Chlorum

The element. Chlorine; (G.), Chlor-gas; (Fr.), Chlore.

Preparations, Saturated solution of the gas in ice-cold water; lower dilutions with water.

Authorities. 1, Hering "and another man," Nenes Archiv, 2, 3, p. 165; 2, Buchner, ibid. ; 3, Berzelius, effect of inspiring the gas, from Hering's resume; 4, Buchheim, general effects, from ibid.; 5, Christison, general effects of gas, ibid. ; 6, Ferrier, ibid. ; 7, Fourcroy, ibid.; 8, Gmelin, effects of inspired ^gas, ibid. ; 9, Hare, effect of plunging the hand into the gas, ibid.; 10, Aster, effect of inspiring the gas, from Hering and Wibmer ; 11 (omitted) ; 12, Pereira, ibid. ; 13, Siebers, ibid. ; 14, Thenar, effect of the inspired gas, ibid.; 15, Wallace, ibid.; 16, anonymous, effect of fumes of Calcium chloride (from Archiv f. Horn., 19, 1, 69), ibid.; 17, Wallace, from Orfila Tox., effects applied to skin; 18, Cattell, symptoms (compiled), B. J. of Horn., 11, 157 ; 19, Dr. Tott, an apothecary, inhaled fumes, Frank's Mag., 4, 823, from All. Med. Zeit., 37, 1425 ; 20, Ziemssen's Handbuch d. Sp. Path, und Ther., 1, acute poisoning, effects on workmen ; 21, ibid., chronic poisoning; 22, Dunham, effects of washing mouth with a solution of Chlorine, Am. Horn. Rev., 2, 18 ; 23, ibid., effect of inhalation of the gas, ibid. ; 24, S. A. Jones, N. Y. J. of Horn., 2, 249, effects of inhaling the gas.

Mind

Emotional. Mind tranquil and active

Excessive anxiety attacks him

Excessive anxiety ; he could not speak a word

His mind is terribly affected ; he is afraid of becoming insane ; thinks it is impossible to get through it ; everything seems confused ; at the same time he cannot remember anything ; worse the second day

Great irritability and disposition to anger

Great fretfulness in the morning

Intellectual. The difficulty of recalling names when he sees the persons is far worse, besides, what is not so common, that of recollecting persons when he sees their names (second day)

Head

Vertiao. Vertigo and stupefaction

General Read. Disagreeable sensation in the head when shuddering

Forenoon at 11, disagreeable sensation in the head ; crawling shudder, most on the back ; he sits with his back to the sun, which makes it worse; later, a feverish sensation

Sensation as if he would have a headache (after the first dose, in a man who never had a headache in his life)

Headache during coryza

Headache, worse after dinner

Vertex. Painful wearing sensation in vertex and doivn the left side, with inclination to lie down (in a man who never had suffered from headache, every time on taking a drop of a weak solution of Chlorine, evening and morning)

Parietals. Headache in the left side, before the shuddering

Occiput. Burning and pressure in the occipital protuberance gradually increased in severity (till he took the antidote, Sulphuretted hydrogen)

Eyes protruding,1".-

Lachrymal Apparatus. Lachrymation during coryza

Lachrymation on waking (third day)

Lachrymation, especially in the open air; the right eye was formerly disposed thereto

Watering of the eyes from Chlorine vapor

Eyes very much affected the second day; he is often obliged to wipe them

Vision. Dimness of the eyes during fever

Suddenly, numerous fantastic images floated before the eyes, which disappeared with lightning-like rapidity

Ears p. 270

Ringing in the right ear (dulness also in the left ; deaf for forty years)

Nose p. 270

Objective. Severe sneezing

Mornings, violent sneezing, after coryza in the evening

Violent coryza

Flow from the right nostril ; his left is always stopped ; a few minutes after taking, afternoons

Abundant discharge of mucus from the nostrils

Nose discharged mucus freely ; water dropped from left nostril ; did not burn or excoriate the skin

In twenty-four hours after coryza sets in, copious yellow mucus appears, as if the coryza were already ripe ; no sneezing, and continued stoppage of the nose

