Chloral and formamide. Occurs as a whitish, crystalline substance, having a somewhat bitter taste. It is soluble in water, but not freely so (about 14 to 100) at ordinary temperature. It may be administered hypodermatically, but preferably in the form of powder, or wafer, or capsule. The dose ranges between gr. v and 3 j, but the hypnotic dose has been fixed at forty-five grains as efficient in most cases in adults.

Actions and Uses

Chloralamide is not very quick in action—an hour or two elapsing before its characteristic effects are manifest. It is said to be somewhat more prompt when administered by the rectum. It is a hypnotic, lessens the reflexes, acts on the vaso-motor center in the medulla, reducing the blood pressure; lowers the respiratory movements and the action of the heart. When sleep is caused by small doses the repose is quiet, undisturbed by dreams, and no after headache or nausea occur. That chloralamide, as claimed by its proprietors, is absolutely free from untoward effects, can not be admitted; for when massive doses are given the same results follow as are observed from most of the members of the aromatic and fatty series of medicaments—that is, more or less profuse sweating comes on, a rigor announces the onset of an active reaction, and irregular action of the heart and sighing and shallow respiration occur. In sufficient quantity it acts on the blood, also disorganizing the red blood-globules, separating the haemoglobin, and giving to the blood the characteristic chocolate color, or brownish-black hue, such as the other remedies of the group bring about when freely administered.

A measles-like eruption is apt to appear on the skin; and in one instance Pye-Smith noticed an exfoliation of the skin, as in scarlatina. In this respect, again, chloralamide resembles its congeners.

In its therapeutical applications chloralamide partakes of the effects of its constituents—chloral and formamide. It is an efficient hypnotic when wakefulness is not due to pain. It occupies a position between chloral and paraldehyde as a sleep-producer, and, like them, is efficient the less the wakefulness is due to serious disturbances. It has been used with success in the insomnia of fevers and acute affections, but has not succeeded well in delirium tremens. In asylum practice chloralamide has been employed in the wakefulness of the insane, but not with a higher measure of success than has attended other approved hypnotics. Dr. Strahan used it in two hundred cases of mental disorder in which insomnia was the chief feature, but he found it no more efficient than chloral or paraldehyde, although it may be safer. Dr. Umpfenbach, an alienist, tried it in many cases of insomnia in asylum practice, but it proved to have no advantages over chloral.

In the wakefulness of paralysis agitans, of sclerosis, and other cerebral affections it acts favorably. Good results may be expected from its use in nocturnal epilepsy. Alt reports favorably on its utility in chorea, having effected cures with it when other approved remedies had failed.