Depressant Drugs and Sudden Deaths
It is very interesting to examine the statistics of sudden death from heart-disease in New York City during the last three years. In 1900 there were registered 4,069 deaths from heart-disease in the greater city of New York, in a population of approximately 3,445,000, while in 1901 there were 4,626 such deaths, the population having presumably increased about 100,000. Thus there was an increased ratio of sudden deaths to population. In 1902 the number of sudden deaths reported from heart-disease had increased still further to 5,461. Calculating the percentages of sudden deaths from heart-disease to population, allowing for the before-mentioned increase of population, the deaths of this kind to each 1,000 were, in 1900, 1.18; in 1901, 1.31; in 1902, 1.34. For the year 1903 there was a decrease in the number of deaths from this cause, so that the ratio was only 1.28 per 1,000. There has been some discussion among sanitarians and public health officials as to the reason for this decrease. A portion of the decrease has been ascribed definitely—and with considerable plausibility—to a certain cause. At the beginning of last year the board of health, suspecting that many prescriptions for phenacetin were being filled by druggists with acetanilid, or with a mixture of phenacetin and acetanilid, sent inspectors to obtain definite information on this matter. Altogether 373 samples of phenacetin were bought from the same number of drug stores in various parts of the city, phenacetin being specially asked for, and in some instances even obtained, on a physician’s prescription. Of the 373 samples, 58 were pure phenacetin; 315 were adulterated with cheaper drugs, mainly acetanilid; and in 267 cases containing more acetanilid than phenacetin; 32 samples were pure acetanilid. The commissioner made these facts public, and threatened to expose and prosecute all druggists who would hereafter be found committing this misdemeanor. It is very interesting, at least, to find that a single year after the investigation and supposed consequent reform on the part of the dispensing pharmacists there should be a slight reduction in the actual sudden death rate from heart-disease, and that at a time when for many years there has been a constant increase in the death rate from this cause. It is well known that acetanilid is a distinctly depressant drug for the heart. Professor Jacobi, of New York, always insists that it is an actual tissue poison, to be used only with great care, and many therapeutists teach that it is the underlying cause for the increase in reported sudden deaths in recent years. This question of the evil of depressant drugs is all the more interesting because of the freedom with which so-called headache powders, mainly composed of acetanilid and other heart depressants, are now so commonly bought and sold. Many women, and even men, think nothing of stepping into a drug store and asking for something for a headache. The headache powders that are dispensed to them so freely always contain acetanilid, and great harm is being done in this way. It is probable that a similar investigation in other cities of the country might also furnish instructive facts. Certain it is that proper legal regulation of the sale of such depressant drugs, so that they could not be dispensed except under the direction of a competent physician, would in the long run have a beneficial effect on the sudden death rate from heart-disease. This cause of sudden death is becoming more frequent in this country, and is a serious menace for those suffering from even slight forms of heart-disease if they are so foolish as to take these remedies.—Journal of the American Medical Association.