Corroding water from the nose

Evenings, sudden flowing and dropping from the nose of a corrosive water, but without a sharp taste; at the same time lachrymation, dryness of the tongue, palate, and fauces, without thirst, but cold water is very agreeable; severe stopping up of the nose while it flows; all symptoms of coryza are worse when lying (two hours after 1 drop)

Subjective. Mucous membrane of the nose attacked

Dryness of the nose

Has a peculiar suffocating odor, which produces a sensation of dryness in the nose and an irritation to cough in the windpipe, with pressure on the chest, lasting a shorter or longer time

When Chlorine gas is inhaled, it causes a very disagreeable sticking sensation, and the consequence of this action is a violent coryza, that disappears again after several hours

Burning pain, with severe tension and great dryness in the nose and eyes

Sensation in the corners of the nose as if eroded, without visible soreness (after several days)

Smell. Smell of Chlorine in right nostril; left one entirely stopped up

Loss of smell,J1.

Face p. 270

Heightened color of the face

Complexion pale, often greenish

Face puny

Face bloated

Swollen face, with protrusion of eyes

Mouth p. 270

Teetll. Sensation of fulness in the teeth (after several drops)

Tongue. Dryness of the tongue, palate, and fauces, without thirst, but cold water is agreeable to him

General Mouth. Mucous membrane of the mouth affected

Mucous membrane of mouth and nose severely affected

Increased vascularity and minute ulcerations in mouth and throat

Dryness in the mouth

Soreness in the mouth, fauces, and pharynx, redness, and even small ulcers (from outward applications)

Soreness of mouth, fauces, and oesophagus, as if the tongue had been burnt, as if he had been eating vegetable acids, or as if his teeth had been injured by acids

Saliva. The quantity and character of the saliva and bile are altered

Flow of saliva (from continued use)

Salivation

Much mucus in the mouth

Abundant discharge of mucus from mouth and nose

Taste. Disagreeable taste and odor, so suffocating that it cannot even be inhaled mixed with common air without a sensation of suffocation and contraction of the chest

Mornings, febrile taste in the mouth, ceased after rinsing it

Speech. Great difficulty in articulating or breathing

Throat p. 270

Choking sensation

Throat sore, from uvula to bronchi (after two hours and a quarter)

For two days after, throat and chest were sore and voice hoarse

Evenings, a few paroxysms, as if he would have a cough ; as if the whole pharynx were raw or becoming so

Swallowing. Inability to swallow

He could not swallow

Stomach p. 270

Appetite. Evenings, less appetite

At first, appetite for tobacco ; later, it does not taste good ; smoking bites the tongue, and causes dryness in the mouth

Thirst. Desire for wine rather increased

Stomach. Inflammation of stomach

Acidity

Acid stomach and other gastric troubles ( in workmen exposed to Chlorine, and for which they eat chalk)

Acts on the mucous membrane of the stomach as a strong local irritant, also increases the secretion of bile ; it cannot, however, act long independently, as it comes in contact with many substances having a great affinity for it ; in this way it increases the quantity of chlorides in the blood, while it lessens that of carbonates and other salts ; its secondary effect will therefore be similar to that of Natrum muriaticum

Abdomen p. 271

Hypoph ondria. The character of the bile was altered

Increased secretion of bile

General Abdomen. Weakness in the abdomen, mornings (third and fourth days)

Stool p. 271

During coryza, diarrhoea and other complaints, even during fever, appetite remains undisturbed

After 1 drop in the evening, some diarrhoea in the morning

After taking, stool next morning at the usual hour, but diarrhoea-like ; a second still thinner the same forenoon ; following day the same

Urinary Organs p. 271

Urethra. Frequent desire to urinate, but it is only passed in moderate quantities, for several days

JJrine. Increased urine

Urine possesses bleaching properties

Urine loses the power of reddening litmus-paper

Sexual Organs p. 271

Sudden impotence, even total aversion to sexual enjoyment ; ordinarily he was easily excited, but now the contemplation of the greatest charms failed to arouse him ; in a vigorous man of 30,16.

