608  On  some  new  Hypnotics.  {^'^^mL*™' 
The  dose  is  from  from  forty-eight  to  eighty  or  ninety  minims ;  sixty 
minims  is  the  average  dose.  Occasionally  a  dose  of  eighty  minims 
has  failed  to  give  the  sleep  which  I  have  desired  to  obtain. 
Urethane  came  into  notice  later  than  paraldehyde ;  it  is  much  more 
pleasant  to  administer,  having  scarcely  any  taste  or  odor. 
When  I  first  gave  it  the  dose  was  too  small,  but  by  increasing  it  to 
thirty  grains  good  results  were  generally  obtained.  Sometimes  much 
larger  doses  are  necessary.  It  is  quite  soluble  ;  fifteen  grains  will  dis- 
solve in  a  drachm  of  water. 
The  after  effects  are  generally  unimportant.  It  has  seemed  once  or 
twice  to  give  rise  to  nausea  the  day  after ;  but  often  the  patient  says 
the  sleep  has  been  very  natural  and  refreshing.  It  is  not  so  sure  to 
produce  sleep  as  paraldehyde. 
Hydrobromate  of  hyoscine  has  the  advantage  of  being  almost  taste- 
less ;  and  the  dose  is  small.  I  began  with  a  dose  of  one  hundred 
and  twentieth  of  a  grain,  as  recommended  by  the  articles  I  had  read ; 
but  soon  found  this  too  small,  and  increased  to  a  sixtieth  of  a  grain, 
using  the  following  formula,  giving  twenty  minims  : 
H       Hydrobromate  of  hyoscme  gr.  j. 
Alcohol....  3iss.  :■> 
Water  sufficient  for...  3  xx.  M. 
In  a  few  instances  I  have  given  twenty-five  minims  of  this  mixture; 
There  is  so  little  taste  to  this  that  it  can  be  given  in  some  sim- 
ple drink,  as  gruel  or  beef  tea,  without  the  knowledge  of  the  patient. 
In  one  patient  it  produced  discomfort  in  the  head  the  next  day,  so 
that  after  two  trials  it  was  given  up  and  urethane  given  instead.  In 
other  cases  the  sixtieth  of  a  grain  given  for  a  week  or  more  has  pro- 
duced no  bad  effects.  In  a  few  cases  it  has  failed  to  produce  sleep, 
and  the  sleep  secured  in  other  cases  has  not  been  of  so  long  duration 
as  that  usually  produced  by  paraldehyde,  but  subsequently  in  these 
same  cases  the  latter  drug  has  not  proved  more  efficacious.  On  the 
whole,  my  experience  with  this  drug  is  that  it  will  act  favorably  with 
a  large  number  of  patients,  that  it  is  acceptable  on  account  of  its  lack 
of  taste  and  odor,  and  because  of  its  small  dose ;  the  sleep  obtained 
is  very  refreshing  and  natural ;  it  is,  however,  rather  more  likely  to 
leave  unpleasant  effects,  and  seems  to  lose  its  power  by  repetition 
sooner  than  either  urethane  or  paraldehyde. 
Hypnone  has  a  strong  odor  of  bitter  almonds.  I  have  given  it  in 
capsules  in  doses  of  five  to  eight  drops  (.07  to  .13)  or  even  more  ; 
