Intense melancholia, with suicidal tendencies, hallucinations and delusions, delirium. Acute and chronic mania, have resulted. A condition, seemingly a cross between idiocy and softening of the brain, sometimes occurs, the patients crying at the most trivial things, and bemoaning their persecution by what would to others appear to be but trifles. The moral nature is profoundly affected, but the tendency to lie does not seem to be so distinct as in the opium habit.
Delirium is not so often found while the patient is taking, as when he stops the drug. In some cases it does not even occur then, but when so happening, is usually very violent.
Convulsive seizures are rare, but do occur, as has been shown by the labors of the Clinical Society, of London. Two of my correspondents speak of such cases. In both, the character of the attack was epileptiform, and occurred in persons who had used large doses of the drug for a long time.
A mind greatly enfeebled by the continued use of chloral is sometimes thrown completely from its balance by the effects of an overdose, or the unusually intense action of an ordinary dose, an accident that is liable to take place at any time. Such a case is related by Dr. Willis P. King,[62] of Sedalia, Mo., as follows:—
“Mrs. S., aged forty years, first began to use chloral during an attack of rheumatism. Has now been taking it for some years. Dose about 32 grains, taken from three to five times a day. I was treating her for acute rheumatism, and allowed her, by her request, to take an occasional dose of a solution that she had been using for years. She begged for more than I was willing to allow, and, in the absence of the nurse, got up, and, from the amount missing, must have taken anywhere from 100 to 200 grains. I found her, three hours afterwards, in profound stupor, pulse small and 190 per minute, respiration rapid and stertorous, extremities cold. Under stimulation, etc., she recovered consciousness after a few hours, but was insane, and was sent to the Missouri Insane Asylum, where she was treated for acute mania. She was always ‘flighty’ before she went to the asylum; on her return from there her mental condition was greatly improved.”
The temper becomes irritable, peevishness is developed, friends and acquaintances are shunned, and the patient lives in a world of his own, built by the warped and distorted outcome of a diseased imagination. The delusions and hallucinations are more often terrifying than pleasant, varying, however, somewhat, with the mental peculiarities of the victim. The following interesting case is sent me by Dr. D. N. Kinsman, of Columbus, Ohio:—
“Patient’s age, twenty-four years. Had been surrounded by a set of vicious companions, and got to drinking excessively. Had an attack of delirium tremens, for which chloral, bromide of potassium and valerian had each been prescribed. In a fit of virtuous indignation at his oft-repeated falls, he signed a ‘Murphy pledge.’ Having learned the value of chloral for the horrors, now, in his abstinence from alcohol, he began the use of chloral. He would sit in the office and sleep in his chair, day after day. His speech became drawling and indistinct, and he could not remember what he read. At the end of two or three weeks he had an eruption appear on his face, neck, and shoulders, like acne. These pimples, at first hard and red, suppurated, being attended with much soreness and pain.
“After being in this condition for some weeks he began to hear voices at night, rose from his bed in great terror, and ran to his father’s room, saying burglars were in the house, on several occasions. His neighbors were in a conspiracy against him; living in a double house, could hear them planning against him, through the walls. On going home at night would go at full run, waiting till very late, to have the streets deserted; asserted he was often pursued by a ‘band of niggers’ who had been hired to injure him. Heard people talking about him, whom he passed, even when I was with him and knew nothing was said. He continued in this state for several weeks; finally became exhausted, had to take to his bed, where he remained several weeks. He had been removed to his father’s farm, several miles distant, at this time, hence, not at this period under my observation. Now, being obliged to abstain, he got better; but when he got better, relapsed into his old habit. Now, he was sent to Fort Hamilton, and there kept for, I think, six months. Perhaps a record of this case can be found there.
“He returned here, and has been fully restored. Though after his sojourn in Fort Hamilton he had another attack of his appetite for chloral, whiskey, etc., which lasted some months.
“His doses of chloral, daily, would amount to half an ounce, I estimate, for days together. The data are impossible to learn, because he never kept it all in one bottle, and he had a supply located at various points, for convenience.