Good Health and Bad Medicine:
First Aid - Part 1
First Aid - Part 2
First Aid - Part 3
First Aid - Part 4
First Aid - Part 5
First Aid - Part 6
Pain - Part 2
Liniments, Rubbing Salves And Plasters
Read More Articles About: Good Health and Bad Medicine
( Originally Published 1940 )
PAIN is a symptom of a disease or a disorder. It is Nature's way of warning us that something is wrong. In effect, pain is simply a "Stop, Look and Listen" sign. But the sign does not, as many people think, point in the direction of the nearest drug store. Nor does it exhort you to take any one of a hundred "pain killers," like Anacin, Pyramidon or Bromo-Seltzer. Yet hundreds of people died every year because they had been persuaded to believe that that is just what pain meant. It has been estimated that at least five hundred died each year from the effects of a single pain-relieving drug, aminopyrine, which was present in many well-advertised remedies. With such a sacrifice of life and health, it is essential that we know what pain is and how to combat it.
Pain occurs in ailments ranging from mild disorders, such as the muscle aches following exercise, to serious diseases, such as the pain of acute appendicitis. The pain may be occasional or chronic. The location of the pain is not necessarily an indication of the seat of disease. While pain in the abdomen may be caused by disease of any organ in the abdomen, it may also be due to disease of the chest, heart and even of the nervous system. It is axiomatic that effective relief of pain demands treatment of the ailment causing it. Self-treatment of painful disorders invites disaster.
For the ailments that can be treated at home or to relieve pain until a physician can be consulted, it is essential to know the limitations and dangers of the various home remedies that are commonly used.
Of the drugs advertised for the relief of pain, aspirin is the safest. Some people, however, are sensitive (allergic) to aspirin and experience one or more unpleasant symptoms even after taking a small dose. The commonest symptoms are nausea, vomiting, skin eruptions, hives and swelling of the lips and face. The appearance of any of these symptoms after aspirin has been taken indicates the existence of a sensitivity to the drug, and its use must be discontinued at once. Persons suffering from asthma, hay fever, hives or eczema should take aspirin with caution and only when absolutely necessary, since severe and even fatal reactions have been known to occur following its use by persons suffering from these disorders. It would be wise for such persons not to take more than one tablet at a time, and then to be on guard against unusual symptoms.
For the person not sensitive to aspirin, one or two 5-grain tablets every three or four hours for two or three doses may have a relieving effect upon a temporary pain such as head-ache or aching muscle. Larger doses of aspirin can produce a depressing effect upon the nervous system and circulation and therefore should be taken only under the supervision of a physician. If there is a tendency to heartburn, the tablets may be taken with a half-teaspoonful of baking soda.
Almost all brands of aspirin are alike. The cheap varieties are as effective as the expensive.
The Bayer Company claims rapid disintegration or "quick solubility" as an asset for its brand of aspirin. However, the Division of Food and Chemistry of the North Dakota Regulatory Department tested twenty-nine different brands of aspirin tablets and found that Bayer tablets took about 25 seconds to disintegrate, which was longer than it took for most of the other brands to dissolve. Besides, even if a tablet dissolves rapidly in water, this would not alter the fact that the drug must pass into the intestine before absorption can occur, and the time required for passage from the stomach into the intestine would permit the disintegration of almost any preparation of aspirin.
There are several compounds on the market that combine aspirin and an effervescent salt compressed into a tablet. When the tablets are dropped into water they bubble vigorously, releasing carbon dioxide and a little bicarbonate of soda. Most widely sold and advertised aspirin bubbler is Alka-Seltzer.
Some other analgesic (pain-killing) compounds contain aminopyrine, acetanilid, acetphenetidin (phenacetin), cinchophen or similar drugs. Many persons are sensitive to these drugs, and severe reactions and even death have resulted from their use. Aminopyrine, for example, can cause agranulocytosis, a disease in which there occurs destruction of vital blood cells. This disease has been responsible for more than 50o deaths a year in the U.S., and aminopyrine remedies were the cause of most of these deaths. The hazard from the use of medicines containing aminopyrine is so great that some local health departments have prohibited or limited its over-the-counter sale without a physician's prescription. The general feeling emerging from a thorough study of the drug is that while aminopyrine may be useful in the hands of a physician, it should be prescribed only when the patient is under constant surveillance so that there is opportunity for frequent examinations of the blood. Even under these conditions some doctors feel that there is too much danger to warrant the administration of this drug under any circumstances.
