Chloralism is a form of drug addiction which appears to be more common among women. As in all other forms of drug, addiction, some previous neu rosis will be found to precede the first use of chloral. The sleep which it pro duces is so profound and followed by no unpleasant sensations that it is repeated as often as occasion calls for it.
Chloral can be taken secretly for a long time without any suspicion of its use. After a time the effect of its use appears in disordered digestion, the ir regular heart-action, and the increased nervousness and muscular unsteadiness. In persons past middle life a form of cardial asthma with a tendency to de lirium appears. These and many other obscure symptoms finally merge into de lirium and death. Some observers have noticed that chloral-takers haA-e pecul iar bluenes.s of the extremities? with VC11011S con!-_,estion; also marked list lessness and lack of energy as promi nent symptoms of this addiction. Chlo ralism is confined largely to the more prosperous classes of society. This drug can be dis!ruised in many ways and used as a fascinating sleep-producer. The amount varies from 20 to 2000 grains a day. Often considerable time will elapse before toxic symptoms appear: then, suddenly extreme prostration with delirium comes on, ending fatally. Sud den palsies, with vasomotor disturb ances, heart-failure, and low stages of delirium, should suggest chloralism, par ticularly if alcohol, opium. cocaine, and chloroform bc excluded. The statei»ent of the patient concerning his condition is of no value. 'Where the history indi cated extreme neuralgia and insomnia and a sudden passing away of these eon ditions, the assumption that chloral is used is possible. When it is established
that chloral addiction is present, the patient should be isolated at once and placed under positive restraint and the drug withdrawn. _Alcohol, opium, chlo roform, ether, and cocaine are all con tra-indicated as substitlite.s. Vegetable narcotics, siich as hyoseyamits, valerian, bull-nettle, and others of this class, may be given as substitutes and withdrawn at the earliest moment. Then thc usual tonic treatment of mix vomica. stryelinine, and arsenic. Cin chona and iron are also excellent drugs. The insomnia and neural<*ia with de ranged nutrition which follow the with drawal should be treated with baths. foods, and careful hygienic management of all the functional activities of the body. Many secret remedies for neu rotic troubles contain chloral, and de cided symptoms of chloralism often ap pear. Chloralism has been mistaken for general paralysis, neurasthenia, and hy perreinia, as well as several affections of the cord. -.Many opilim and alcohol eases are found to be complicated with chloral addiction, and their recovery is more difficult. T. D. Crothers (-Med. Standard, _Aug., mot).
Therapeuties.—In convulsive and spas modic disorders chloral is undoubtedly one of the best remedies in the materia medica. It has been found useful in asthma (see RESPIRATORY DISEASES); puerperal, infantile, and general convul sions; chorea and epilepsy; tetanus, trismus, whooping,-cough, ete.