Chloroformum

Formula, CHC13.

Preparation, for internal administration, solutions in alcohol.

Authorities. 1, Lembke, provings with repeated doses of 1 to 22 drops, A. H. Z., 39, p. 369 ; 2, Dr. Board, effects of 4 ounces internally, Br. Med. J., 1866; 3, Dr. Busy, effects of a teaspoonful internally, Am. J. of Med. Sc., Oct. 1872 ; 4, Chereau, effects of 37f drachms, Med. Times and Gaz., 1857 ; 5, Howling, effects of H ounces, B. and F. Med.-Chir. Rev., July, 1864; 6, Dunereicher,- effects of inhalation, Loud. Ed. M. J. of M. Sc., 19, 372 ; 7, Fricke, effects of a tablespoonful internally, Phil. Med. Tinier, May, 1871 ; 8, Haffoldt, chronic effects of habitual inhalation by an asthmatic patient, L'Art Med., 6, 378; 9, Hammond, inhalation, fatal, Med. T. and Gaz., 17, 174, n. s. ; 10, Lamm, fatal case of drinking considerable for sleeplessness, A. H. Z. (M. B.), 5, 42 ; 11, Langenbeck, inhalation, Deutsche Khu., 48; 12, Mackei, effect of 12i drachms internally. Union. Med., 1864 ; 13, Richet, fatal inhalation, Med Times and Gaz., 18, 142 ; 14, C. H. Smith, 2 ounces internally, Am. J. M. Sc., Oct. 1857 ; 15, Spence, 2 ounces internally, Lancet, Ang. 1856 ; 16, Yvonneau, general effects, Hirschel's Archiv., 1, 158; 17, Holmes, effects of 3i ounces, Assoc. Journ., 1856; 18, Journ. de Toul., 1857, a woman swallowed 2 ounces; 19, Pringle, effects of 2 ounces internally, Lancet, 1856; 20, Robert, Gaz. des Hop, 1853 ; 21, Santesson, inhalation, Hygeia, 2, 599 ; 22, effects of inhaling for extraction of tooth, All. Med. Zeit. (from Am. Obs., 7, 528) ; 23, Berridge, effects of inhalation, M. H. Rev., 16, 38.

Mind

Emotional. Wild excitement, followed by complete insensibility

On waking from its effects, she felt almost tipsy, frequently laughing, and not understanding what she said or did

Laughed and talked ; told how the medicine burnt her tongue and hurt her (after half an hour)

Talked nonsense, but spoke grammatically

In two provers obscene language was used under its influence

In two cases they sung comic songs, and one addressed the surgeon in a most familiar manner

Afterwards she could scarcely be persuaded to leave the piano, of which she was very fond ; she would have continued playing all night if permitted ; she could scarcely be persuaded to go to bed

Intellect ual '. Seemed scarcely to understand anything said to him, and kept on muttering

The patient pronounced some incoherent words, and sought to get away from the chloroform

Insensible, still continuing to vomit (soon after)

Could not be roused from insensibility (after ten minutes)

Remained unconscious for ten hours, and felt no uneasiness on awaking

Entirely unconscious (after eight minutes)

Lying in a state of perfect unconsciousness (apparently in a profound sleep), from which she could not be roused (after twenty minutes)

Complete unconsciousness

Utter loss of consciousness

Head p. 264

VeitiifO. Sensation of vertigo rising from the spine into the occiput (fourth day)

Vertigo

Dizziness

Whirling of the head ; sensation as if he would fall forward (second day)

Sensation as if the ground were waving, on closing the eyes (third day)

General Head. Empty feeling in the head (fourth day)

The head is light, with a peculiar sensation of clearness (first day)

Heaviness of the head (fourth and fifth days)

Heaviness in the head and pain in the forehead (sixth day)

Felt a rush of something to the head

Headache

Violent headache (after sixteen hours)

Pressure in various places in the brain (fifth day)

Pressure in various parts of the brain (sixth day"!,1.

Temples. Pressing in the temples (fifth day)

Pressure upon the temples (second day)

Occiput. Heaviness of the occiput (fourth day)

Heaviness in the occiput, with vertigo (fifth day)

Lye p. 264

Lids. Inclination to close the eyes (fourth day)

Eyes closed involuntarily (fifth day)

The eyes close in spite of one (fourth day)

Lachrymal Apparatus. Moisture of the eyes (third day)

Moisture, almost lachrymation of the eyes (third day)

Conjunctiva. Conjunctive injected

Conjunctiva quite insensible (after twenty minutes)

Hall. The eyes were suddenly turned up

Eyes fixed towards upper and inner angle

Pupil. Pupils dilated (third day)

Pupils dilated (just before death),-0.

