Chlorum

Chlorine. The element.

Introduced and first proved by C. Hering, in 1846, and published in Archives, 2, 3, p. 165, which contains his symptoms and those of aaotlier prover, Mr. Wliitey, besides numerous chemical, toxicological and pharmacological obser- vations. For later provings, including S. A. Jones' involuntary proving, from inhaling the gas, see Encyclopedia, v. 3. It was first used in practice by Carroll Dunham.

CLiNiCAii Authorities. — Hemorrhage from bowels in typhus, Schweich, Eiick. Kl. Erf., v. 4, p. 754; Spasmus glottidis, C. Dunham, Hom. Eev., v. 2, p. 20, and U. S. Med. & Surg. Journ., Oct. 1869, p. 117; Suffocative attacks, Searle, Ilaue's Path., p. 337; Spasmodic cough, C. Dunham, Hom. Rev., v. 3, p. 370; rhthisis and Chronic catarrh, a number of cases relieved and cured by inha- lation, Frank's Mag., v. 3, p. 130 ; Malignant pustule, Frank's Mag., v. 1, p. 432.

^ Mind. Mind tranquil and active. Apprehension. A horrible state of mind, fears he will go crazy, fears he

cannot make a living. Everything seems in confusion. Cannot remember names if he sees people, and when

seeing the names does not remember the j^erson.

■ Quiet delirium, in alternation with the greatest restless-

ness and desire to run away. ^Typhus. Restless desire to walk about, as if whole attention must be centred on act of respiration.

■ Intoxicated feeling with sopor and great nervous irrita-

tion ; dry mouth and diarrhoea. ^Typhus. Inclined to anger.

■ After excitement. ^Spasmus glottidis.

^ Sensorium. ■Disposition to faint. (^Typhus.

97 CHLORUM.

Vertigo and stupor.

I Coma, fainting and cold, viscous sweats. ^Typhus, ^Scarlatina. ^Measles. ^Variola.

■ Partially comatose during suffocative attack.

Partial unconsciousness, followed by free respiration and deep sleep. ■^ Inner Head. Rush of blood to head.

Painful aching in vertex and down 1. side, with inclina- tion to lie down.

* Outer Head. Warm sweat breaks out on forehead while

coughing. ■^ Sight and Eyes. iDuU and glassy expression of eyes. ^Spasmus glottidis.

■ Staring eyes. Dimness before eyes.

I I Running of tears < in open air.

Eyes protrude with coryza, sunken face, and spasmodic cough.

■ Purulent ophthalmia.

* Hearing and Ears. Singing in ears.

I Deafness. ^Typhus. ^ Smell and Nose. Dryness in nose before coryza.

I Nose smoky or sooty. ^Typhus. Corrosive feeling in corners of nose. Nose completely stopped.

Sudden running in drops, of a sharp, corroding fluid, with tears in eyes, dry tongue, palate and fauces.

Nose discharged mucus freely.

Water dropped from left nostril, did not burn or excoriate the skin.

I I Coryza with headache.

Fluid coryza very soon changes to yellow, copious phlegm. ■ Evening coryza, morning sneezing. Severe sneezing.

Nasal complaints < lying down. ^ Upper Face. iFace pale and bloated. ^Spasmus glottidis. Pale, dirty -yellow, cadaverous color ; face puffed up. Face high colored.

■ Child became livid. ^Spasm of glottis.

■ Face extremely livid, blue.

■ Ash colored face. ^Typhus.

Swollen face, with protrusion of eyes, abundant discharge

of mucus from nostrils. Warm sweat broke out on forehead while coughing. ^ Lower Face. iLips, tongue and teeth brown, black and

sooty. ^Typhus. '" Teeth and Gums. Sensation as if teeth were too full, or had been injured by acids.

VOL. IV. — 7. ,

CHLORUM. 98

I Teeth black. " Taste and Tongue, i Tongue dry. (^Typhus.

Sensation as if tongue had been burnt.

I Tongue black. ^' Inner Mouth, l Dryness of whole buccal cavity. ^Typhus.

Abundant discharge of mucus from mouth and nose.

Salivation.

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

Sore mouth.

Increased vascularity and minute ulcerations in mouth and throat.

Opening the mouth to take food or drink produced spasm of glottis.

I Putrid odor from mouth. ^Stomacace. 13 Throat. Dryness of throat.

Inability to swallow.

Throat sore from uvula to bronchi, including fauces and oesophagus.

Throat and chest sore, voice hoarse.

Any attempt to examine the throat produced spasm of the glottis.

