BY B. F. JOSLIN, JR., M. D., NEW YORK.

Having recently seen very decidedly beneficial effects from the use of chlorine in spasmodic affections of the air passages, as recommended by Dr. Carroll Dunham in the present volume of the Review, page 18, I have thought it desirable to report the same.

The first case in which I used it, was very similar to the one reported by Dr. Dunham; a form of disease by no means common, viz.: “true spasmodic croup or spasm of the glottis.”

The patient was a boy, aged fourteen months, whose health had previously been exceedingly good. I was called in haste to visit him, on the 8th of February, 1860. For two weeks previously he had had paroxysms of a suffocative character, accompanied by a crowing sound of respiration; he would appear to be unable to breathe or cry, and his face would become purple. Had neither cough nor wheezing respiration. Any excitement or drinking would bring on paroxysms.

The paroxysms had steadily become more frequent and severe. On the morning of my visit during one of these suffocative attacks, a severe convulsion ensued which lasted ten minutes – the first convulsion he ever had.

For two days before the patient had vomited his milk, and the bowels had been loose, evacuations greenish. Gave him 1 Bell.³⁰ then Sulph. ³⁰

In the evening of the same day I found him crying as from pain; – his mother said that as much crying on the previous night would have brought on his paroxysms of choking: he had had only two of these since morning and two greenish evacuations. Gave him Samb^.200 a dose every 3 hours.

9th. No choking since. Bowels better. Continued Samb ^200.

10th. Paroxysms commenced at 4 p. m. yesterday, has had at least six this morning. Bell³⁰ every 3 hours.

11th. No paroxysms after I saw him till 4 p, m., since then several. Bell^.20 every 3 hours.

12th. Has had a number of paroxysms since. Continued during night and today. – Bowels better. – While asleep has snoring respiration. – Short dry cough. Opium,¹ solution, a dose every 3 hours.

13th. No paroxysm since yesterday afternoon. Continue Opium.¹

14th. Several slight paroxysms. General health improved. Continue Opium.¹

16th. No paroxysm. Continue Opium.¹

26th. The choking paroxysms continue, sometimes only once a day, at other times more frequently. Continue Opium.¹

March 6th. Rather worse. Frequent paroxysms of choking. Bowels loose. Cham.¹²

8th. Was quite severely affected yesterday, today had another severe convulsion. Samb^.200 was given.

9th. Has had a number of suffocative attacks. Prescribed solution of Chlorine, As we have no standard by which to indicate the precise strength of the Chlorine solution, I can only state that the diluted solution given had a very faint smell. Directed about 20 drops to be given at a dose, three or four times a day, or more frequently if he had severe suffocative attacks.

10th. Paroxysms not so severe nor so frequent. Continue Chlorine.

11th. No paroxysms since. Appears brighter. Continued Chlorine.

13th. No paroxysms until this morning, when he had several slight ones. Gave him solution of Chlorine prepared fresh.

15th. Several very Blight paroxysms since. Continued Chlorine.

19th. Paroxysms daily, but not severe. Continued Chlorine.

23d. Slight paroxysms daily, but is much better as regards general health. Chlorine was continued.

29th. Improving. Continued Chlorine.

April 3d. Worse since 1st inst. Rather severe and frequent turns of choking with blueness of face. The Chlorine solution has stood since 29th, prepared it fresh.

12th. No better. Has several paroxysms of choking each day. Prescribed opium.¹ solution every 3 hours.

The paroxysms ceased a few days after, and have not returned. Although the Chlorine seemed in some measure to loose its effect at the very last of the case, still it was very decided when first given and for nearly a month afterwards. The occurrence of a second convulsion and the alarming severity and frequency of the choking paroxysms almost discouraged me.

These symptoms were promptly relieved. The paroxysms which we recorded as occurring daily, were quite slight, and would scarcely have been noticed were it not for the previous occurrence of the severe ones.

The only other case in which I have used Chlorine, was one of true membranous croup, accompanied by some degree of stridulous respiration. Other remedies had been used before with only slight effect, the Chlorine when given stopped the stridulous respiration in a few hours, nor did it return during the progress of the case, which though finally successful was tedious. The Chlorine served only to relieve the portion of the disease which was of a spasmodic nature, no effect was produced by it on the dry wheezing respiration.

I shall probably report this case more in full at another time. I merely allude to it to illustrate the action of Chlorine.

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