Pupils dilated and insensible,5 11 16.

Pupils widely dilated and insensible

Pupils very much dilated

Pupils enormously dilated

Pupils very large (third day)

Pupils contracted (second day)

Pupils at first contracted (soon), (fifth day)

Pupils very much contracted (after twenty minutes)

Pupils greatly contracted

Pupils variable, now dilated, now contracted

Pupils during narcosis dilated; afterward, before death, contracted

Vision. Everything seemed more distinct than usual (immediately)

Dimness before the eyes (sixth day)

Darkness before the eyes (fourth day)

All seemed to grow dark except one bright spot

The sight gradually went during inhalation till everything seemed quite dark ; it returned gradually

Dark points and bright streaks before the eyes (fourth day)

Small black points float before the eyes (third day)

Dark spots before the eyes, with bright spots on closing them (fourth day)

Large black spots before the eyes (second day)

A number of small gray spots and linear bodies appear to float a few inches before the eye ; while looking at a distance they follow the motion of the eye; the same appearance before each eye separately (third day)

Numerous bright points before the eyes, w ith great inclination to close the eyes, and much yawning (fourth day)

Bright and dark points; white flames when the eyes are closed, or when looking at a dark background (fifth day)

Bright and dark spots before the eyes (sixth day after fifteen minutes)

Flickering before the eyes (fifth day)

Sparks before the eyes

Flashes of light before the eyes

Far p. 265

Ears seemed stopped with cotton (fifth day)

Ringing in the ears (fifth day)

Roaring in the ears (sixth day)

Roaring in the ears like boiling water (fifth day)

Nose p. 265

Objective. Nostrils obstructed by swelling of the mucous membrane

Bleeding from the left nostril a teaspoonful of dark blood ; it afterwards bleeds easily (fifth day)

Smell, Sense of smell is weaker than usual (third day)

Entire loss of smell (lasted two mouths),8. _ Face.

Cadaverous countenance

Expression that of a person partially intoxicated (after half an hour)

Some flushing of the face

Face flushed

Face livid,6; (after two hours)

Face became turgid

Trismus

Mouth p. 265

Teeth. Teeth smooth, as after acids (fourth day)

Tongue. Tongue pale

Tongue covered with frothy saliva (third (lay)

Tongue dry and parchment-like

General Mouth. Mouth half open

Mucous membrane of mouth and throat flaccid and swollen

Foamed at the mouth

Complained of the burning sensation the dose produced (immediately)

Complained of the pungency of the medicine

Saliva. Much saliva (second day)

Thin saliva (fourth day)

Taste. Soapy taste in the mouth (third day)

Altered taste of all food and drink, especially coffee (lasted two months)

Sense of taste abolished

Speech. Could hardly articulate

Throat p. 265

Jugular veins distended

Scraping and dryness in the throat (second day)

Prickling sticking in the throat, especially on swallowing (soon), (second day)

Fa uces. Fauces very red, with scraping in them (fourth day)

Violent burning in the fauces and heat in the stomach (immediately after 20 drops), (sixth day)

Scraping in the fauces (third day)

Violent scraping and coldness in the fauces, on inspiration (fifth day), (soon aftertaking)

Swallowing, [HO.] Deglutition interrupted, slow, and difficult

Stomach p. 265

Th first. Thirst (second day)

Great thirst at first

Eructation and Hiccough, Eructations tasting ethereal

Frequent eructations smelling strongly of chloroform, and causing prickling in the nose (fourth day)

Constant hiccough

Nausea and Vomiting. Nausea (sixth day),1; (second day)

Nausea, with much saliva (fifth day )

Urging to vomit (fifth day)

Vomiting

Vomiting (soon after)

Violent vomiting

Stomach. Pain in the epigastrium (during convalescence)

Severe pain about region of stomach and spleen

Burning in stomach

Burning in the stomach alternating with chilliness (fifth day)

Pressure in the stomach (third day)

Pressure in the stomach, increased by external pressure (third day)

Pressure in the stomach, with nausea (fifth day)

Dull pressure in the stomach- (third day)

Abdomen p. 265

Objective. Abdomen tense (before death)

Rumbling, with passage of flatus (fifth day)

Rumbling in the abdomen (fourth day)

Rumbling in the abdomen, with passage of flatus (third day)

Much rumbling in the abdomen, with warmth (third day)

Passage of much flatus (third day)

Abdomen painful (second day)

Cuttings deep from the stomach to the navel (second day)

Rectum and Anus p. 266

Although the rectum and intestines were as torpid as the genital organs, yet the sphincter ani preserved its contractility

