Clinical observations on hydrate of chloral as a hypnotic in typhus / by James B. Russell.

  • Russell, James Burn, 1837-1904.
Date:
1870
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Licence: Public Domain Mark

Credit: Clinical observations on hydrate of chloral as a hypnotic in typhus / by James B. Russell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    I have contrasted chloral with opium at much length, because opium is really the only hypnotic of sufficient value to be contrasted with it. Having in the course of practice gradually acquired the opinions regarding its dangers in fever, to which I have already given strong expression, it was natural that I should employ any drug or method which promised good results as a sedative. Space forbids any lengthened reference to this partly experimental practice. For some time, the bromide of potassium and cold-sponging have almost entirely displaced Graves’ mixture, and Battley and ether, which, for a long time, were my only sedatives. The bromide formerly tried, but imperfectly, and thrown aside, was revived by Dr Tennent, at the request of the Professor of Materia Medica in the University, and has been extensively used. It is capricious, sometimes acting with excellent effect, but oftener proving useless in apparently similar circum- stances. We give it in drachm doses, three times repeated, at intervals of an hom\ It rarely acts, even when the best results ultimately follow, within forty-five minutes, or an hour. No dysphagia or other toxic effect has ever been observed, and its narcotic action manifests none of the dangerous tendencies of opium. Chloral, however, far excels the bromide in efficiency and certainty. In cases IV., VI., and VII., where chloral produced prolonged sleep, followed by no recurrence of delirium, it was appealed to after the bromide had failed. Cold sponging again, soothes by the abstraction of heat from the periphery, and is consequently useful only in the acute delirium and insomnia of the acme of fever, when the skin is pungently hot, and the condition such as I usually describe by the adjective “ fiery.” In these circumstances, sponging with iced water every 2 or 4 hours, has often a calmative effect. During the prolonged course of Case V., various sedatives were used. The following notes will show their comparative action. The effects of the bromide, though not so rapidly produced, were quite as good as those of the chloral in this case. Case . Elizabeth II , aged 30. A case of severe typhus, with pro- minent cerebral symptoms throughout, which ultimately outlasted the
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