Dr. Henry Jackson, Jr., of Harvard University Medical School, who has had a great deal of experience in the treatment of agranulocytosis, recently asserted that "the serious nature of this disease makes it imperative that no drug of this sort be administered unless there is urgent need and proper indication. When such chemicals are given the physician should be constantly on the watch for the development of leucopenia [diminution in white blood cells]."
Nevertheless, patented preparations containing aminopyrine continue to be marketed. If there is a local ordinance prohibiting or limiting the use of the drug, another drug such as aspirin is often substituted for it.
Quinine is also frequently found in pain-relieving pills. Disorders of hearing and skin eruptions have been reported fallowing the taking of popular "home" remedies containing quinine. Persons with ear trouble or those who are hard of hearing particularly must avoid quinine remedies.
Acetanilid is another potentially dangerous drug present in many proprietary remedies. Even single doses of acetanilid in average quantities (about 3 grains) can cause weakness, skin disorders, blood changes and signs of heart disturbance. Larger doses may cause restlessness, delirium and collapse. Death from heart failure may occur after taking large doses, particularly in those with heart trouble.
The main dangers of acetanilid are that it can lead to strong addiction and to chronic poisoning. One dose of acetanilid often leads to frequent doses, especially for the treatment of a symptom like headache, which is so often recur-rent. It has been repeatedly observed and recently emphasized that the continual and repeated use of acetanilid produces an irresistible craving for it, so strong that, as with opium and cocaine addiction, there is a "moral degeneration in the method of obtaining the drug...."
As a rule, acetanilid remedies are first taken for headaches or "hangovers." It may then be discovered that fatigue, weakness, a run-down feeling are also temporarily relieved. The remedy is then taken as a stimulant, and a pep-producer.
A typical addict has stated that the drug produces a peculiar "happy" feeling, and that he is so strengthened and stimulated that he can do almost anything, This feeling comes from about 15 to 30 minutes after taking the drug. But the patient also stated that the sensation of happiness (euphoria) is soon followed by depression and headache. Headache and fatigue, symptoms for which acetanilid remedies are usually taken, are actually caused by the drug itself. Thus is a vicious cycle set up that leads to addiction.
Bromo-Seltzer, the most popular of the acetanilid medicines, has also Iong been a favorite "hang-over" remedy.
It is worth noting that pharmacists and soda-dispensers have long been aware of Bromo-Seltzer addicts. One observant clerk has learned to spot them by their blue lips. This blue color, which may be very marked, is called cyanosis, and is the outstanding symptom of chronic acetanilid poisoning. The cyanosis is caused by the presence in the blood of a toxic substance derived from acetanilid.
Other symptoms of the poisoning that follows repeated or continuous use are weakness, loss of weight, nervousness, impairment of mental faculties, symptoms of heart disturbance, dizziness, visual and digestive disorders. The serious blood disorder called agranulocytosis has also been reported. Finally, collapse and death from heart failure may occur.
There is another serious danger attending the use of acetanilid, a danger it shares with other pain-relieving drugs. Acetanilid does relieve headaches; not only the occasional innocent headache that so many of us get, but also the head-aches due to brain tumors, meningitis, ear infections, eye disorders and many other serious ailments. It is because they tend to mask a symptom that is frequently of grave significance and thus give a spurious feeling of security that acetanilid remedies are thrice damned. The fact that an acetanilid remedy relieves a headache or a pain is no token that the pain is not a symptom of a serious disorder.
Acetphenetidin (also called phenacetin) is another drug present in headache remedies and is a sister-drug of acetanilid. Its action is similar to that of acetanilid but it is less toxic and less prone to cause addiction.