VALUE OF AMINOPYRINE

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Abstract
Six cases are reported to illustrate the potent antipyretic effect of aminopyrine. In 3 of these cases (one of periarteritis nodosa, and 2 of prolonged intractable debilitating fever of unknown origin, but most likely due to acute exacerbation of rheumatic fever and carditis) aminopyrine was the only drug which controlled the fever and reversed the progressive downhill course of the disease; after weeks of ineffective therapy (in one case under the mistaken diagnosis of subacute bacterial endocarditis) with large doses of chemotherapeutic, antibiotic, and other antipyretic agents. In these 3 cases the action of aminopyrine simulated that of a specific drug and proved to be life-saving. In the case of chronic rheumatic heart disease with mitral stenosis, and acute exacerbation of chronic ulcerative colitis, aminopyrine alone controlled the prolonged fever, previously refractory not only to chemotherapeutic and antibiotic agents, but also to corticotropin. In the last 2 cases (far advanced pancreatic carcinoma) aminopyrine also was the only agent which controlled prolonged fever, and thereby contributed temporarily to the comfort and welfare of the patients. Agranulocytosis did not occur even when the drug was taken over long periods of time (up to 5 months continually in 2 cases; and up to 2 years intermittently in another); and a tendency to leukopenia in 1 case was readily controlled by reduction in dosage. Aminopyrine has its place in therapeutics under well-controlled clinical conditions (frequent blood counts) and under the supervision of a physician, but its careless and indiscriminate use is to be condemned.
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