Hydracetine produces diminution in frequency of pulse and respiration with production of profuse perspiration. Like other antithermic remedies it controls the pains of acute rheumatism. In divided doses of 1 grains daily it causes remissions for several hours. Employed in the form of an ointment of 10 per cent. of hydracetine, favorable action is produced in psoriasis, while it is also useful as an analgesic in cases of sciatica. Hydracetine may be used freely as an external application, but great care must be used in its internal administration. Not more than 1 grains should be given at a single dose, preferably of a grain every hour. Even then the treatment should not continue longer than three days.

METHACETINE.

Methacetine occurs in shining, white, odorless and almost tasteless scales. It is an active antipyretic, three, four, or even five degrees being lost within a few hours after the administration of a therapeutic dose. In doses of 2 or 3 grains given to a child it exerts a marked antithermic action, the reduction of temperature being gradually produced, and remaining at the lowest point several hours, then gradually increasing. Frequently marked perspiration is produced within an hour after its administration. It has been employed in pulmonary tuberculosis, tubercular meningitis and in pneumonia, the patients all being children. In one case it produced slight collapse, but never vomiting, ringing in the ears, vertigo or erythema. In its action methacetine is said to correspond in every respect to phenacetine.

EXALGINE.

Exalgine, a compound obtained from one of the products of the destructive distillation of coal tar, presents itself in the form of fine needles or large white tablets. It seems closely allied to antipyrine, though its effects on the sensorium are more marked than the latter, while it exerts a less marked action as an antipyretic. It is best administered in powder or some alcoholic solution flavored with an aromatic. The usual dose is 4 to 6 grains given at once, or 6 to 12 grains given in twenty-four hours. The analgesic effect is claimed to be very marked in all forms of neuralgia, especially congestive and dental neuralgia, also including visceral neuralgia, in which it is even claimed to be superior to antipyrine. It is said

that no gastro-intestinal irritation, rash or cyanosis has been noticed after its administration. It is also noted that after the physiological effect of the drug has been developed, while painful sensations are destroyed, the tactile sense remains unaltered.

Exalgine is eliminated by the urine, upon the quantity of which it exerts a marked influence, diminishing the quantity of the secretion. In diabetes it diminishes both the quantity of urine and sugar eliminated.

Dr. Dujardin-Beaumetz says of exalgine: "After antipyrine, and almost at an equal rank from an analgesic point of view, I place methyl acetanalid (exalgine), and if this methyl compound were more soluble, it would certainly deserve to occupy the first place, and this, because it is more active and because under its influence we have never seen an eruption appear." Exalgine given in doses of 4 to 12 grains modifies considerably the pain of a patient suffering with neuralgia or any other painful affection. In these doses it is said that it has never produced any other trouble than slight vertigo and ringing in the ears.

Exalgine is poisonous when administered in doses equivalent to 7 grains to every two pounds of body weight, so that in ordinary therapeutic doses it may be stated to be absolutely inoffensive, and that this new remedy is less dangerous than aconitine, digataline and all the alkaloids frequently given to patients.

Exalgine is especially valuable from the fact that it does not irritate the stomach, and the dose required is small

References.-Therapeutic Gazette, "Notes on New Remedies," ; Pharmaceutical Record, National Druggist, American Druggist, Medical Record, Medical and Surgical Reporter.

PERPLEXING SYMPTOMS ARISING DURING TREATMENT OF A CASE OF OPIUM HABIT-WHAT NAME SHALL BE GIVEN TO THE GROUP OF SYMPTOMS ?

By R. J. NOBLE, M.D.

(Read before the Medical Society of North Carolina at Oxford May 27th, 1890.)

Mr. President and Gentlemen of the Medical Society of the State of North Carolina:

I beg leave to report the symptoms arising during the treatment of an opium-eater for the cure of the habit. There has been a question in my mind as to what name should be given to the group of symptoms that arose in this case. If any member of the Society can enlighten me I would be glad to hear from him.

On the 8th of May, 1889, I was called to Mrs. W., who I found suffering with supra-orbital neuralgia. She requested me to give her a hypodermic injection of morphine, which I did, giving her

grain of morphine and 1-200 grain of sulphate of atropia. Two hours after I repeated the injection, as the other did not relieve her a particle. The second injection relieved her for some hours. She had bromidia and bromide potassium given her freely, also morphine hypodermically twice or three times a day until the 16th, when she was well enough to do without the morphine.

