BROMIDS AND CHLORAL
If there is much restlessness and the circulation is good, that is, if myocarditis is probably not present, the bromids may be of great value, especially in children. The dose should be sufficient to quiet the nervous system. The drug may be discontinued after a few days, if the conditions improve. If the bromid, except in large doses, will not cause sleep, a sufficient dose of chloral should be given. Chloral is one of the most satisfactorily acting drugs which we have to produce sleep and to cause cardiac rest. While it should not be given if there is real cardiac weakness, the good which it does is so much greater than the possible bad effect on the heart, that it should not be forgotten for some newer hypnotic. The worst part of this drug is its taste, and the best way to administer it is to have it in solution in water and the dose given on cracked ice with a little lemon juice to be followed by a good drink of water and a piece of orange pulp for the patient to chew. Ordinarily a bad-tasting drug such as chloral is well administered in effervescing water, but effeverscing waters are generally inadvisable when there is any kind of inflammation of the heart, as they are liable to cause distention of the stomach and pressure on the heart. Some physicians prefer chloralamid as a less disagreeable drug and one which acts almost as efficiently as chloral. As the close of this must be larger than the dose of chloral, it is a question of doubt as to which is the better drug to use. Of the newer hypnotics, veronal=sodium (sodium-diethyl-barbiturate) is among the best. It acts quickly, is less depressant and is a safer salt than most of the other newer hypnotics. It is the readily soluble sodium salt of veronal (diethyl-barbituric acid). When combined with any active drug, sodium seems to make it less toxic and less depressant. The dose of this drug is from 0.2 to 0.3 gm. (3 to 5 grains).