Drugs that enslave

by H. H. Kane

“This was stated within two years after the substance, chloral hydrate, came into medical use. If at that time the mind of the public had been as ripe as it is now for the acceptance of the truth, or if I could then have reached the ear of the public more plainly, much evil might have been nipped in the bud. As it was, the warning had little effect, except to expose me to adverse criticism as an alarmist, and the evil has gone on with increasing rapidity and mischief. There is, at the present time, a considerable community addicted to the habitual use of chloral hydrate, on one pretence or another, and a learned medical society has recently framed a series of written questions on the subject, which questions it has felt it expedient to address to members of the profession of medicine generally, for their replies.

“The persons who become habituated to chloral hydrate are of two or three classes, as a rule. Some have originally taken the narcotic to relieve pain, using it, in the earliest application of it, for a true medicinal and legitimate object, probably under medical direction. Finding that it gave relief and repose, they have continued the use of it, and at last have got so abnormally under its influence that they cannot get to sleep if they fail to resort to it. A second class of persons who take to chloral are alcoholic inebriates who have arrived at that stage of alcoholism where sleep is always disturbed, and often nearly impossible. These persons at first wake many times in the night, with coldness of the lower limbs, cold sweatings, startlings, and restless dreamings. In a little time they become nervous about submitting themselves to sleep, and before long habituate themselves to watchfulness and restlessness, until a confirmed insomnia is the result. Worn out with sleeplessness, and failing to find any relief that is satisfactory or safe, in their false friend, alcohol, they turn to chloral, and in it find for a season the oblivion which they desire, and which they call rest. It is a kind of rest, and is, no doubt, better than no rest at all, but it leads to the unhealthy state we are now conversant with, and it rather promotes than destroys the craving for alcohol. In short, the man who takes to chloral after alcohol enlists two cravings for a single craving, and is double shotted in the worst sense.

“A third class of men who become habituated to the use of chloral are men of extremely nervous and excitable temperament, who by nature, and often by labors in which they are occupied, become bad sleepers. A little thing in the course of their daily routine oppresses them. What to other men is passing annoyance, thrown off with the next step, is to these men a worry and anxiety of hours. They are over susceptible of what is said of them and of their work, however good the work may be. They are too elated when praised, or too depressed when not praised or dispraised. They fail to play character parts on the stage of this world, and as they lie down to rest they take all their cares and anxieties into bed with them, in the liveliest state of perturbation. Unable in this condition to sleep, and not knowing a more natural remedy, they resort to the use of such an instrument as chloral hydrate. They begin with a moderate dose, as occasion seems to demand, and at last, in what they consider a safe and moderate system of employing it, they depend on the narcotic for their falsified repose. Among these classes of men the use of chloral hydrate is on the increase. The use is essentially a bad business at the best, and while I do not wish in the least to exaggerate the danger springing from it, while, indeed, I am willing to state that I have never been able to trace out a series of fatal organic changes of a structural character from such use, I have certainly seen a great deal of temporary disturbance and enfeeblement from it, without any corresponding advantage that might be set forth as an exchange of some good for some harm. The conclusion I have been forced to arrive at is, in brief, to this effect, that if chloral hydrate cannot be kept for use within its legitimate sphere, as a medicine to be prescribed by the physician, according to his judgment, and by him as rarely as is possible, it were better for mankind not to have it at any price.”

A case showing the evil effects of the continued use of chloral in large doses, and aptly illustrating how readily some of these patients pass from the use of this drug to alcoholic stimulants and vice versa, is related by Dr. T. Inglis,[59] of the Royal Edinburgh Asylum. I here give an abstract of his very interesting article.

“F. S. P., shopkeeper, male, aged forty-seven. Patient’s father died of kidney disease, at an advanced age. Mother “nervous,” died of paralysis. Two sisters neurotic and eccentric. Brother a confirmed dipsomaniac, died of brain softening. Patient a man of average intelligence, neurotic temperament, previous general good health, but has had asthma. Habits teetotal for ten years, up to three weeks before admission.

“Seven years before was ordered chloral and bromide of potassium, for relief of spasmodic retention of urine. Of these he took about one drachm each, daily, for six years regularly, and during that time neither he nor his friends noticed any ill effects on either mind or body.

“At the end of this time he had an attack of bronchitis, for the dyspnœa attending which he was given chloral, without bromide. Recovery from bronchitis was rapid. Death in his family and other troubles, however, led him to the continued use of the chloral. Commencing with sixty grains daily, he came to use one hundred and eighty grains daily. This in ten-grain doses, often repeated. Effect not hypnotic, but calmative and soothing.

“No headache or vertigo were complained of, but there was lassitude, nervous debility and exhaustion; irritability of temper and peevishness. Anorexia, acidity, nausea and vomiting appeared. Piles became troublesome and the fæces white and hard.