Single doses, or the use of moderate doses for a short time, has been found to produce erythema, eczema, papular, pustular, or macular eruptions; also urticaria and herpes zoster. In a few well-authenticated instances, eruptions, exactly resembling and in some cases mistaken for those of measles and scarlatina, have been produced. They passed through regular gradations, finishing with the typical desquamation of the disease simulated. Further use of the chloral again produced the same disturbances.[87] It has been suggested that these effects are due to disorders of the digestion, as excessive acidity, etc., produced by chloral. This is disproved by the fact that in the majority of instances where they occur, the digestive organs are not disturbed.
Schüle[88] believes that the majority of these skin affections are due to nervous disturbance.
The following cases of hemorrhage are of interest in this connection:—
Dr. A. E. M’Rae (Edinburgh Medical Journal, Nov., 1871) relates a case of hysteria, where he gave chloral for months. Bleeding from the lungs became so frequent and violent that twice the patient’s life was despaired of, and he had to abandon the use of the drug entirely. He refers also to a case by Dr. Husband, where fatal hemorrhage from a fibrous tumor of the womb occurred in a patient who was taking chloral. Spencer Wells (Medical Times and Gazette, Sept. 18, 1869) has, however, given it in cases of cancer of the womb, without producing bleeding. Turnbull (Philadelphia Medical and Surgical Reporter, Aug. 31st, 1872) claims that it increases the menstrual flow. Dr. C. R. Cullen, of Richmond, Va., writes me that he has seen flooding follow its use. R. C. Shettle, Physician to the Royal Berkshire Hospital, believes that its use is dangerous in labor cases, owing to the likelihood of flooding afterwards. This is totally disproved by a mass of testimony sent me by my correspondents.[89]
Bleeding from the nose has been noted by Inglis (Edinburgh Medical Journal, Sept., 1877), by Mauriac, in three cases (Gazette des Hopitaux, 1870, p. 405) and Dr. F. Delmont, of San Buena Ventura, Cal. (by letter). This was a hysterical lady, who was using large quantities of chloral. After one of her spasms about an ounce of blood flowed from her mouth in a fine stream, as though thrown by a syringe.
MUSCULAR SYSTEM.
Upon this system the effects are decided, and are chiefly produced through the agency of the nervous system.[90] Trembling, spasm of isolated muscles and muscular fibres, convulsions, paralysis, loss of coördinative power, etc., have already been spoken of.
Certain symptoms, as flabbiness, paleness, atrophy and weakness, result from imperfect nutrition. By confining these patients to the house a great deal it still further lowers the tone of the general health.
RESPIRATION.
This vital function is very seriously affected in certain advanced cases. Dyspnœa is the most prominent symptom. This is more marked if alcoholic stimulants are taken. The trouble is undoubtedly of purely nervous origin. It is usually accompanied by a slight cough, and excessive secretion of mucus. Ludwig Kirn[91] says:—