CHLORALUM (see vol. ii, p.152)
I. 8. Effect of Chl. upon the circulation within the skull was ascertained in two persons having a traumatic defect of the frontal bone. Its first effect was found to be anaemia of the brain, probably in consequence of vascular paralysis and dilatation at the periphery (skin, &c.). The supervention of sleep coincides with hyperaemia of the brain from the gradual extension of the vascular paresis to its vessels. At the end of sleep and in the first portion of the waking state a decrease in the volume of the brain occurs, as well as an increase of vascular tonus that passes gradually into the normal. (Cappelli and Brugia, Neurol. Centralbl. 1866, No. 14.)
II. 20. In a case of aggravated dysmenorrhoea in a nervous (probably hysterical) subject, Dr. Bender gave j as a palliative. It produced a tingling warmth all over the body a few moments after ingestion; and soon the pains descended to the feet and disappeared. Nearly an hour’s freedom from pain followed, simultaneously with hysterical feeling attended with immoderate laughing. Shortly afterwards ” heavenly sleep,” in her own words, set in, lasting 5 h. No pain returned for 3 hours more; there was loss of motor power, which hindered her from moving even a finger, and mental confusion. Throbbing headache of congestive type ensued with intolerance of light, for which she received bell. Headache increased spite of the medicine until 4 p. m., just 19 hours after the dose of chloral, when with the violent pains drowsiness supervened, preceding sleep for a few m., and then a wake up with a start, head so much worse that the patient would beg to be kept awake. Objects and persons appeared distant and small, and the flowers on the wallpaper very red, luminous, and glaring. When addressed she would barely answer, and with difficulty, relapsing immediately afterwards into unconsciousness, to wake up quickly with a start, and a request that she should not be allowed to sleep. I prescribed lach., which quieted her within a short time, leading to fitful, successive naps. Till 31 hours afterwards she felt under the influence of the hypnotic, elated and inclined to laugh, although at the time very weak the laughing tendency unusual. She also complained of the head feeling very large; after two doses of lach., she asked her attendant if her head was not diminishing. &Hahn. Monthly, vii, 506.)
21. On May 15th, a lady aet. 35, in 7th mo. of pregnancy, had a febrile attack with repeated vomitings; and next day an eruption came out on neck, hands, and legs. When Dr. Piedvache saw her on 17th this had extended all over body. It consisted of minute papules, like those of variola on 2nd day, non – acuminated, of vivid redness, which disappeared under pressure. On forehead they were rather larger, and rest of face was slightly swollen. There was intense general pruritus; tongue, mouth and throat were coated, with salivation; pulse 120, large and full; temp. 39 o; skin very dry; no headache. A cough which she had had for 4 weeks, but which had much diminished, was now worse, with anguishing pain under sternum, and fine sub – crepitant rales all over left side, here and there on right; percussion normal. It was ascertained that she had had a short attack of same character, but of short duration, some 12 day before; also that for the cough she had during three weeks past been taking a syrup of Chl. Not suspecting this, Dr. Piedvache did not order its discontinuance and only prescribed aconite. She accordingly continued to take the syrup for 3 n. more. 18th. General state worse; temp. 40 o; marked prostration; complete insomnia; agitation and sub – delirium at night; dyspnoea and sub – sternal anguish, incessant cough, expectoration slightly bloody, very fine mucous rales in left lung, sibilus in r. Chills all m. Itching intolerable; papules much enlarged and gathered into groups, in some places resembling erythema papulata. Their colour is very deep, but disappears under pressure; scratching does not whiten them. Face is more swelled, especially in eyelids, which are reddened, with injection also of ocular conjunctiva and some photophobia. Lips very swollen and hard, their free border much cracked. Abundant salivation. On buccal m. m. a discrete aphthous eruption here and there. Tongue somewhat enlarged, dry and cracked on dorsum. Slight oedema of velum palati, which is dark red; much dysphagia. 19th. – Papules larger and more numerous; skin in face and extremities swollen as in variola; intervals of healthy skin are of as dark a red as the papules; eyes are closed, lips enormous and somewhat everted; salivation abundant. In the labio – gingival fold the aphthae have become elongated ulcers, with grey base, extremely painful and making breath offensive. Aphthae were seen in pharynx also; swallowing was nearly impossible; there were momentary attacks of suffocation. Tongue was visibly swollen. Cough very frequent, and expectoration still sanguinolent; but rales were larger. Temp. early in m. was 38 o only; but between 11 and 12 a prolonged rigor took place, and thermometer at noon marked 40 o; no sweating. (That evening grm. 0.75 of quinine were given.) 20th. – N. not quite so bad, and symptoms slightly less severe, but buccal ulcerations are larger. At noon, rigor recurred. Mercurius corr., 2nd trit., was administered, with grm. 1 of quinine at n. The chloral was now suspected and stopped. N. was better; but there were attacks of dyspnoea, with acute pain under sternum. Other symptoms unchanged, save that febrile paroxysm was much weaker and later. Arsenicum was substituted for the mere. corr., and the quinine repeated. On 22nd all symptoms had begun to improve, which they continued to do hence forward. Prostration was very great for some d. The skin underwent desquamation repeatedly during days from 24th May to 4th June; but skin remained somewhat discoloured. On this last day, patient ventured to take, for toothache, a spoonful of the syrup at bedtime. During n. she felt poorly and suffered from itching; in m. she found whole surface of raspberry hue, with slight oedema of face and eyelids; there was nausea, anorexia, and a febrile state. All this had gone off by next day (Bull. de la Soc. Medorrhinum Hom. de France, xxvi, 163.)
22. Among the most striking features of chronic chloralism is muscular weakness, which is particularly manifested in the legs. There is such marked debility that on attempting to walk patient appears to be paralysed. There is no special group of muscles affected, but a general loss of power in the limbs. This paresis may also manifest itself in the upper extremities. There is feeble action of heart, with cold extremities and tendency to profuse sweating; pulse is accelerated, but weak, arterial tension reduced. Active delirium, like day tremens, has been observed from prolonged use in increasing doses; but more commonly patient becomes constantly dull and dreamy; will power seems completely wanting; judgment and intellectual faculties are impaired. The vasomotor centres lose to a certain extent their functional powers. This is partly shown by the condition of the cutaneous circulation; the extremities become cold and blue, and various inflammations of the skin occur. Sugar may appear in the urine, although it is not constant – at least I cannot say that I have found it so. (Da Costa, Medorrhinum Times and Gaz., 1883, ii, 168, from Phil. Medorrhinum Times, March 24th, 1883.)
CHLORUM.
Introduction
Chlorine gas, pure or dissolved in water (Liquor Chlori).
Provings
1. Small doses of chlorine water, equal in strength to 1x, were taken for 2 d. Symptoms appeared in the following order, beginning on the 2nd d.: – Weakness and languor, indisposition for mental or physical effort: later, the stomach felt as if enormously distended and filled with fluid; sensation as if stomach hung loosely in abdomen, and it would gurgle and shake about on motion; a dragging in epigastrium as if stomach hung too heavily and was not properly supported. About 3 a. m. on 4th day contents of stomach were suddenly and forcibly ejected through mouth and nose. This was not preceded by nausea or any premonition. There followed extreme prostration and death – like nausea. Great thirst, but water would be thrown up immediately. Vertigo as though being revolved through space, turning over and over – while lying it was as if the bed were turning to the right – no position could be assumed to overcome the feeling. A dull heavy headache was followed by one with some throbbing in temples, pulse full and hard. Great prostration led to abandonment of proving. (Honan, North Amer. Journ. of Hom., April, 1890.).
Poisonings
1. Accidental inhalation of large quantities of chlorine. The immediate effects were of asphyxia, and 4 hours after accident, following symptoms were noted: – Intensely bright red throat, worse on right side, with superficial blue vessels over red ground; pain in larynx aggravated by using voice; feeling of foreign body with constant effort to extricate it by hawking – each effort, matter how frequently made (about 15 times a m. at first), would bring up a quantity of frothy mucus that looked like beaten white of egg.The patient is in a state of anxious excitement; can hardly control himself, wants to relieve himself quickly or fears a serious condition will surely arise; tries to keep still knowing that there is no real occasion for alarm, but the presentiment of impending danger continues to return. Throat and larynx feel lifeless, and yet there is some pain. The parts feel as if sprinkled with impalpable powder which prevents phonation. This condition lasted 2 d. Some pain and distress developed in chest the next day; he could map out the trachea and its bifurcation by the sense of soreness and rawness. (Ibid.)
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.