In some instances an overdose was accidentally taken; in others the person is found dead, it being probable that he took no more than his customary dose, which, however, acted with unusual strength upon a system surcharged with the drug.
Here, for instance, is, supposably, one of these cases. It is sent me by Dr. P. C. Remondino, of San Francisco, Cal.:—
“Isaac H., barrister, aged fifty-six; about four years ago began taking chloral for sleeplessness, due, he was told, to cerebral anæmia; was then a portly gentleman; hair and beard dark; beard slightly tinged with gray; feeling the need of stimulus, began to drink quite freely, and also to take morphia; then soon followed the habitual use of chloral. He now takes as much as one hundred and eighty grains per day, in three to four doses. Sometimes takes ten grains of morphia with one of the doses; is more than usually nervous; now is greatly emaciated; hair and beard a bleached white; skin itches and has a hard, dry feel; has small brownish spots, about the size of this ◯, that cast off a small scab of skin; suffers with pain in wrists and knees; also elbows and ankles, but not so severely as in the wrists and knees; insomnia and loss of appetite. Bowels regular; mental faculties are active; of course nothing like those he formerly possessed, as his physical debility makes him childish, but still he can use his mind and will, to a certain extent; acts perfectly gentlemanly, although he is as stated. His physical state is that of the debility and tottering of a man of ninety.”
A short time afterward the doctor writes: “The chloral eater died some few days ago, in Los Angelos. Was found dead in the water closet of his hotel. The despatch says, ‘supposed cause apoplexy.’ I think it was more likely cardiac asthenia.”
Dr. R. F. Lewis, of Lumberton, N. C., writes me: “A prominent physician of this place who was intemperate in the use of spirits, morphine, etc., began the use of chloral instead, and for weeks or months was more or less under its influence. He died suddenly after using it in increased quantities the day and night before. No autopsy.”
Dr. A. R. Kilpatrick, of Navasota, Texas, sends me the following curious note:—
“About four or five years ago there was a doctor living at Port Hudson, West Feliciana Parish, La., named (I think) Harris, who wrote several papers for the Med. and Surg. Reporter, of Philadelphia. He wrote one or two papers especially on the use of chloral and on the chloral habit, and very impressively warned people about its use and abuse, and in less than a year after the publication of those pieces I saw his death announced, and that he had been a habitual consumer of chloral, and that it killed him.”
Here is another case of death from an overdose, in an habituè, contributed by Dr. S. Henry Dessau, of this city:—
“The only case where I have known death to be in any way connected with the administration of chloral, was in a case of dipsomania in a hysterical female. I prescribed a combination of fifteen grains of chloral with thirty grains of bromide of potassium, to be repeated every two hours, until sleep was procured; the effect was obtained after three or four doses. About eight doses were given in the mixture. I ceased attending the case, and about a year after learned through the press that the patient had died from an overdose of chloral. On inquiring from the druggist who had prepared the prescription, I learned that the patient continued to use the medicine steadily after my visits ceased, and that for twenty-four hours before death she had used two bottles of the mixture, or in other words four ounces of chloral with one ounce of bromide of potassium.”
Two cases of chloral habituation in men past middle age are reported by Dr. C. A. Bryce of Richmond, Va., where death occurred from symptoms resembling apoplexy.