and how often. His ex- 
perience was in favor of giving them in 
small doses. Five grains were as many 
as he gives, repeated every three or four 
hours. He had treated cases in the 
country by sending these remedies in 
connection with other medicines, without 
seeing the cases.