Respiratory Organs p. 271

Larynx, Trachea, and Bronchi. Inflammation of the air-passages and lungs

Inflammation of the bronchial mucous membrane

Phlegmonous inflammation of the bronchial membranes

Bronchial catarrh, very common

* Violent spasms of glottis

A feeling as if the rima glottidis were stiff, as if made of an iron ring (after two hours and a half)

Inhaled mixed with air it causes a sensation of distress and suffocation, and violent cough ; it always gave me a sensation as if the air-passages were contracted, as if there must be a cramp in the muscular fibres of the bronchi ; the attack passed off with increased secretion of mucus, often with spitting of blood

Sensation of constriction in air-tube*, tightness, and suffocation

Violent irritation in larynx and bronchi

Violent irritation in epiglottis, larynx, and bronchial tubes

Immediately, a violent irritation in the larynx, windpipe, and bronchi, cough, oppression, pressure in the chest ; he could not swallow ; exercise in the open air agreed very well with him, but did not relieve the excessive pressure and constriction ; violent anxiety seized him, he could only utter single words, breathed heavily ; the mucous membrane of the mouth and nose was severely affected ; much mucus in the mouth, violent coryza ; Ammonia did not help him ; the face was bloated, eyes protruded, spasmodic cough tormented him, pulse slightly changed ; inhalations of sulphuretted hydrogen gas relieved him very much ; excepting cough and slight pain in the chest all other symptoms ceased after one hour and a half

Irritation to cough

Voice When inhaled undiluted, it causes spasms in the vocal cords

Loss of voice for seven months

Aphonia for six months, from damp air

Cough and Expectoration. Cough

Cough, with spitting of blood

Cough ; tightness and sensation of pressure in chest

Inhaled in small quantities it causes cough and oppression ; inhaled frequently, haemoptysis and consumption

Violent cough

Spasmodic cough

Tormenting spasmodic cough

Chronic cough

Whistling-wheezing cough

Coughs seldom ; no expectoration, but a little hoarseness ; at each cough, a spot in the chest (region of right bronchus) feels sore, as if the cough jarred and hurt it (after two hours and a half)

Cough, with expectoration of thick, white, frothy mucus

Fits of coughing, in which phlegm was always raised and ejected, but only after long and fatiguing efforts ; in a minute or two phlegm would again collect, causing a fit of exhausting coughing until it was expectorated

Constant cough, the bronchi apparently filled with thick, tenacious mucus; no relief from expectoration, chest seemed to fill again at once; when coughing, it seemed as if I must surely vomit, as if the efforts to "raise the phlegm would also empty the stomach, yet no nausea is felt; warm sweat broke out on the forehead while coughing

Abundant expectoration of mucus

Inhaled in great quantities it produces spitting of blood and even death, with the most violent pains

Haemoptysis

Workmen who inhale it often are attacked with haemoptysis and lung disease

Respiration. Whistling rales, which are quite loud on a forced expiration (after two hours and a quarter)

Respiration and heart's action much increased

Expiration easy and noiseless, inspiration a little difficult and attended with rales (after two hours and a half )

Inspiration easy, but not sufficient to fully inflate the lungs, could not completely fill them tooth air; inspiration is attended with a short rattlingcrackling rale; expiration difficult, prolonged, and seems as if insufficient, as if the air-cells were hardly half emptied; expiration is accompanied by prolonged, loud, whistling rales (not one sound merely, but a combination of several), and each pulsation of the heart gives a crescendo diminuendo effect to them

Great anxiety, not that he thinks he will die, but on account of the impeded respiration (should call it a physical, not a psychical anxiety)

Dyspnoea rapidly increasing ; profound sense of impending suffocation

Warm room was very suffocating, but cold open air gave no marked relief

* Scarcely had the liquid been received into my mouth, when I became sensible of a spasmodic action of some part of the respiratory organs of the following character: Inspiration was unimpeded, and could be effected in the natural manner, but expiration was absolutely impossible, and this impossibility arose, if I might trust my sensations, not from any inability of the muscles of expiration, but from a closure of the rima glottidis ; expiration being felt to be impossible, inspiration was again attempted, and was accomplished fully and easily, although the act was attended by a slight crowing noise; expiration, which was again attempted, was impossible as before. By these successive operations the lungs became inflated to a most painful degree, fad so firmly did the glottis appear to be closed that it seemed as though air might pass through any part of the thoracic walls more readily than by the way of the larynx; this arrest of respiration having endured for about a minute, the face becoming turgid and livid, partial coma supervened, the spasm relaxed, and respiration became free again

