| Gm. or c.c. | |||
Hydrated chloral | 2 | │6 | gr. xl |
Syrup of orange peel | │ | ||
Water of each | 30 | │ | fl ℥ i |
A tablespoonful (15.0 c.c.) of this mixture, containing 10 grains (0.65 gm.) of hydrated chloral, will often induce sleep in the absence of severe pain or serious disturbance, and seldom does this dose have to be repeated more than once in such simple cases. Hydrated chloral is often used in somewhat smaller doses in combination with potassium bromid, which may be prescribed in a mixture such as the following:
| Gm. or c.c. | |||
Hydrated chloral | 1 | │3 | gr. xx |
Potassium bromid | 3 | │9 | gr. lx |
Syrup of orange peel | │ | ||
Water of each | 30 | │ | fl ℥ i |
In producing sleep when severe pain is absent this is as effective as the preceding, in similar doses. The use of repeated doses of hydrated chloral in such a mixture as this, or in the form of Bromidia or other nostrum when sleeplessness is due to severe pain is highly dangerous. It should be remembered that while hydrated chloral is an effective hypnotic in case of simple sleeplessness, it is not actively analgesic except in distinctly dangerous doses. Bromidia in repeated doses will induce sleep even in the presence of pain, of course; but any active narcotic does that, and it is correspondingly dangerous. Small doses of morphin given alone are preferable when sleeplessness is due to severe pain.
TONGALINE
“Tongaline” is an example of the type of “shotgun” nostrum that would be merely ludicrous if we could look on anything that degrades therapeutics so lightly. A report was made to the Council on Pharmacy and Chemistry, and published in The Journal, July 17, 1915, p. 269, and in this report it is stated that Tongaline is said to consist of tonga, cimicifuga racemosa, sodium salicylate, colchicum, and pilocarpin. Whether the formula was cut short just there because the office boy ran out of breath at that point, or because the discoverers of this wonderful combination had not heard of the eminently potent substances that the witches added to their cauldron, we can leave to the reader’s imagination, for it is manifestly impossible to present an orderly discussion of the pharmacology and therapeutics of such a preposterous jumble of drugs.
PEACOCK’S BROMIDES
“Peacock’s Bromides” belongs to a slightly different class. It is said to consist of the bromids of sodium, potassium, ammonium, calcium and lithium. In the absence of a logical explanation of the pretended superiority of this mixture over one that is made extemporaneously, the exploiters seem to have been driven to the necessity of pretending that its freedom from contaminating chlorids explains its claimed advantages over mixtures of the official or commercial bromids. The truth is that the chlorids are used as antidotes in bromid poisoning.
Disregard the claims made for Peacock’s Bromides, and ask yourself the question whether you have ever actually seen any ill results following the use of the official bromids that you could reasonably attribute to contaminating chlorids. Furthermore, carefully consider the relative advantage of a single bromid (say the bromid of potassium, or bromid of sodium, if you prefer it), with the opportunity of observing its effects and adjusting the dose in accordance with the results of your experience, and a mixture such as Peacock’s Bromides, the composition of which you do not know, and which the manufacturer can alter to suit his own convenience.
While it is true that the therapeutic art will not degenerate in its entirety merely because some physicians continue to use the most fraudulent and worthless nostrums, yet, on the other hand, to the extent that a physician continues to be guided by the false teachings of nostrum venders who have no therapeutic training, he is plunged into therapeutic chaos.—(From The Journal A. M. A., March 2, 1918.)