Reported to have had a favorable effect upon the diphthe- ritic process. ^^ Appetite, Thirst. iLoss of appetite. ^Spasmus glottidis.

No thirst with coryza, but cold water is very serviceable. ^^ Eating and Drinking. Even tasting food was prevented by spasm of glottis; while eating, and after it, hot feel- ings; irritable, and disposed to get into a rage.

After eating increase of the headache with fever.

Smoking causes a dryness in mouth. ^'^ Nausea and Vomiting. Disposition to vomit.

Desire to vomit when coughing, without nausea.

Violent vomiting of dark liver-colored masses of blood, without any pain, lessening the pain in prsecordia and the sensation of suffocation. ^'^ Scrobiculum and Stomach. Contracting sensation and pain in prsecordia.

Cannot bear any pressure on pit of stomach.

Peculiar painful sensation with the cough, beginning in region of stomach and extending to head.

Acidity of stomach.

Irritation of stomach.

Stomach inflamed.

Mild catarrh of stomach and chronic bronchitis, with loss of flesh, and an unhealthy color of skin.

99 CHLORUM.

^^ Hypochondria. Increased secretion of bile.

^^ Abdomen. Weakness in abdomen.

^ Stool and Rectum. Stools of bright blood.

I I Diarrhoea with dryness of mouth, after the appearance

of eruption in typhus. I I Hemorrhage from bowels in typhus; blood black, coag- ulated or thin, smelling like carrion. I I Diarrhoea in the morning. ^^ Urinary Organs. Urine possesses bleaching properties. Urine does not redden litmus paper. Frequent urging to urinate. ^^ Male Sexual Organs. Sudden impotence with aversion to

sexual intercourse. ^ Voice and Larynx. Trachea and Bronchia. Loss of voice. I Aphonia from damp air. Great difficulty in articulating or breathing. I Spasms of vocal cords.

Sensation of warmth in respiratory passages; increased secretion from mucous membranes, and increased ex- pectoration. Feeling of stiffness in rima glottidis with impeded expira- tion. ■Sensation of constriction in air tubes, tightness and suffo- cation. Sensation as if the whole larynx were raw or would be- come so, with single coughs threatening a very violent attack. Feeling as if the rima glottidis were stiff, as if composed

of an iron ring. I I Violent irritation in epiglottis, larynx and bronchial tubes. - 1 1 Violent spasms of glottis ; air is admitted well enough, but its exit is prevented. 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 way of larynx. ■ Thirty or forty attacks of spasmus glottidis occurring

within twenty-four hours. Scratching sensation in bifurcation of windjDipe. Chronic bronchitis and mild catarrh of stomach, with loss of flesh and an unhealthy color of skin (workmen ex- posed to fumes). Phlegmonous inflammation of bronchial membranes. Inflammation of air passages and lungs. Is said to have caused croup. ^® Respiration. Respiration and pulse frequent. ■Sudden tightness of chest.

CHLORUM. 100

Sensation of oppression felt more in r. lung.

Dyspnoea with great physical anxiety.

liSudden and extreme dyspnoea from spasm of vocal

cords. When dyspnoea was at the worst, it was attended by a

feeling as if a narrow band were drawn tightly around

lower third of whole chest. I Dyspnoea increasing, great anxiety, not that he thinks

he will die, but on account of the impeded respiration;

physical, not psychical anxiety. Sense of impending suffocation.

■ Paroxysms of suffocation followed by catarrh.

■ Inspiration easy, but could not completely fill the lungs

with air. • Inspiration is attended by a short crackling rale.

■ Suddenly and without warning, child makes a long

crowing inspiration, an attempt is made to exhale, but without success; another crowing inspiration followed by a forcible, but ineffectual effort to exhale ; and this was repeated until she became blue around the mouth, and sank into partial unconsciousness, when free in- spiration would take place and child would generally sink into deep sleep; frequently toward close of an attack, convulsive movements of extremities take place. ^Spasmus glottidis. Expiration easy and noiseless; inspiration difficult, with rales.

■ B Inspiration unimpeded and can be effected in the natural

manner, but expiration is absolutely impossible.

■ Gasping inhalation and expiration nearly impossible.

■ Breathing consists of a succession of crowing inspirations,

each followed by an ineffectual effort at expiration, in- flating the chest to a more painful extent. ^Spasmus glottidis. t'Emphysema pulmonum.

■ Crowing inspiration; absolutely obstructed expiration;

face turgid and livid; convulsive movements of ex- tremities; partial coma. Expiration accompanied by prolonged, loud, whistling rales, each pulsation of heart gives a crescendo dimin- uendo effect to them.

