External

Acetanilid has been used in form of a dusting powder for soft and hard venereal ulcerations, in place of iodoform, or as an ointment (1 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-organisms 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 dangerous 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 introduced which is probably a mixture of 20 parts of sodium bicarbonate, 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 bromide.

Toxicology

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 inhalations. Warmth to the feet and body.