CHAPTER XI.
SYMPTOMS OF ABSTINENCE FROM CHLORAL—DOSES AND DANGERS—TREATMENT.
The symptoms incident to the abrupt withdrawal of chloral from those who have used it for a long time are rarely severe; never so severe as those attending the same procedure in opium or morphine habituès. Many chloral takers voluntarily intermit the use of the drug for weeks at a time, themselves.
One of the most prominent symptoms that occurs occasionally is the supervention of severe delirium, very like that of delirium tremens. Such a case is reported by Dr. Geo. F. Elliot.[99] The patient, a man, aged thirty-five years, had, however, taken fifteen grains of opium, daily, for many years. He had for a few weeks substituted chloral, taking 200 grains of this drug daily. On withdrawing the chloral all the phenomena of delirium tremens appeared. It subsided on the use of large doses of tartar emetic and opium. Similar symptoms are reported by many of my correspondents.
Flashes of heat, nervous prostration, palpitation of the heart, dyspnœa, insomnia, sometimes persistent, intense headache with vertigo, and neuralgic pains in the occipital region, are likewise common.
Pains in the limbs are usually found, but are not so severe as those occurring after stopping the use of morphine. They are speedily relieved by large doses of gelseminum. This drug was first used for the pains occurring in the limbs of chloral eaters, during the continuance of the habit, by Mr. Herbert M. Morgan.[100] It acted well. Baths, electricity, the cold pack, and the measures recommended for the treatment of the morphia habituès, should be used. There should be no gradual reduction, unless the patient is very anæmic and much debilitated. Quinine in twenty-grain doses is an excellent sleep producer in these cases. The delirium tremens is best treated by digitalis and bromide of potassium. Stimulants should be freely used for the first three days, and strychnia and iron be given in large and frequently repeated doses. Cod-liver oil, extract of malt, and a generous diet should be prescribed. Pepsine should be given in fifteen to thirty grain doses after each meal. The bowels should be kept gently moving, by some mild laxative and cold water enemata. Hemorrhage from the bowels, stomach or urinary passages is readily controlled by the homœopathic tincture of witch-hazel, in ten-drop doses.
After the first ten days of treatment, strenuous efforts should be made to improve the patient’s health and mind by means of exercise, free diet, good reading, and pleasant conversation.
The conjunctivitis is best treated by mild astringent applications, as tea, or the following:—
| ℞. | Acid tannici, | gr. vj | |
| Sodæ biboratis, | gr. xv | ||
| Vin. opii, | ʒ j | ||
| Glycerinæ, | ℥ j | ||
| Aq., | ℥ ij. | M. |
Sig.—Eye wash.