This section is from the book "Dental Medicine. A Manual Of Dental Materia Medica And Therapeutics", by Ferdinand J. S. Gorgas. Also available from Amazon: Dental Medicine.
Chloretone is a white crystalline compound with an odor like that of camphor. It is highly soluble in chloroform, ether, acetone, alcohol and in glacial acetic acid; also soluble to the extent of one per cent. in cold water, but more soluble in boiling water. Chloretone, or aceton-chloroform, was produced synthetically by Willgerodt in 1881, and unaware of these experiments, John J. Abel in 1891 discovered its value as a practical hypnotic and anaesthetic.
Experiments with moderate doses of chloretone on animals caused a profound sleep and complete anaesthesia which lasted for several hours; and very large doses induced anaesthesia which continued for four days, without ill effects on recovery. It has no action on the blood, and no toxic effect on the heart, and is supposed to be decomposed in the body, as the largest doses failed to show any signs in the urine, and its use increased the chlorides in the urine.
It is a hypnotic and nervous sedative, its action resembling that of chloral, but not depressing the heart or respiration, unless excessive quantities are given; it also acts as a sedative to the stomach without irritating it. It is efficient in vomiting due to irritation, and relieves the pain of gastric carcinoma. Donald reports a case in which 120 grains of chloretone were taken in the course of 24 hours, which caused a profound sleep lasting for six days, without any bad effects except gastric irritability.
The one per cent solution has marked germicidal properties, and is used as a local anaesthetic to irritable ulcers, and infected wounds. It is also effective as a local anaesthetic in minor surgical operations.
Of chloretone, gr. ij to x although gr. viij to xx have been given in 12 hours, in the form of sugar-coated tablets of 3 grains each.
For a local anaesthetic in the extraction of teeth; as an obtundent for hypersensitive dentine; for the removal of living pulps of teeth; for relief of pain in setting crowns and bridge-work; the ethereal solution being employed in removing pulps. It appears to possess all the good qualities of cocaine and betaeucaine, without any of the objectionable effects of either. Dr. M. Leo recommends a solution for extracting teeth, prepared by mixing 15 per cent of alcohol with 85 per cent. of distilled water and adding enough chloretone to make a saturated solution: also a solution made by mixing equal parts by weight of ether and chloretone, for use as an obtundent in preparing painful cavities for fillings, and setting crowns, and bridge-work.
Dr. A. I. Welsh recommends the following solution, which he claims to have used on hypersensitive dentine with marked success, and which, in preparing cavities in teeth, caused but little pain:
3/12 sulphuric ether aquae distill.
q.s. to make I ounce. After standing, this solution being non-miscible, divided into a solution of chloretone and ether, and a solution of chloretone and water. The floating ethereal solution was used with success on sensitive dentine; the aqueous solution under the ether layer was injected into the gums for the extraction of teeth, and in one case nine teeth were extracted with little pain, and with less risk than when cocaine is used. Dr. C. E. Klopp suggests a solution of 1/2 drachm of oil of gaul-thesia, 1/2 drachm of pure alcohol, to which 18 grains of chloretone are added; after the chloretone is dissolved, the mixture is added to I ounce of distilled water and then filtered to obtain a clear solution, and claims great success with it in the extraction of teeth. Some recommend waiting six or seven minutes after injecting before operating.