Chloralum
By Constantine Hering — The Guiding Symptoms of our Materia Medica
Hydrate of Chloral. C 2 HCl 3 O + H 2 O.
Discovered in 1832, by Liebig.
Proved by W. Eggert, S. Swan, D. A. Babcock, etc. See Encyclopædia , vol. iii .
Poisoning, by E. W. Berridge, N. Y. J. H., vol. i, p. 307.
"Prepared by passing a stream of chlorine through absolute alcohol, until it comes over unchanged.
The thick fluid remaining behind is chloral. The simple addition of water converts chloral into its hydrate."
The first therapeutic application of this substance was made by O. Liebreich, of Berlin, who conceived that the transformation of chloral into chloroform might be expected when it reached the blood of a living animal. On coming into contact with its alkalis the chloral would separate into chloroform and formicic acid. W. W. Keen, of Philadelphia, has made use of chloral as an antiseptic and deodorant in the dissecting room and in surgical practice.
CLINICAL AUTHORITIES.
- Melancholia and headache , J. H. Sherman, N. E. M. G., vol. 9, p. 412 ; Mania-a-potu , J. C. Wilson, N. E. M. G., vol. 6, p. 160 ; Ophthalmia , Dyce Brown (2 cases), B. J. H., vol. 32, p. 509 ; Conjunctivitis (2 cases), Dyce Brown, B. J. H., vol. 32, p. 510 ; Conjunctivitis and Keratitis on left eye , Dyce Brown, B. J. H., vol. 32, p. 510 ; Toothache from decayed teeth (2 cases), Excelsior, N. A. J. H., vol. 23, p. 123 ; Odontalgia traumatica , Hale, N. E. M. G., 1872 ; Colic of children , Hale, Symptomatology ; Ascites, Bishop, Med. Inv., vol. 11, p. 139 ; Enuresis , Œhme, Raue's Path., p. 691, also El. Crit. Med., Aug., 1874 ; Incontinence of urine (5 cases), E. Vechetti, Hom. Rev., vol. 18, p. 571, Leonardi, N. A. J. H., vol. 22, p. 408 ; Chordee , E. M. Hale ; N. A. J. H., 1870, p. 244 ; Dysmenorrhœa , Excelsior, N. A. J. H., 1870, p. 244 ; Dysmenorrhœa , Excelsior, N. A. J. H., vol. 23, p. 122 ; Pruritus vulvæ during pregnancy , Dyce Brown ; Inefficient labor pains , Excelsior, N. A. J. H., vol. 23, p. 123 ; Puerperal convulsions , F. A. Lord, U. S. M. & S. J., vol. 7, p. 360 ; Puerperal eclampsia , D. Baumetz (from Lancet), Hom. Rev., vol. 17, p. 310 ; Infantile tetanus , Hale (See Sympt.) ; Typhoid pneumonia with sleeplessness , J. C. Neilson, N. E. M. G., vol. 6, p. 161 ; Palpitation during phthisis , Swan, Am. Ob., vol. 10, p. 136 ; Foul-smelling foot sweats , Ortega, N. A. J. H., vol. 26, p. 412 ; Violent hysterical fit , J. C. Neilson, N. E. M. G., vol. 6, p. 161 ; Chorea , Strange, N. A. J. H., vol. 23, p. 123 ; Chorea during pregnancy , J. Russel, N. A. J. H, vol. 23, p. 123 ; Idiopathic tetanus , M. L. Sircar, Calcutta Journ., vol. 3, p. 389 ; Anasarca from valvular disease of heart , Swan, A. H. Obs., 1873, p. 135 ; , Geraldis, A. O. ; J. C. O. Will, Hom. Rev., vol. 16, p. 561, Ober, N. A. J. H., vol. 24, p. 567 ; , Dyce Brown, B. J. H., vol. 32, p. 512 ; (2 cases), Dyce Brown ; J. C. Burnett, H. M., vol. 13, p. 56 (2 cases) ; A. C. Clifton, H. R., vol. 21, p. 526.
MIND [1]
Comatose for days, ending in cerebral congestion.
Melancholia, idiocy and insanity.
Fixed despair of recovery ; believes he will give his imaginary disease (syphilis) to others.
Confusion of mind, inability to concentrate thoughts, impaired memory ; could not keep the thread of sermon.
(OBS :) Mental diseases, and general paralysis of patients suffering from mental diseases.
Constantly hears voices.
Sleeplessness at night, with restless irritability ; headache, confusion in head ; melancholy ; inclined to wander and hide herself, avoiding shrewdly the vigilance of her friends ; would then return, unable to give any account of where she had been.
He walks hurriedly up and down the room, talking to himself in an excited manner, and holding conversation with imaginary beings. θ Acute mania induced by severe mental excitement.
Jumps out of bed with fear, cold sweat, screams as if in mortal terror ; night terrors of children.
Gorgeous visions of arches, tapestry and colors pass before the eyes when shut, or open in the dark.
Wild delirium changing to a busy delirium ; visions of fantastic objects ; a great deal of fever ; pulse 120 most of the time. θ Delirium tremens.
Delirious, she hurls a hot water bottle at an imaginary figure at foot of bed.
Boisterous mania.
(OBS :) Delirium of typhus.
Delirium tremens, when brain is congested.
Puerperal mania, with sleeplessness.
Hydrophobia.
INNER HEAD [3]
Cephalalgia.
Hard, full, pressing pains in head, continuing a long time without relief. θ Dysmenorrhœa.
Dull, heavy, aching pain in forehead and occiput all day, < by motion.
Severe pain in frontal region over supraorbital ridge, which nothing relieves, < by motion.
Headache in forehead, extending to occiput.
Headache over both eyes, running down into eyes, left side <, with feeling as if eyes were constricted.
Neuralgia of temporal region.
Feeling as if a hot band was drawn across forehead from temple to temple directly over eyes, with sensation of a burning ring around each eye.
Dull, heavy headache in occiput and forehead over eyes ; a feeling of weight and soreness, which seems wholly within cranium ; < by moving about and lying down, slightly > by going into open air.
Cerebro-spinal congestion.
Cerebral congestion following a condition of extraordinary depression of nervous system.
Congestion of brain with some mental excitement.
OUTER HEAD [4]
Great heaviness of head ; cannot lift it.
Erythema of head and neck.
SIGHT AND EYES [5]
Retinal hyperesthesia.
Sensitive to light.
Colors are unusually bright.
Objects look white ; color blindness.
Dark spots before eyes.
Dimness of sight.
Eyesight weak, dim, globe congested, lids swollen and sometimes partially paralyzed.
Peculiar dimness or weakness of sight ; must read with one eye at a time-for a minute or two with each ; if one eye was used longer than a minute the words and letters became blurred and indistinct.
If one eye only is used until objects fade, the other sees objects plainly for awhile.
Can see small objects only for a few moments, they fade away.
Eyeballs feel too large.
Burning in eyes and lids.
Sensation of a burning ring around each eye.
Feeling as if eyes were constricted, with headache.
Sharp pain in eyeballs.
Redness and watering of eyes.
Watery eyes, especially when looking at anything.
Conjunctiva congested.
Eyes injected and bloodshot, constantly watering.
Face and eyelids so swollen that he could hardly see. θ Urticaria.
Conjunctivæ injected, face has a puffed and swollen appearance, especially below eyes.
Ocular and palpebral conjunctiva of left eye much injected, with considerable pain ; a small ulcer on cornea reduced to size of a pin point.
Right eye much injected, with great pain ; left eye also slightly injected. θ Conjunctivitis.
Conjunctivitis of right eye, which is very red and painful, deep cut ulcer in centre of cornea ; of a strumous family.
Conjunctivitis and corneitis on left eye ; cornea is dim ; in r. eye considerable redness of palpebral and ocular conjunctiva at one point ; great photophobia.
Conjunctivitis of both eyes ; small ulcer on left cornea ; feeling of sand in eyes, but almost no photophobia ; is a very strumous patient.
Catarrhal ophthalmia ; there are one or two phlyctenæ on right eye, at edge of cornea ; severe circumorbital pain and photophobia.
Intense itching of inner canthi and edges of lids.
Puffy swelling of lids.
Eyelids feel so heavy he can hardly lift them.
Ptosis (in a man who took it for overtaxed mind).
HEARING AND EARS [6]
Great sensitiveness to noise.
UPPER FACE [8]
Dark scarlet flushing and heat of head and face, from roots of hair to ramus of lower jaw, neck and chest, including eyes, persistent under pressure ; blotchy in places.
Face red and swollen. θ Urticaria.
Face erysipelatous ; swollen so he could not see.
(OBS :) Neuralgia of infraorbital branch of fifth nerve.
LOWER FACE [9]
Lips covered with sordes and dried blood.
Swelling of parotid and submaxillary glands.
Blueness of lips.
TEETH AND GUMS [10]
Neuralgia from decayed teeth.
Odontalgia traumatica from pressure of filling ; pain unbearable ; < when lying down.
Excruciating toothache from decayed teeth, with neuralgic affection of jaw.
Neuralgia of inferior dental branch of fifth nerve.
TASTE, SPEECH, TONGUE [11]
Deeply coated tongue.
A black streak along centre of tongue as though ink had been rubbed over it.
INNER MOUTH [12]
Lips, mouth and fauces red and raw, gums spongy, tongue blistered and ulcerated.
PALATE AND THROAT [13]
Spasm of throat.
Partial paralysis of œsophagus.
She could not utter a syllable and swallowed with difficulty.
APPETITE, THIRST. DESIRES, AVERSIONS [14]
Loss of appetite.
Thirst.
HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]
Vomiting and nervous irritability during course of cerebro-spinal meningitis.
SCROBICULUM AND STOMACH [17]
Feebleness of stomach.
Sense of sinking and oppression at pit of stomach.
HYPOCHONDRIA [18]
Hepatic and renal colic, dependent on passage of calculus.
Gall stones.
Atrophy of liver.
ABDOMEN AND LOINS [19]
Severe colic of children, when pain threatens to cause spasms.
Ascites attendant upon supposed case of phthisis pulmonalis.
STOOLS AND RECTUM [20]
Soft, lumpy, strong smelling stools twice a day, and frequent passages of fetid flatus.
Diarrhœa at night with excessive nervous excitement. θ Dentition.
Cholera without vomiting or diarrhœa.
URINARY ORGANS [21]
Nephritic and hepatic colic dependent upon passage of calculus.
Increases urine when given for anasarca from heart disease.
Urinated copiously in bed without knowing it.
Nocturnal incontinence of urine ; in children in latter part of night, even if they have urinated during night and drank no water.
Frequent and profuse urination of dark amber color, clear and without odor.
MALE SEXUAL ORGANS [22]
Loss of sexual power ; no desire or erections ; impotence.
Chordee during gonorrhœa.
FEMALE SEXUAL ORGANS [23]
If taken immediately before onset of catamenial discharge, it entirely checks it.
Menses irregular. θ Urticaria.
Severe spasmodic pains in and about the uterus. θ Dysmenorrhœa.
Pains very severe and labor-like. θ Dysmenorrhœa.
Thick, yellow leucorrhœa, tinged sometimes with a little blood. θ Urticaria.
PREGNANCY. PARTURITION. LACTATION [24]
Troublesome pruritus during pregnancy.
Tedious labor lasting over eighteen hours ; nervous, irritable, hysterical condition ; the pains which are apparently normal and forcible have no effect on the uterus.
(OBS :) Severe labor pains.
Puerperal convulsions.
Severe case of chorea during pregnancy.
VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]
(OBS :) Bronchitis.
RESPIRATION [26]
Gasping breathing and confusion of thought ; sinking at stomach.
Great dyspnœa, a sense of suffocation ; oppression at base of chest (in front), with urgent thirst.
Slow respiration, with imperceptible pulse.
Laborious respiration, occasional deep inspiration, with a sighing expiration.
Wheezing respiration.
Stertorous breathing, with loud snoring during sleep, in any position.
When lying on back, the inspiration was through the nose, while the expiration was blown from the lips as in apoplexy.
Asthma ; the nightly paroxysms are very severe ; he is bent forward, can hardly catch his breath.
COUGH [27]
Hard, difficult cough. θ Chest affections.
Spasmodic cough accompanying last stage of phthisis.
Labored cough of bronchitis and phthisis.
Whooping cough.
Croup.
INNER CHEST AND LUNGS [28]
Pulmonary congestion.
Constriction at base of chest, with dyspnœa, in organic heart affections.
Sense of weight on chest in region of sternum at night, causing expiration to be easier than inspiration.
Singular sensation of fulness of chest, not as if it was filled up as a person experiences after a meal, but rather as if all the tissues were hypertrophied, producing an indescribable sense of tightness and pressure on the lungs, causing very labored breathing and redness of face.
Great dyspnœa with labored action of lungs. θ Dropsy.
(OBS :) Congestive bronchitis with spitting of blood ; painful and audible breathing.
Severe attacks of typhoid pneumonia ; unable to sleep from nervous irritation, dyspnœa and cough.
HEART, PULSE AND CIRCULATION [29]
Heart's action regular but with increased frequency and diminished force.
Increased action of heart and oppressed respiration.
Violent palpitation with dyspnœa. θ Hypertrophy with dilatation.
Palpitations so violent that they can be heard ; great difficulty of respiration, patient requires constant fanning. θ Phthisis.
Palpitation accompanies hyperemic condition of skin ; < from wine, beer or spirits.
Heart dilated or weakened, with peculiar fulness and lightness of chest and sense of emptiness in stomach.
(OBS :) Angina pectoris.
Valvular disease of heart with anasarca.
Diminution of heart's action in organic affections, with dyspnœa and constriction of base of chest.
Heart beats become feeble, irregular, very rapid.
Heart feeble, pulse weak ; could not lie down ; general anasarca.
Cardiac neurosis.
Threatened paralysis of heart. θ Pericarditis.
Pulse frequent, irregular, weak, intermittent, heart acting regularly but with increased frequency and diminished force.
Weak, irritable pulse, threatening paralysis of heart.
Imperceptible pulse, cold extremities, slow respiration.
Pulse 88.
NECK AND BACK [31]
Erythema of head and neck.
A purple discolored band, two inches wide, along each side of vertebral column.
Large patches of redness with urticarious wheals about neck, trunk and extremities.
At base of skin large greenish spots.
UPPER LIMBS [32]
Upon red surface of left arm a mass of minute points of a deeper red.
Left arm swollen and indurated.
Erythematous inflammation, desquamation and ulceration around border of nails ; pain, great sensibility to touch.
LOWER LIMBS [33]
Sensation and motion paralyzed in both legs.
Foul-smelling foot sweats.
LIMBS IN GENERAL [34]
Wandering rheumatoid pains.
Cold extremities, with blueness of lips, slow respiration, imperceptible pulse.
Large red patches on arms and legs, exactly like nettlerash, in large raised wheals, with intense irritative itching.
REST. POSITION. MOTION [35]
Limbs extended, head low, appearance of impending death.
Lies in a state resembling catalepsy ; hysteria.
Lying down : < headache ; < toothache ; impossible on account of weak action of heart.
Lying on back : inspiration through nose, expiration through lips.
In any position : stertorous breathing.
Bent forward : in asthma.
Could neither lie nor stand ; chorea.
Motion : < pain in forehead and occiput ; pain over supraorbital ridge.
NERVES [36]
Lassitude.
Unaccountably depressed and very weak, especially in lower limbs, this weakness increasing until he is compelled to give up his daily walks from sheer inability to put one leg before the other.
Great muscular prostration, limbs extended, head low, appearance of impending death.
Tendency to weakness, feebleness of stomach, blue lips, cold extremities, slow respiration, imperceptible pulse.
Great exhaustion from sleeplessness. θ Acute rheumatism.
Extraordinary depression of nervous system, following cerebral congestion.
Great prostration, tendency to somnolence.
Neuralgia.
Violent hysterical fit ; she lies in a state resembling catalepsy.
Nervous irritation ; mania ; hysteria ; mania-a-potu ; epilepsy ; convulsions of children.
Chorea : patient could neither lie nor stand, the head, limbs and body being in constant motion and each muscle apparently partaking of irregular action.
Long-continued and obstinate chorea.
Intense chorea, where constancy and severity of spasmodic movements threaten life of patient.
Trismus and trismus nascentium.
Traumatic tetanus and infantile tetanus.
The whole body engaged in tetanic rigidity, fits coming on at very short intervals ; mouth can only be slightly opened ; deglutition very difficult. θ Tetanus.
Sudden violent tetanic fit with lockjaw ; weeping mood ; sudden very violent pain in abdomen. θ Tetanus.
Motor and sensory paralysis of both legs.
SLEEP [37]
Insomnia arising from overfatigue, mental or physical.
During sleep, stertorous breathing with loud snoring in any position.
Night terror, especially in teething children.
Horrible dreams with frightful visions, they scream and cry out, sit up in bed and cannot be quieted.
Wakes from disturbed rest, cries out and screams until perfectly exhausted and in danger of general convulsion. θ Chorea.
TIME [38]
At night : sleeplessness ; terror of children ; diarrhœa with nervous excitement ; enuresis ; paroxysms of asthma ; sense of weight on chest, in region of sternum ; irritation of skin.
Latter part of night : incontinence of urine in children.
Towards evening : itching of chin, and front and back of neck.
TEMPERATURE AND WEATHER [39]
Requires constant fanning ; palpitation and dyspnœa in phthisis.
Open air : > headache.
FEVER [40]
Sensation of heat all over body, particularly in face.
High fever.
Fevers where cephalic symptoms do not contraindicate its use.
ATTACKS, PERIODICITY [41]
Paroxysms : of asthma nightly.
Lasting over eighteen hours : tedious labor.
All day : headache in forehead and occiput.
Continuing a long time : pains in head.
For days : comatose.
LOCALITY AND DIRECTION [42]
Left : above and in eye, headache < ; conjunctiva injected ; eye slightly injected ; conjunctivitis and keratitis ; small ulcer on cornea ; bad eruption on arm ; arm swollen and indurated.
Right : eye injected, painful ; conjunctivitis ; ulcer on cornea ; redness of palpebral and ocular conjunctiva ; phlyctenæ on edge of cornea.
SENSATIONS [43]
As if a hot band was drawn across forehead ; as if eyes were constricted ; as of a burning ring around each eye ; as if eyeballs were too large ; as of sand in eyes ; sinking and oppression at pit of stomach ; as if tissues in chest were hypertrophied (fulness) ; on chin and neck like minute insects or hairs.
Excruciating pain : in teeth.
Sharp pain : in eyeballs.
Hard pains : in head.
Severe pain : in frontal region ; in abdomen.
Neuralgia : of fifth nerve ; from decayed teeth ; from pressure of filling of jaw ; of inferior dental branch of fifth nerve ; of temporal region.
Rheumatoid wandering pains.
Stinging : over whole body.
Spasmodic pains : in and about uterus.
Colic : hepatic and renal ; of children.
Labor-like pains : in dysmenorrhœa.
Burning : in eyes and lids ; ring around each eye ; stinging over whole surface.
Aching pain : in forehead and occiput.
Dull pain : in forehead and occiput ; over eyes.
Full pains : in head.
Heavy pain : in forehead and occiput ; over eyes.
Pressing pains : in head.
Soreness : within cranium.
Pressure : on lungs.
Oppression : at base of chest in front ; at pit of stomach.
Tightness : on lungs ; over whole surface.
Constriction : at base of chest.
Fulness : of chest.
Heaviness : of head ; of eyelids.
Weight : within cranium ; in chest in region of sternum.
Lightness : of chest.
Emptiness : in stomach shortly after eating.
Heat : of head ; of face ; all over body.
Itching : of inner canthi and edge of lids, of chin, and front of back and neck ; over whole body.
Hardness : over whole surface.
TISSUES [44]
Patient anemic and emaciated. θ Chorea.
Acts primarily on ganglia of brain, then of spinal cord, finally on those of heart, so that paralysis of heart sets in.
Causes cessation of cardiac movements, diminishes excitability of motor centres, of respiratory and abdominal muscles, and lessens irritability of vaso-motor centres.
Produces first sleep, then more or less anesthesia, and during both relaxation of muscles.
In muscular debility, fatty degeneration and dilatation, when there are evidences of nervous deficiency, as shown by irregularity or intermittency of action and palpitation of heart.
The temperature falls, with sinking of pulse and respiration.
Destroys coagulability of blood.
Hemorrhagic diathesis.
Typhoid cases with epistaxis ; hæmoptysis ; hematemesis.
Favors the production of hemorrhage and tends to reopen recently cicatrized ulcers of mucous membranes.
Anasarca.
Purpura hemorrhagica.
Gangrene on places exposed to pressure, especially in patients laboring under mental diseases, the gangrene spreads in depth with an intact skin.
Rheumatism and gout.
Antiseptic dressing for wounds even when there is erysipelas.
Applied to fetid ulcers it has septic properties.
TOUCH. PASSIVE MOTION. INJURIES [45]
Seasickness ; is said to be preventive.
Touch : sensitive around border of nails.
Pressure : does not alter scarlet flush on head and face ; erythema remains unchanged.
SKIN [46]
Hyperemia of skin < from smallest quantity of wine, beer or spirits, with distressing palpitation.
An itchiness of chin and front and back of neck, coming on towards morning, sensation like minute insects or hairs.
Pruritus of whole skin and of mucous surfaces of upper outlets of body.
Violent stinging, itching sensation over whole body. θ Urticaria.
Burning-stinging sensations, and a feeling of tightness and hardness over whole surface.
Intense irritation and itching of skin, preventing sleep at night.
Great irritation of skin with swelling of eyelids.
Marked cutaneous anesthesia.
Bright, scarlet eruption on face, body and limbs.
She is much flushed, and there is present over the whole body a diffuse inflammatory redness closely resembling the smooth eruption of scarlatina.
Bright red or bluish erythema over whole body, permanent under pressure, mottled with livid patches and deep red spots.
Eruption on arms, legs and face and subsequently over whole body in large blotches of different shapes, raised above the surface and of a deep red color ; these blotches gradually coalesce, till the whole skin is in a red and blotchy state, resembling measles.
Blotches of redness over legs and body in distinct wheals, not much fever.
A mass of minute points or stigmata upon the red surface of left arm, of a much deeper red, permanent under pressure.
Eruption on arms and legs, exactly like nettlerash in large raised wheals, with intense, irritating itching, œdematous swelling of face, cheeks, eyelids, ears, coming on suddenly from a chill, not from heat.
Wheals come on suddenly from a chill, crops of them appearing many times a day ; as long as she remains in the warmth is not troubled with them.
Rash "like the sting of a nettle," coming out every night, and almost disappearing during the day ; it is very itchy, and after washing with soap and water becomes painful, disturbing sleep at night.
Urticarious eruption, which disappears by day and comes out at night, with such itching as to keep child from sleeping.
Large greenish spots at base of spine.
Eruption rises in white blisters on being scratched, there is great pruritus. θ Urticaria.
Nettlerash < at night, compelling scratching until places bleed ; fever and restlessness.
Arms red and speckled, with threads of white dead epidermis partially separated from subjacent cutis.
General desquamation in round patches like blisters, from which serum had been absorbed, leaving skin beneath of a purple and in some places yellow color.
Purpura hemorrhagica ; herpes circinatus.
Decubitus. θ Dropsy. θ Scarlatina. θ Erysipelas.
STAGE OF LIFE, CONSTITUTION [47]
"Its action is more uncertain in persons who are free livers and in those accustomed to the use of alcohol."
Children, incontinence of urine.
Peter B., æt. 6 months ; already weaned ; red blotches and wheals over legs and body.
Robert J. æt. 9, of a strumous family ; conjunctivitis.
Girl, æt. 13 ; symptoms commencing at menstrual period ; the remedy also caused passage of a round worm ; tetanic convulsions.
Jane W., æt. 13 ; taken ill with headache, sickness and vomiting, which lasted three days, when an itching urticaria developed.
Girl, æt. 18, had a previous attack ; violent hysterical fit.
Mrs. S., æt. 38 ; catarrhal ophthalmia.
Mrs. S., æt. 38, and son, æt. 8 ; urticaria.
German, æt. 46 ; from having become wet ; urticaria.
German, æt. 64 ; urticaria.
RELATIONS [48]
Relations
Antidotes : Ammonia, Atrop., Digit . (heart) ; Moschus , electricity.
Compare : Bellad ., Chlorof ., Gelsem., Nux vom., Opium .
(OBS :) It may be used where opium is contraindicated, in general, after operations.