Treatment of Poisoning by Paralde hyde.—The treatment of poisoning by paraldehyde is directed against the paral ysis of the respiratory centre. Respira tory stimulants, atropine, coffee, and the battery are indicated.
Therapeutics. — Paraldehyde is used chiefly as an hypnotic and nervous seda tive. On account of its depressant effect upon the respiratory centres, W. H. Flint (Then Gaz., Jan. 15, '90) claims that it is contra-indicated in cases of cyanosis with depression of the respiratory centres, as in the advanced stages of emphysema and cardiac dilatation; he believes it to be likewise contra-indicated in most cases of insomnia attended with much phys ical or mental depression. Bright's dis ease does not appear to prohibit the use of paraldehyde.
In the sleeplessness of chronic alcohol ism, alcoholic mania, delirium tremens, and " chronic disturbers," B. D. Evans, of Morristown, N. J., finds paraldehyde the best hypnotic. In many of the forms of insanity he has found it to act well, but occasional failure follows. He has not found the drug to disturb the ap petite or depress the heart's action ("Ephemeris of Mat. Med.," Jan., '96).
A. B. Cook has found paraldehyde serv iceable in asthma, puerperal convulsions, and cough. In spasmodic asthma W. Mackie relieved the spasm by doses every half-hour for one to three doses. Humphrey has found the drug an excellent remedy in Cheyne-Stokes res piration associated with bronchopneu monia. With the combined use of oaf. feine (4 to S grains daily) and paralde hyde (30 to 45 drops at night) Cevello found, in cases of oedema, ascites, and pleuritic effusion, that the amount of urine was increased.
Attention called to antispasmodic ac tion of paraldehyde in asthma. Person ally used with good effect in about thirty cases of asthma, including ordi nary spasmodic asthma, asthma with epilepsy, with heart disease, or with renal disease, and with chronic bron chitis, and in two cases of asthma with pneumonia. In majority of cases relief was rapid and complete, and in re 5— =hider distress was lessened. Dose em
ployed was from 45 to 60 minims, and one dose was usually sufficient; a few patients needed a further dose of from 30 to 45 minims an hour or so later. The drug scents the breath strongly for about twenty-four bolus, Addition of a few drops of alcohol renders paralde hyde perfectly miscible with water ; any flavoring tincture can be used for this purpose. V. P. Ilearder (Brit. Med. Jour.. Mar. 21, '96).
ID asthma paraldehyde has given most satisfactory results. It is absolutely safe, not only relieving the spasm, but inducing tranquil, refreshing sleep with out any objectionable after-effects. As it gives rise to no drug habit, however much its use may be prolonged, it is far more desirable and safe than either morphine or chloral.
A drachm should be used as a dose, and, as the system does not acquire tolerance for the drug, the same quan tity will answer as well after months of use as at the beginning. Good way of administering paraldehyde is in ex pressed oil of almond. Equal parts of the oil and the paraldehyde flavored with essence of cinnamon make a pala table dose. It can likewise be given in water, milk, beer, or wine, by using I V, ounces or more of these vehicles for each dose of the paraldehyde. A. Macgregor (N. Y. Lancet, p. 127, '09).
Paraldehyde is especially indicated in the insomnia of alcoholics, in delirium tremens, morphinomania, and as an anti dote for strychnine, etc. The dose varies from 1 to 2 or 3 grammes (15 to 30 or 45 grains). It is contra-indicated in those who arc taking iodides. It causes a breath like that of a drunken man, which may, however, be counter acted by giving vanilla at the same time. Rogues (Jour. des Prat.. Aug. 17. 1901).
Paraldehyde may give rise to indiges tion and diarrhoea, but is seldom followed by headache or depression. Obstinate ulcers of the nose and cutaneous erup tions have occasionally followed the con tinued use of this drug.