Am.  Jour.  Pharm.  ) 
Mar.,  1874.Suppl.J 
Croton  Chloral, 
15S 
The  medicinal  advantages  of  hydrate  of  croton  chloral  over  ordi- 
nary hydrate  of  chloral  are  :  1st.  In  cases  where  hydrate  of  chloral 
is  inapplicable  on  account  of  heart-disease  (it  does  not  interfere  with 
the  action  of  the  heart).  2d.  In  cases  of  neuralgia  in  the  district  of 
the  nervus  trigeminus  (it  is  a  remarkable  phenomenon  that  when 
given  in  small  doses  it  produces  anaesthesia  of  the  fifth  nerve,  sin- 
gling out  one  nerve,  and  that  one  alone,  while  the  sensibility  of  the 
body  generally  and  pulse  and  respiration  remain  unaffected).  3d.  In 
cases  where  very  large  doses  are  necessary  to  produce  sleep,  here 
Liebreich  recommends  the  addition  of  croton  chloral  to  hydrate  of 
chloral. 
Dr.  Burney  Yeo,  of  King's  College  Hospital,  London,  etc.,  is 
making  a  systematic  investigation  on  the  value  of  this  medicine,  and 
he  lays  his  first  communication  in  a  paper  published  in  the  Lancet, 
January  31,  1874;  he  administered  it  in  six  different  classes  of  cases,, 
and  gives  details  of  each.  The  results  he  has  arrived  at  are,  that  m 
croton  chloral  we  possess  a  remedy  of  remarkable  efficacy  in  some 
cases  of  neuralgia  of  the  branches  of  the  nervus  trigeminus,  and  that 
it  also  has  the  power  of  affording  relief  in  other  obstinate  forms  of 
neuralgia;  that  it  is  of  use  in  certain  cases  of  diffused  muscular  pain;, 
that  there  is  scarcely  any  remedy  that  is  likely  to  prove  more  valua- 
ble for  the  relief  of  the  distressing  night  cough  of  chronic  phthisis. 
Its  efficacy  in  procuring  sleep  seems  very  variable  in  moderate  doses; 
its  effect  in  purely  rheumatic  cases  is  scarcely  appreciable,  while  for 
hysteria  it  is  of  little  or  no  use. 
Dose. — Dr.  Yeo  says  : — "  I  am  satisfied  that  in  dealing  with  this- 
substance  we  must  give  an  unusually  wide  range  to  the  dose,  for  its- 
effects  vary  greatly.  The  doses  I  have  given  varied  from  one  to  ten 
grains.  In  delicate  females  I  have  found  very  decided  effects  from 
doses  of  two  and  three  grains  ;  in  strong  males  a  dose  of  ten  grains- 
is  often  required  to  produce  any  appreciable  effect.  As  may  be  ex- 
pected, persons  who  have  been  accustomed  to  the  use  of  anodyne- 
medicines  require  larger  doses  than  others." 
The  dose  must  always  be  proportionate  to  the  severity  and  long 
continuance  of  the  pain.  I  would  advise  that  it  should  be  always 
given  in  moderate  and  quickly  repeated  doses,  until  the  amount  of 
"  tolerance  in  the  medicine  in  each  particular  case  has  been  discov- 
ered. In  severe  neuralgias,  from  two  to  five  grains  may  be  given* 
every  hour,  or  the  smaller  dose  every  half  hour,  until  fifteen  grains. 