June 2d I was called again, when the same treatment was given her except that the morphine was given in doses of 14 grains three times a day hypodermically. This was continued until the 15th of June, when only two doses of 1 grains each were given, and, as he was so much better the next day, no more was given her. I had told her husband that she was an opium-eater, showing him the doses of morphine before giving them. He on her recovery from that attack asked her if she was not taking morphine, and, after a good deal of coaxing and argument, she admitted that she was, and had been for two or three years.

About the 1st of September he came to me telling me that his wife wished me to see her, that she would put herself in my hands and if I would not cut off the morphine too suddenly she would, with my help, quit the habit. I asked her how much she was taking

daily. Having no morphine she took some quinine and showed me about the size dose that she was taking, which I thought to be about 1 grains three times a day. I weighed out 10 grains of morphine, put it in an ounce of water, telling her to take one teaspoonful three times a day. She took it in two days. I expected her to take it in eight days, but she filled the spoon as full as it could be filled, only getting six teaspoonfulls to the ounce, thereby taking 5 grains a day. I saw her often, and knew she was not taking her usual quantity. Her husband told me that as the time for her dose drew near she was nervous and was always anxious and ready for it.

The third day I put 8 grains in an ounce of water and told her not to fill the spoon so full, but she took it in two days. She was so nervous and complained so much of pain in her abdomen, especially in the left iliac region, that I gave the same on the fifth and sixth days. Though no better, I reduced the morphine on the seventh day to 7 grains to the ounce-dose as before. On the ninth day to 6 grains to the ounce. I now told her husband to get a graduated medicine glass so that she would get eight doses to the ounce instead of six, but the glass not being graduated correctly, he made ten doses to the ounce. She was now complaining of some pains in her arms, legs, abdomen, especially over the left ovary, and head. The room was darkened and everything kept quiet. Bromide of potassium was given her in doses of 60 to 80 grains every four hours. One and a half drachms of bromidia was given at bedtime with sometimes a dose during the day and injections of morphine three times a day soon got her straight again. twelfth day I put 6 grains in eight ounces of water, giving her one ounce at the dose. She was very nervous and restless, but said she must hold out to the end and not to give her any more than I was.

grain of

On the

On the 20th of September diarrhoea set in with a return of the supra-orbital neuralgia. I gave her a few doses of paregoric and syrup of rhubarb, which controlled the diarrhoea. She continued taking of a grain of morphine three times a day for two weeks. Then I put 5 grains to the eight ounces, giving one ounce three times a day. Continued that until the 12th of October. I saw her two or three times a day, giving her all the encouragement I could to hold out to the end.

On the 12th of October she said she had slept but little the night

before, begged me for a little morphine, as the pains in her head and bowels were so severe that she thought they would kill her. She was now taking 1 grains of morphine daily in three doses (grain each) per orem. I gave her grain hypodermically, which quieted her for some three or four hours. My next injection was of a grain. The third for the day was grain, making a total of 1 grains for the twenty-four hours, none being given by the mouth. From the 12th to the 20th there was but little change in her condition; some days I would get down to 1 gr. others going back to 14 grs. per day.

About the 21st she began to have hallucinations, and, although the walls of her room were perfectly white, she imagined they were checkered and striped; she could see ropes and threads crossing each other from different parts of the room. This I attributed to the effect of the cannabis indica in the bromidia which she had been taking freely-I suppose nearly, if not quite, half an ounce daily. So the bromidia was stopped and the following given instead :

B.-Hydrate chloral.

Potass. bromide....

Morph. sulph...

Aquæ...

M. Sig. One Dessert-spoonful as required.

Div.

viij.

gr. ij.

3 ij.

This, with the injections of from 1 to 1 grs. of morphine daily, was my treatment with little or no improvement until the 24th, her mind gradually getting worse, delirious all the time. Her temperature never went above 994°, though her pulse went to 114. Her temperature was taken twice daily.

On the 24th Dr. J. B. Beckwith was called in consultation. He advised giving her 10-drop doses of tincture avena sativa three times a day aud 1 drachm of bromide of sodium every four hours, increasing the doses 10 grs. every other dose until 2 drachms were taken, which I did. She was better on the 25th. She continued taking the regular doses of morphine.

On the 26th her bowels acted several times-she was naturally of a constipated habit. The morphine was given in and gr. doses three times.