: Drugs that enslave by Kane H H Harry Hubbell - Drug addiction

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mbling 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. 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.

Sch?le 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 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 has, however, given it in cases of cancer of the womb, without producing bleeding. Turnbull 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.

Bleeding from the nose has been noted by Inglis , by Mauriac, in three cases and Dr. F. Delmont, of San Buena Ventura, Cal. . 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. Trembling, spasm of isolated muscles and muscular fibres, convulsions, paralysis, loss of co?rdinative power, etc., have already been spoken of.

RESPIRATION.

This vital function is very seriously affected in certain advanced cases. Dyspnoea 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 says:--

"An important symptom which we have noticed in a series of cases of the long continued use of chloral is an interference with respiration, which may remain slight and scarcely troublesome to the patient, or may become positive dyspnoea.

"This symptom was experimentally produced by the Swede, Hammersten, who observed severe dyspnoea in a cat that had taken chloral, and was briefly noticed by Jastrowitz, one of whose patients, while taking chloral, suffered from severe dyspnoea, with occasional cessation of breathing; and it was finally completely described and explained by Sch?le, who observed a patient who, after a long use of chloral, used regularly to suffer after meals from a sense of oppression, which made going up stairs extremely difficult, and even interfered with speech, although there was no chest disease to account for this. The symptoms persistently recurred in spite of all treatment, until the chloral was left off, when the oppression entirely disappeared. A similar chloral dyspnoea, though not so long continued, occurred in many cases observed by us, either with or without a rash, and a feeling of heaviness and anxiety. That the chloral dyspnoea does not always stop at the lower degrees, but may proceed to the most severe and dangerous developments, is shown by the following observation communicated to me by an eminent physician. This gentleman was summoned in consultation by a lady prostrated by long suffering, who had of late suffered from attacks of extreme dyspnoea, which had increased to asphyxia. At the same time the face was swollen, the facial muscles paralyzed, and there were also all the signs of cerebral effusion.

"Every remedy had failed, and the patient seemed on the brink of the grave. The physician, therefore, recommended the discontinuance of a daily dose of forty-five grains of chloral which had been given as an hypnotic, whereupon all these highly alarming symptoms vanished, in an almost magical way; the cerebral disturbance ceased, and the respiration quickly resumed its normal type. The dyspnoea may be anatomically explained by analogy with the effects of chloral upon the skin and mucous membrane, by hyperaemia of the lungs, which is produced through the channel of the vaso-motor nerves.

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