This section is from the "A Handbook of Useful Drugs" book, by State Medical Examining and Licensing Boards.
A liquid consisting of from 99 to 99.4 per cent, of chloroform, CH.Cl3, and from 0.6 to 1 per cent, of alcohol, C2,H5OH. added as a preservative.
Chloroform is now largely made by the decomposition of chloral by alkalies.
Properties : Chloroform occurs as a heavy clear, colorless and mobile liquid, of a characteristic odor, and a burning sweet taste. It is but slightly soluble in water (1 :200), but is miscible, in all proportions, with alcohol, ether and the fixed and volatile oils.
Incompatibilities : Chloroform should be protected from the light by storing in a dark place or in dark well-stoppered bottles. It readily deteriorates under the influence of heat, light and air, and the decomposition products must be avoided in the use of this product in general anesthesia. For this reason the vapors should not be allowed to come in contact with a flame.
Action and Uses: Chloroform acts locally as a penetrating and fairly powerful irritant, which may blister if its evaporation is prevented. It is used in liniments. Taken by mouth, small doses are carminative, anodyne and antiseptic; it is therefore used in gastric fermentation and colic. Large doses are sometimes employed as a vermifuge, but are rather dangerous. Excessive doses produce unconsciousness and coma, similarly to the results of its inhalation.
Its main use is by inhalation, for the production of general anesthesia. The excitement stage is similar to that with ether, but of shorter duration and therefore less unpleasant. It is much more dangerous, however, most acute fatalities occurring by stoppage of the heart early in the administration. This danger is lessened by atropin
The anesthetic stage is also more dangerous than with ether, there being a gradual but progressive fall of blood-pressure, even if the administration is carefully managed. The fall is due to depression of both the cardiac muscle and vasomotor center. The respiratory center is also more depressed. If an excessive concentration is given, death occurs, in this stage usually by stoppage of respiration; but since the heart and vasomotor center are also greatly weakened, recovery is more difficult than with ether. Sometimes, especially in cardiac disease, the heart may be the first to give out.
The irritant actions on the kidneys and respiratory tract are probably about the same as with ether.
Prolonged administration is especially dangerous, often producing death after several days by so-called delayed chloroform poisoning. This is characterized by general fatty degeneration, especially marked in the liver, which may pass into a condition analogous to acute yellow atrophy.
Chloroform is distinctly less safe as an anesthetic than ether and should be employed only when ether is unavailable or its use inadmissible for some reason. Chloroform is held by many physicians as specially suitable for anesthesia in children and during childbirth.
It is frequently given to relieve pain in the stomach or bowels, especially pain of a colicky nature.
Dosage: From 0.05 to 0.3 c.c. or from 1 to 5 minims.
Chloroform may be prescribed in a variety of forms. The Pharmacopeia includes: