Chloral Hydrate.

Other tomes: Potter

Properties: Hypnotic, anesthetic, sedative and narcotic.

Physiological action: In overdoses it will produce profound narcosis, a marked reduction in temperature, pulse and respiration. The pulse becomes more irregular, rapid, feeble and thready; complete muscular relaxation, coma and death result from paralysis of the respiratory nerve centers and cardiac motor ganglia. In full therapeutic doses if indicated it produces sleep which is not followed by headache or depression. It appears to cause an anemia of the central nervous system, and for that reason is indicated where there is marked cerebral excitement with engorgement. It has no anodyne properties but is a hypnotic and thus sometimes overcomes pain to some extent, by overwhelming the centers and acting indirectly as an anesthetic. It must be borne in mind that it has little control over pain. Used hypodermically it often produces inflammation and ulcers, and for that reason should never be used in that manner. In small doses it increases the fluidity of the blood, while in large doses it destroys the blood corpuscles, especially the white. Used for some length of time it will cause those symptoms for which it is generally given. A red rash will appear on the skin, which is generally followed by desquamation. Appetite is impaired, bad taste and breath, fetid discharges and a general disturbance of the gastro-intestinal tract, with deficient secretion.

Use: It acts first upon the cerebral ganglion cells, then on the spinal ganglia and then upon the heart. During its use the temperature is reduced, muscles relaxed, showing that its first action is on the sympathetic ganglia. It is then plain that chloral should only be used in conditions where there is increased heart's action and nervous excitement. In conditions where there is great restlessness with nervous excitability it will produce a natural sleep. We think of it in sleeplessness, delirium tremens, chorea, hysteria, asthma, whooping cough; in which cases it will produce quiet rest and sleep. In pruritis from nervous causes it has given relief. Where there is a rigid os uteri no progress being made in labor and where the vagina is hot and there is irritating pain, it is a valuable remedy and it will correct the rigidity and nerve excitement. In delirium of fevers, especially inflammatory, it may be given. It is a valuable hypnotic if indicated. Some people will not bear the drug well and it should therefore first be given in small doses and its effect watched. It should never be given in any condition where there is marked depression. As this remedy is profound in its action we find that milder remedies such as passiflora or gelsemium are safer, and if effective should be substituted.

The Materia Medica and Clinical Therapeutics, 1905, was written by Fred J. Petersen, M.D.