Stool p. 266

JHarrhwa. Bloody diarrhoea (during convalescence)

On two occasions, I have noticed involuntary discharge of faeces

Much blood in the stools (second day)

Constipation. Constipation sometimes lasted eight days, but without giving rise to uneasiness

The torpidity of the large intestine was such that he was obliged to resort continually to cathartics

Urinary Organs p. 266

Urethra. Emission of urine painless, but accompanied with a curious sensation along the urethra

Stitches in the urethra (fifth day)

Voluptuous tickling at the orifice of the urethra, with erections and desire to urinate (fourth day)

Much desire to urinate (fourth day)

31micturition. Urine increased in quantity (third and fourth day)

Bladder distended, and bedclothes stained by urine that had escaped

When the bladder was distended, the urine was only expelled after much effort

Urine suppressed

Urine. Urine dark yellow (fourth day)

Specific gravity of urine rather lower than normal; it contained a large proportion of triple phosphates, and traces of uric acid crystals

Sexual Organs. Genitals as if much shrivelled (third day)

On one occasion erection of the penis occurred

No erections for two months

Sexual desire, with a peculiar feeling in the testicles, which made him believe that the spermatic secretion still continued, and that the impotence was owing to paralysis of the perineal muscles

Sexual appetite wanting, and the generative functions in a languid state, for several weeks

Respiratory Organs p. 266

Tracheal rale

He spoke in an altered drawling voice

Loss of power of speech ; could not utter any sound whatever ; remained in that state for five weeks, after which she began to speak in a low tone

Respiration stertorous,12; (after ten minutes),1,1 1<!.

Breath smelt of chloroform

Short, quick, irregular, and superficial breathing

Breathing slow and stertorous

Respiration became very slow (2), and stertorous

Respiration very slow and deep (sixth day)

Respiration became very slow, full, and deep

Respiration very slow and difficult

Respiration very slow, with plainly perceptible beating of the heart internally (fourth day)

Respiration 15 (usually 22), (soon), (sixth day)

Respiration fell to two in a minute

Deep, slow respiration (after one hour) ; respiration very slow, fifteen to the minute, superficial, with at times deep inspiration (after one hour and a quarter), (fifth day)

Frequent deep breathing (fifth day)

Respiration during narcosis feeble and slow, afterward before death it became rapid, deep, and rattling

Irregular respirations

Respirations sometimes irregular and short, at others deeper and separated by longer intervals

Some oppression of breathing

Respiration appears embarrassed

Respiration arrested every now and then

Eight or ten inspirations were distinctly remarked after the complete and entire cessation of the cardiac movements

Chest p. 266

Slow, but regular, heaving of the chest, with some subsultus of the muscles

Moist crepitation over lungs

Tension in the chest and bruised feelings in the joints (fourth day)

Oppression of the chest, with slow respiration for a long time (fifth day)

Sternum. Pain in the right margin of the sternum, deeply seated (fourth day)

Pressure behind the sternum (fifth day)

Heart and Pulse p. 267

PriBCordium. Pressure on the heart (sixth day )

Stitches in the region of the heart and upper half of the left lung (sixth day i

Internal pulsation of the heart, like a trembling, rather more while sitting, with oppression of the chest, nearly the whole day (fifth day)

Heart's Action, Action of heart occasionally tumultuous

Beating of the heart powerful, rapid, felt through the whole chest into the arms, and moving the book held in the right hand (first day)

Beating of the heart felt in the chest without being noticed in the hand (fourth day)

Heart beat so feebly that it required sustained attention to perceive its weak and rare contractions

Heart-sounds feeble

Pulse. Pulse frequent and undulating

Pulse rapid and weak

Pulse more rapid than usual (immediately)

Pulse at first increased, afterwards small and indistinct

Pulse 78, soft and tolerably full (after twenty minutes")

Pulse 100 aud feeble; afterwards insensible

Pulse 100 to 120, soft (second day)

Pulse slower than normal (at first),-1.

Pulse became slower, and suddenly stopped

Pulse 64, usually 75 (third day )

Pulse about 60 (after ten minutes)

Pulse 60 (after half an hour), ( fourth day s1.