■ Expiration difficult, prolonged, and seems as if insuffi-

cient, as if air cells were hardly half empty. Whistling rales quite loud in forced expiration. '" Cough. 'Any attempt to cough produces spasm of glottis. Spasmodic cough. Whistling-wheezing cough.

■ Desire to cough resulting from a tickling and a sensation

of rawness behind the thyroid cartilage; when he seeks

101 CHLORUM.

to yield to this desire, he finds it impossible to expel the air from the chest; the cough is therefore abortive, although the desire grows continually more and more intense; the obstruction to cough results from an ap- parent constriction just below larynx, although he can draw air freely into the lungs.

■ The freedom of inhalation and impeded exhalation, to- gether with constantly increasing tickling in larynx which compelled him to make very energetic but un- availing efforts to cough, continue until he sinks ex- hausted and covered with sweat upon a couch, when the spasm seems to relax and he can cough and exhale with comparative freedom; paroxysms recur about every two hours. ^Spasmodic cough.

I I A continuous little dry cough.

Cough seldom ; no expectoration, but a little hoarseness.

At each cough, a spot in the chest (region of r. bronchus) feels sore, as if the cough jarred and hurt it.

Cough, tightness and sensation of pressure in chest.

Violent cough, sensation of constriction in air tubes, tight- ness and suffocation.

While coughing, warm sweat breaks out upon forehead.

Coughing, with a desire to vomit.

When coughing it seems as if he must surely vomit; as if the effort to "raise" the phlegm would also empty the stomach ; yet no nausea is felt.

Constant cough, the bronchi apparently filled with thick, tenacious 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.

Cough, with expectoration of thick, white, frothy mucus.

1 I Cough, with spitting of blood, with pleuritic pains.

No relief from expectoration; chest seems to fill again at once. ^^ Inner Chest and Lungs. Sensation of w^armth in respira- tory organs.

Feeling as if a narrow band was tightly drawn around lower third of whole chest.

Lungs inflated to a most painful degree.

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

CHLORUM. 102

Rush of blood to chest. Hgemoptysis.

■ Inflammation of lungs and air passages. ^Phthisis pul-

monalis. Increased secretion from mucous membranes and in- creased expectoration. ^^ Heart, Pulse and Circulation. Heart's action much in- creased. Pulse frequent.

I Pulse small and soft. Pulse diminished. I i Congestions to head and chest. ^ Lower Limbs. Weakness in lower limbs. ^ Limbs in General. ■ Convulsive movements of extremities.

In the morning less stiffness in back than usual, but more in limbs. ^^ Rest. Position. Motion. ' l Inclination to lie down with pain in head and exhaustion. Lying down : < nasal complaints.

Attempt to cough : produces spasm of glottis. Was restless; desired to walk about; could not be easy "either lying, sitting or walking; seems as though the whole attention must be centered upon the act of respi- ration. Walking up or down improves feverish malaise. 36 jferyes. Nervous sensibility.

Great physical anxiety with dyspnoea.

■ Loss of strength and playfulness. ^Spasmus glottidis. I Great prostration. ^Typhus.

I The nervous symptoms continually increase in third or

fourth week of typhus. iSubsultus tendinum. ^Typhus. I I Violent spasms with the coming of eye teeth. I The interrupted breathing results in asphyxia with or

without convulsions, during which relaxation follows

and free perspiration takes place again. ^Laryngismus

stridulus.

■ Towards the close of an attack convulsive movements.

^Laryngismus stridulus. ^"^ Sleep. I Attacks of spasmus glottidis occur frequently dur- ing sleep, arousing child suddenly; they are most fre- Cjuent from midnight to 7 a.m.

Night sweat. 38 Time. Midnight to 7 a.m. : attacks of spasmus glottidis.

I I Wakens at 3 or 4 a.m. with apprehension of a terrible disease coming on.

On waking in morning he has tears in his eyes.

In the morning: ill humor; difficult to rouse; sneezing;

103 ' CHLORUM.

feverish taste ; weakness in abdomen ; diarrhoea ; stiff in

all the limbs. 10 A.M. to 2 P.M.: crawling over front of arms, back and

thighs. oActs quicker when taken in the evening. In the evening less appetite, sudden coryza, threatening

cough, crawls and chilliness.

Temperature and Weather. When sitting with the sun shining on his back, drizzling crawl, followed by febrile sensations.

Walking in open air relieves chest affections.

Warm room is suffocating to him, but cold open air gave no marked relief.

In open air, running of tears.

