Bromids And Chloral

If there is much restlessness and the circulation is good, that is,

if myocarditis is probably not present, the bromids may be of great

value, especially in children. The dose should be sufficient to

quiet the nervous system. The drug may be discontinued after a few

days, if the conditions improve. If the bromid, except in large

doses, will not cause sleep, a sufficient dose of chloral should be

given. Chloral is one of the most satisfactorily acting drugs which

we have to produce sleep and to cause cardiac rest. While it should

not be given if there is real cardiac weakness, the good which it

does is so much greater than the possible bad effect on the heart,

that it should not be forgotten for some newer hypnotic. The worst

part of this drug is its taste, and the best way to administer it is

to have it in solution in water and the dose given on cracked ice

with a little lemon juice to be followed by a good drink of water

and a piece of orange pulp for the patient to chew. Ordinarily a

bad-tasting drug such as chloral is well administered in

effervescing water, but effeverscing waters are generally

inadvisable when there is any kind of inflammation of the heart, as

they are liable to cause distention of the stomach and pressure on

the heart. Some physicians prefer chloralamid as a less disagreeable

drug and one which acts almost as efficiently as chloral. As the

close of this must be larger than the dose of chloral, it is a

question of doubt as to which is the better drug to use. Of the

newer hypnotics, veronal=sodium (sodium-diethyl-barbiturate) is

among the best. It acts quickly, is less depressant and is a safer

salt than most of the other newer hypnotics. It is the readily

soluble sodium salt of veronal (diethyl-barbituric acid). When

combined with any active drug, sodium seems to make it less toxic

and less depressant. The dose of this drug is from 0.2 to 0.3 gm. (3

to 5 grains).

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