Pulse 56 (after one hour), (fourth day)

Pulse 50, very weak

Pulse weak and slow, afterwards, just before death, it became full and strong; then rapid (160), and weak

Pulse 95 (after ten minutes) ; 65 ( after half an hour) ; 70 (after three-quarters of an hour) ; 54 (after one hour and a quarter) ; 66 (after two hours and a half)

Pulse 63, irregular ; before the proving 70 to 75 (fifteen minutes after 12 drops), (fourth day)

Pulse soon after taking small, irregular, scarcely perceptible, 80; after a few minutes 85, regular; after half an hour 70, for several beats in succession; then again some very slow beats; 62 (after threequarters of an hour), firm ; 64 (after one hour) ; 58 (after one hour and a half) ; 70 (after two hours and a half), (fifth day)

Pulse very irregular, at one time very slow, then soon again rapid beats in quick succession (second day)

Pulse small (third day, three-quarters of an hour after 8 drops)

Pulse small and fast failing

Pulse became very weak

Almost imperceptible pulse

Almost pulseless

Pulse suddenly ceased, face became pale

Pulse, from beating at the rate of 100, stopped as if it had been struck with lightning

Neck and Back p. 267

Veins of neck swollen

Dull pains in the region of the kidneys (second day)

Extremities in General p. 267

Objective. During commencing anaesthesia, twitching of the muscles of the extremities, especially of the arms

Cracking in the joints and loss of power in them, on moving (fifth day)

Excessive weakness in the limbs (fourth day)

Complete resolution of the limbs

Subjective. Compressed sensation in the right ankle and left elbow (second day)

Bruised pain in the shoulder and ankle-joints (third day)

Feels very much bruised in all the limbs (sixth day)

Superior Extremities p. 267

Bruised sensation in the arms (fifth day)

Forearm. Pressing pain in the muscles of the right forearm and in the flesh above the hollow of the right knee (second day)

Hand. Peculiar unsteadiness of the hands, with sensation of prostration (second day)

Fingers. Finger-nails blue (fourth day)

Fingers convulsively pressed against the palms of the hands, leaving impressions of the nails

Inferior Extremities p. 268

Staggered in walking (after half an hour >,3

Constant painful weakness in the whole left leg, especially the lower leg and calf (first day)

Great weakness in the feet (fifth day)

Generalities p. 268

Objective. Great nervous excitement

The muscles stiffened

Muscles become relaxed

Frequent stretching and yawning (fifth day)

Very feeble

Every exertion of the muscles fatigues very soon (third day)

Restless and tossing about before death

Subjective. Anaesthesia, with muscular resolution

Absolute general anaesthesia

Complete loss of sensibility and recognition, but not of self-consciousness. (Hirschell)

Sense of touch perverted

When under its influence, felt extremely comfortable; could have remained as she was forever

She felt as if floating on wings

Excessive weariness in all the joints, especially the ankles (third day)

Sensation as if the seat were tottering (fifth day)

While sitting, a sensation as if the chair and table were moving in different directions (third day)

Felt queer twitchings in her body, which lasted over twenty-four hours

Felt as if hammers were beating all over her

Skin p. 268

Skin very blue, with coldness of the eyes (fourth day)

Tingling of the limbs

Crawling in the left fingers (first day)

Sleep and Dreams p. 268

Yawning (fourth day)

Much yawning and closing of the eyes, even while walking (sixth day)

Excessive yawning, as though he would dislocate the jaw (third day)

Great sleepiness and much yawning (fourth day)

A very agreeable sensation of sleepiness, with a very quiet mood (fourth day)

Very sleepy, with chilliness and cold extremities (sixth day)

Much sleep (fourth day)

Apparently deep unconscious sleep, from which she could not be awakened

Comatose sleep

After vomiting had been induced, sank quickly and suddenly into a profound and alarming coma, characterized by excessive pallor of the features, sunken eyes, contracted pupils, insensibility of the cornea, perfect and universal muscular relaxation, complete anaesthesia, coldness of the extremities

Fever p. 268

Chilliness. Skin cold, pale

Cold skin, especially on the extremities, with chilliness in the back, during the whole proving

Surface of body cold and clammy

Constant chilliness, with cold extremities (third day)

Internal chilliness (fourth day)

Much internal chilliness, with cold skin (fifth day)

Very cold

Temperature during narcosis diminished, but before death increased

Chilliness deep in the back, extending to the temples (sixth day)

Great coldness in the innermost portion of the spine, with coldness and paleness (after one hour and a half ), (fourth day)

Extremities cool

Heat. Feverish excitement (after sixteen hours)

Heat in the head (sixth day)

Head hot

Heat in the occiput (fifth day)

Warmth in the stomach (fourth day)

Sensation of warmth in the bronchi that increases to a biting-burning, with a very troublesome constriction of the larynx, and with difficult interrupted sighing respiration, even amounting to a suffocative anxiety

Sweat. Sweat copious before death

Conditions p. 268

Aggravation.

(On closing eyes), Sensation in head.

( On inspiration), Scraping, etc., in fauces.

(External pressure), Pressure in stomach.

(Sitting), Pulsation of heart.

Amelioration p. 268

(Brandy), The symptoms.