Am.  Jour.  Pharm. ) 
March,  1890.  J 
Chloralamid  as  a  Hypnotic. 
149 
The  man  suffering  from  cerebral  softening  who  was  quieted  by  the 
drug  is  also  a  striking  case.  Probably  the  house  physicians,  sisters, 
and  nurses  are  the  best  judges  Of  hypnotics,  as  they  see  the  patients 
frequently  during  the  night.  They  all  tell  me  that  those  who  take 
chloralamid  sleep  well  and  comfortably  after  it,  and  the  sisters  of  the 
three  wards  in  which  I  have  used  it  tell  me  that  the  patients  sleep 
better  after  chloralamid  than  after  any  of  the  hypnotics  which  have 
been  introduced  during  the  last  few  years.  My  own  experience, 
and  what  the  patients  themselves  tell  me  certainly  agree  with  this. 
In  none  of  the  twenty  patients  to  whom  I  have  given  it — and  many 
of  them  have  taken  several  doses — have  any  effects  followed  that 
can  be  looked  upon  as  contra-indications  to  its  use.  Never  have  I 
observed  any  depressing  results,  nor  has  headache  followed  its  use. 
The  time  which  elapses  between  its  administration  and  the  commence- 
ment of  sleep  varies  between  a  quarter  of  an  hour  and  two  or  three 
hours.  If  it  is  given  in  the  evening,  when  once  asleep  the  patient  usually 
sleeps  quietly  till  morning.  Some  writers  have  stated  that  occasionally 
after  a  dose  in  the  evening  the  patient  does  not  go  to  sleep  till  the 
next  morning,  and  that  he  remains  asleep  all  the  day.  This  was 
so  with  one  of  my  patients;  but  it  must  be  remembered  that,  as  the 
drug  is  feebly  soluble  in  water — 20  grains  take  five  hours  to  dissolve 
in  2  ounces,  of  water — it  is  often  given  as  a  powder  with  some  milk. 
It  was  administered  in  this  way  to  my  patient  who  slept  the  next 
day,  and  I  should  think  that  some  of  these  cases  of  delayed  action 
were  due  to  delayed  absorption.  Now  I  always  prescribe  it  with 
spirit ;  20  grains  will  dissolve  in  1  drachm  of  rectified  spirit  in  fifteen 
minutes,  and  water  may  be  added  to  this  solution  without  reprecipi- 
tating  the  drug.  A  good  way  of  giving  it  is  to  tell  the  patient  to 
dissolve  it  in  a  little  brandy,  add  water  to  his  liking,  and  drink  it 
shortly  before  going  to  bed.  If  given  in  milk,  not  only  is  it  insolu- 
ble, but  it  is  difficult  to  swallow,  for  it  sticks  to  the  sides  and  bottom 
of  the  glass.  The  taste  is  slightly  bitter,  but  by  no  means  dis- 
agreeable. It  should  never  be  prescribed  with  alkalies,  for  they 
decompose  it,  nor  should  hot  water  be  mixed  with  it,  for  it  decom- 
poses at  1480  F.  For  an  adult,  20  to  60  grains — the  exact  amount 
depending  upon  the  cause  of  the  insomnia — is  the  dose  ;  usually  30 
grains  will  suffice.  It  has  the  advantage  over  sulphonal  that  it  is 
only  half  the  price,  and  it  has  the  great  advantage  over  paraldehyde 
that  it  has  no  nasty  smell  or  taste,  nor  is  it  difficult  to  dissolve. 
