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JAMA 100 Years Ago
June 4, 2003


Author Affiliations

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Assistant Editor.

JAMA. 2003;289(21):2876. doi:10.1001/jama.289.21.2876

Nothing is more disconcerting for a physician than to have a remedy that he has given in perfect confidence of its harmlessness produce annoying symptoms or perhaps serious toxic effects. Needless to say there are cases of this kind being constantly reported, however, and only a previous knowledge of the special susceptibility of the patient will absolutely protect the physician from such occurrences in his practice. It is well known, of course, that this idiosyncrasy for certain drugs is often a family trait and, consequently, when certain substances, as quinin, for instance, are prescribed it is advisable to ask if the patient knows of any bad effects that have occurred in near relatives. The number of drugs that may produce untoward and unintended complicating symptoms is growing with the enlargement of the materia medica, and especially with the increased use of synthetic products. Some of the recently reported incidents of this kind, as they may be gathered from Squibb's Ephemeris1 for the present year, are worth noting. Antipyrin is one of the drugs that is well known to produce unpleasant symptoms. Most of the cases reported, however, are of European origin and serve mainly to show how much larger doses of the drug are employed with comparative impunity than are usually considered advisable with us. Simon and Mahu of Paris report a case of toxic hemoglobinuria, following the administration of antipyrin, but as the young girl had been given 9 grams, nearly 140 grains of antipyrin, in four hours, this is not so surprising. Doses as high as 60 to 90 grains during the day are not unusual on the Continent, however. Professors Curschmann and Zweifel of Leipsic, thoroughly conservative authorities, administer from 2 to 4 grams, 30 to 60 grains of antipyrin in twenty-four hours and obtain with this more satisfactory results in the treatment of the fever of peurperal septicemia than with any other remedy. They not infrequently see the cutaneous rashes peculiar to antipyrin administration in certain patients, but they do not consider these a contraindication to the continuance of the drug.

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