Comparatively free, but crowing inspiration and absolutely obstructed expiration presented themselves, the face became extremely livid, convulsive movements of the extremities began, and the patient became partially comatose ; I administered ammonia by olfaction, the spasm relaxed, and consciousness returned along with normal respiration

Respiration difficult

Difficult breathing; he could hardly speak

* Sudden and extreme dyspnoea, from spasm of the vocal chords ; sufficient air cannot be inspired, even with the aid of all the auxiliary muscles of respiration, to sustain life, the eyes are staring, the face becomes blue, cold sweat covers the body, the pulse becomes small and soft, the temperature sinks from 37.4° to 36.8° C.,20.

.Suffocating sensation directly after taking Chlorine largely diluted with water

Paroxysms of suffocation

* Chlorine gas mixed with common air produces paroxysms of suffocation, often followed by a catarrh of some, duration

Chest p. 273

Inflammation of lungs and air-passages

Contraction of the chest

Slight pain in chest and cough

At once, tightness of the chest

When the dyspnoea was at the worst it was attended with a feeling as if a narrow band were drawn tightly around the lower third of the whole chest

Pressure on the chest

Oppression

Oppression and constriction of the chest, not relieved in open air

The sensation of oppression was most felt in the right lung

Sensation in lower and inner third of right lung, as if it was ruptured ; there is & feeling as if the air escaped from the lung into the pleural cavity at each 'inspiration; the inspiration being attended by a separate rale, confined to the quasi-ruptured locality, the vibrations of which were felt by the common sensation (ccensesthesis), perceptible to the touch (hand on chest), and audible to the bystander

Two hours and a quarter after inhaling the gas the chest feels sore interiorly, especially on coughing

The right lung seems to feel the force of the gas most markedly (having been dosed by inhalation, the superior size and position of the right bronchus most probably explains this seemingly one-sided action)

Heart and Pulse p. 273

Pulse frequent

Accelerated pulse

Pulse becomes more frequent, and perspiration breaks out

Pulse diminished

Inferior Extremities p. 273

Weakness of the legs (second day)

Generalities p. 273

Objective. The workmen seem very old; those 30 or 35 seem at least 40,21.

Absorption of the fat

Loss of fat

Disappearance of fat (in workmen)

Phthisis

Consumption

Increased secretion from mucous membranes, and increased expectoration

Was restless, desired to walk about ; could not be easy either lying, sitting, or walking; seems as though the whole attention must be centred upon the act of respiration

Inclination to lie down (second day)

Inclination to lie down during headache

Finds it difficult to rise in the morning, and great ill-humor

Subjective. Nervous sensibility

Excessive sensitiveness of skin,ls.

Sensibility diminished (from application of pure chlorine)

Feeling of comfort and increased cheerfulness

Sensation as if a severe sickness were coming on, mornings at 3 oclock

Wakes up at 3 or 4 in the morning, and feels as if a dreadful sickness were approaching

Skin p. 273

Objective. Skin red and painful, becoming tumid and swollen, and thickened, as in facial erysipelas

From ordinary application of the gas, the skin became red ; if the application is continued a long time, it causes a violent pain, which increases with the redness ; the skin swells and looks like erysipelas, with an unpleasant sensation, as if the parts were bruised ; these symptoms continue some days, as if the skin were deeply affected ; at last, itching and desquamation

Ou tis anser ina

Skin like cutis anserina, dry, yellow, and shrivelled

Slight desquamation

Furfuration

Inflammation of cuticle and ulceration

Determination of blood to the skin, with eruption of minute papillae, chiefly on the back, loins, breast, abdomen, and arms, so close that the skin has a general red appearance at a short distance, like injected papillae of cutis anserina ; the papillae suppurate and vesicate, or desquamate