Chilly in warm room, evenings; not in open air, morn- ings.

From damp air, loss of voice. *^ Fever. Cold feeling in head, stomach and limbs.

Chilliness and crawls.

Crawls and shaking in evening.

From 10 a.m. to 2 p.m. crawls over front of arms, back and thighs.

Dimness of eyes, followed by fever.

■ Burning dry heat with anxiety and raving. ^Typhus.

Copious perspiration.

I Cold sweat covers the body.

Cold viscous sweat in typhoid state of eruptive diseases.

I I A genial glow all over surface with night sweat during sleep.

I Night sweat of consumptives.

I I In typhus give five drops of chlorine water, every two or three hours until the tongue gets moist (Goullon, Sr.).

*^' Attacks, Periodicity. Every two hours, attacks of spas- modic cough.

Thirty or forty attacks of spasmus glottidis within twenty- four hours. ^ Sensations. As of impending suffocation ; as if teeth were too full or had been injured by acids; as if tongue had been burnt; as if rima glottidis were made of an iron ring; as if a narrow band were drawn tightly around lower third of chest; as if lower third of r. lung was ruptured and air escaped into pleural cavity; as if an insect flitted over skin and stung it.

Pain: in prsecordia; from stomach to head, with cough.

Aching: in vertex and down 1. side.

Stinging: in skin, as of a nettle or minute insects.

Corrosive feeling: in corners of nose.

Rawness: of larynx; behind thyroid cartilage.

CHLORUM. ' 104

Scraping: in windpipe. . Soreness : at each cough in a spot in region of r. bronchus.

Pressure: in chest.

Biting: in skin as of minute insects.

Contracting sensation : in prsecordia.

Constriction: in air tubes; just below larynx.

Oppression: most in r. lung.

Weakness: in abdomen; in lower limbs.

Stiffness : in rima glottidis.

Warmth: in respiratory organs.

Cold feeling: in head, stomach and limbs.

Tickling: behind thyroid cartilage.

Itching: with stinging and smarting in skin. ^ Tissues. Acts principally on the mucous membranes, par- ticularly on those in juxtaposition with the ascending aorta.

■ Rapid emaciation. ^Spasmus glottidis.

1 I Loss of fat ; absorption of fat.

I Acute rheumatic pains. ^^ Touch. Cannot bear pressure in pit of stomach. ^ Skin. I Excessive sensitiveness of skin.

Itchiness with greatlj^ increased sensibility; he tries to avoid scratching; slight smarting.

Stinging, as of a nettle.

Stinging and biting here and there as of very minute in- sects, indescribably transient and minute, occurring at intervals on arm, back, belly and lower limbs; as if an insect flitted over the part and stung it, desires to slap the part with the palm, has no rest.

Stinging like from cantharides leaves soreness and bruised sensation, replaced by itching; cuticle comes off in white scales.

Accumulation of blood in capillaries of skin with heat.

Determination of blood to skin, with eruption of minute papillae, so close that the skin has a general red ap- pearance at a short distance, like injected papillae of cutis anserina; the papillae suppurate and vesicate, or desquamate.

Eruption of minute vesicles thickly studded over skin, on shoulders their bases very nearly touch one another; on disappearing, leave minute red and livid spots.

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

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

Inflammation of the cuticle and ulceration. I I Cutis anserina; dry, yellow and shrivelled.

Urticaria febrilis.

105 CHLORUM.

■ Typhoid state in scarlatina, measles, variola, spotted and piitrid fever. ^Typhus.

Furfuration; slight desquamation.

': Malignant pustule and carbuncle. ^'^ Stages of Life, Constitution. Female infant, set. 9 months, well developed and large ; spasmus glottidis.

Child, set. 1^; spasms during dentition.

J. S., set. 52, has suffered from follicular pharyngitis, has had larynx and fauces treated with nitrate of silver, until it became unendurable, has now much pain in throat, habitual cough and expectoration of glairy mu- cus; spasmodic cough. ^® Relations. Antidotes : Inhalation of sulphuretted hydro- gen is the best chemical antidote; albumen; Lycop. an- tidotes the impotency; Plumb, ac. antidotes the blood spitting and pleurisy.

It antidotes: Hydr. ac; sulphuretted hydrogen (suffocation from).

When Phosphor, had been given, without use. ^Typhus.

Closely resembles Mephitis (suffocative feeling with ina- bility to exhale, bloated face, convulsions).

Similar to all the halogens, particularly to Bromine.

Like all other constituent elements of the human body, it acts by preference on those organs in which it has a function to perform.

CHROMICUM ACIDUM. 106