Accumulation of blood in capillaries of skin, with heat

Eruptions. Eruption of minute vesicles, thickly studded all over the skin ; on shoulders, their bases very nearly touch one another; they disappear on the second day, leaving minute red and livid spots

Nettle-rash, wheals white, small, in clusters, surrounded by diffuse redness

Urticaria febrilis

Causes tetter-like eruptions, and critical sweat

Subjective. Sticking, pricking sensation iu skin for several hours

After several days the skin of the nose feels as if eroded

Slight smarting

Stinging, as of a nettle

Stinging sensation, succeeded by symptoms like those from Cantharides, which subside after half an hour; succeeded by soreness and bruised sensation for some days ; replaced by itching sensation, the cuticle coming off in thick scales, as in psoriasis

Sensation of stinging or biting in different parts, as of very minute insects, indescribably transient and minute, occurring here and there at intervals, on arm, back, abdomen, and lower limbs, as if an insect flitted over the part and stung it; increases, with desire to dap the part with the palm, so as not to allow any rest

Diluted with water or air, and brought in contact with the skin, it causes a very peculiar sensation, resembling the stings of insects, with copious sweat, rush of blood to the skin, sometimes an eruption of little pimples, or even vesicles. Applied to the skin undiluted, it acts in the same way, but more violently

Sensation (after ten minutes) as of stings or bites of small insects, in various places ; the number of these places increases, and a sensation of general itching or heat follows; copious sweat usually begins with the itching, this sweat continued during the night after the application of the Chlorine ; after this vapor-bath, there was an eruption of small pustules over all parts of the body, especially on the back, lumbar region, abdomen, chest, and arms; these seldom suppurated

Itchiness, with greatly increased sensibility; he tries to avoid scratching

Sleep and Dreams p. 274

Falls asleep late after every mental excitement, during the first days ; is sleepy very early the following days

Fever p. 274

Chilliness. Chilliness in the warm room, evenings; not in the open air, mornings, several days

Shuddering and shaking (one hour after 1 drop, in the evening)

From 10 to 11 forenoon to 2 in the afternoon, cold shudders over the outer surface of both arms, and over the back and thighs, with dimness before the eyes, then a feverish sensation with unchanged pulse

Headache, left side, before the shuddering. After dinner, at 2 oclock, he feels much worse in his head, and so badly in general, that he is obliged to lie down. He is only improved by walking back and forth. The next day at the same time, the same, but more lightly. (Two days after omitting the remedy, in one who never had intermittent fever)

Heat. Heat of surface of body

Heat while eating and after eating, with great irritability and disposition to anger, while drinking wine and coffee

Slight fever and coryza

Inhaled highly diluted with air, it causes a sensation of warmth, and promotes expectoration

Pleasant feeling of warmth, and diminished sensibility (from application of pure Chlorine)

Warmth in the stomach

Agreeable warmth in the stomach, accelerated pulse, sensation of comfort, increased cheerfulness, heightened color, increased urine ; but from larger doses, vertigo and stupefaction ; from still larger, nausea, vomiting, colic, and diarrhoea

Warmth in the air-passages

Sensation of warmth in respiratory passages

With the atmosphere at 15° R., the hand dipped in Chlorine gas, feels a heat of from 32° to 55° R., although the thermometer is not affected. This must have been occasioned by a chemical combination of Chlorine, with the exhalations of the skin

Sweat. Perspiration increased

Copious perspiration

Night-sweat during sleep, with genial glow all over surface of body

Causes critical sweat

Conditions p. 275

Aggravation

(Morning), Fretfulness ; on waking lachrymation ; sneezing; taste in mouth; weakness in abdomen; at 3 oclock, sensation as if sickness were coming on.

(Afternoon), From 10 or 11 a.m. to 2 p.m., shudders over arms, etc.

(Evening), Flowing from nose; paroxysms; less appetite; chilliness.

(Night), Sweat.

(Open air), Lachrymation.

(After dinner), Headache.

(During and after eating), Heat, etc.

(Lying), Symptoms of coryza

(Sitting with back to sun), Shuddering.

Amelioration p. 275

(From motion in open, air), Some relief.

(From inspiring sulphuretted hydrogen gas), Great relief.