Chloralum hydratum

A synthetic hypnotic/sedative introduced in the 19th century and widely employed for insomnia, delirium tremens, and convulsive states. Toxicologically it depresses the cerebrum, vaso-motor and cardiac centres, producing sopor, flushed head with cold extremities, irregular/weak pulse, respiratory depression, and skin eruptions (especially urticaria and pruritus). The homœopathic preparation is made by dilution and potentisation from the crude drug. The proving and rich clinical record yield a picture centred on insomnia with cerebral excitement, night terrors, terrible dreams, pruritic eruptions, and cardio-respiratory weakness with vaso-motor instability. [Clarke], [Allen], [Hughes], [Boericke]

Proving data (Allen, Hughes) plus abundant toxicological and clinical confirmations: insomnia despite fatigue, terrifying dreams with startings from sleep, night terrors of children, delirium tremens with red hot face and cold extremities, urticaria/pruritus (worse warmth of bed), irregular weak pulse, sighing/sterterous breathing, and collapse. [Allen], [Hughes], [Clarke], [Boericke], [Hering]

Chloralum hydratum is the night-panic and hot-head–cold-limb remedy. Its essence is a drug-state where the brain cannot release itself to sleep without terror: the moment of dropping off triggers images, startings, gaspings, and heart-irregularity. The skin burns and itches, the room is too warm, the face is scarlet, the hands are cold, and the pulse wavers. Around this pivot are urticaria, jactitations, sighing/stertor, and a tendency to collapse in the small hours. The modalities are tight and practical: worse at night, warmth of bed, lying flat, alcohol, sudden stimuli; better cool, uncovered head, propped, quiet companionship, and small regular sips. Distinguish from Opium (heavy stupor without fear) and Coffea (bright wakefulness without terror); choose Chloral when fear on falling asleep + pruritic heat + weak pulse entwine. Cure is recognised when sleep begins quietly, the images stay out, the pulse steadies, and the skin stops shouting. [Clarke], [Allen], [Boericke], [Hughes], [Farrington]

• Cerebrum & sleep centres. Insomnia from cerebral excitement, sleeplessness with terrible dreams, night terrors (children), somnambulism, startings on falling asleep; sleep that does not refresh. See Mind/Sleep. [Allen], [Clarke], [Tyler]
• Vaso-motor & heart. Flushed, hot head with cold extremities; face suffused; weak, irregular pulse; tendency to collapse, syncope on rising, and cardiac depression. See Heart/Generalities. [Hughes], [Boericke], [Clarke]
• Respiration. Sighing, stertorous or irregular breathing, oppression at night, threatened apnœa in sleep with sudden start and gasp. See Respiration/Sleep. [Clarke], [Hale]
• Skin. Urticaria, intolerable itching as if skin were scalded, eczema-like eruptions; worse warmth of bed and scratching. See Skin/Generalities. [Allen], [Clarke], [Boericke]
• Nervous system. Trembling, jactitation, choreiform twitchings during sleep; alternating excitement and depression; neuralgia of head/face with congestion. See Head/Extremities. [Allen], [Hering]
• Mind (toxic delirium). Hallucinations, fear, panic at night, delirium tremens; alternating laughter and tears; confusion on waking. See Mind. [Clarke], [Tyler]
• Gastro-intestinal mucosa. Nausea, vomiting, gastric burning in over-dosed states; appetite capricious; thirst for small sips in collapse. See Stomach. [Hughes], [Allen]

• Night, especially before midnight; on falling asleep (starts, terrors, dreams). [Allen], [Clarke]
• Warmth of bed and over-heating—itching and rash blaze up. [Boericke], [Allen]
• Emotional excitement, fright, alcohol; delirium tremens setting. [Clarke], [Hughes]
• Lying flat; respiration and heart feel oppressed; snoring with threatened apnœa. [Clarke]
• Sudden noises or light when dosing; precipitate startings and panic. [Allen]
• After overwork and long watching; neurasthenic insomnia. [Tyler], [Nash]
• Scratching—itching spreads; skin burns as if scalded. [Allen], [Boericke]
• Warm rooms, feather beds, close curtains. [Clarke]
• On rising suddenly—giddiness, faintness, irregular pulse. [Hughes], [Clarke]
• Suppression of eruptions—restlessness, insomnia, and heart symptoms intensify. [Clarke], [Farrington]

Sleep is craved and feared. The patient cannot get off though worn out; when he dozes he is thrust awake by startings, jerks, or images of terror (10b). Night terrors in children—screaming, cold sweat, staring with dilated pupils—are canonical; they do not know the persons near them for a minute or two, then subside into a brief sleep before repeating (Affinity; Mind). Dreams are horrid, grotesque, fiery, often of suffocation or falling; they cling into waking and leave a panicky heart. Snoring, halting breath, and sudden gasps point to the respiratory depression of the drug-state; lying flat is difficult, and the sufferer instinctively props the head (10b/10a). Skin itching wakes the patient repeatedly; the warmth of bed is intolerable, compelling him to uncover the head or seek the cool side of the pillow. The best sleep is towards morning after repeated brief dozes; it does not refresh, and the day begins with giddiness and languor. Regular timing and a cool, well-aired room improve the pattern, but any emotional disturbance at dusk threatens a relapse. The infant sleeper who screams, perspires, and then drops asleep with a sigh is a classic Chloral picture. [Allen], [Clarke], [Tyler], [Boericke]

No proven information

A neuro-vascular remedy marked by insomnia with fear, night terrors, startings on falling asleep, hot head with cold extremities, weak irregular pulse, sighing/irregular breathing, and itching skin that abhors warmth. Worse at night, before midnight, from warmth of bed, sudden noises/lights, emotional excitement, alcohol, overwork, and lying flat; better for cool air, cold sponging, uncovering the head, propped posture, quiet company, and small, regular sips/feeds (modality harmony). The organism oscillates between flush and faint; between images and blankness; cure is read in the lengthening of quiet sleep, disappearance of startings, cool head without chill, even pulse, and skin at peace. [Clarke], [Allen], [Hughes], [Boericke], [Farrington]

No proven information

No proven information

Congestive headaches with hot, flushed face and throbbing carotids; head feels heavy, bursting, especially frontal and temporal, with cold hands and feet (vaso-motor inversion). Motion, warm rooms, and mental exertion aggravate; cold applications, fresh air, and darkness relieve (10a/10b). The headache escorts the insomnia and itching, peaking at night, easing toward morning. Neuralgic streaks pass along the trigeminal branches during congestive flushes; the scalp feels tender and itchy; hair-brushing is disliked. In toxic states there is giddiness on rising, tendency to sway, and a sense of sinking at the occiput; eyes feel heavy and lids droop. Recovery of the head accompanies improvement in sleep and pulse steadiness; a relapse of heat/itch warns of a new restless night. [Clarke], [Allen], [Hughes], [Boericke]

Injected conjunctivæ, photophobia during headaches and after night terrors; lids heavy; vision blurred in the small hours with palpitating temples. Black specks on rising; flicker with giddiness; colours seem too bright after startings. Children stare wide, pupils dilated during terrors, then become drowsy and half-conscious as fear recedes. The eyes burn and smart from heat of room; cool sponging soothes. There is no granular catarrh—signs are vascular–neurotic rather than structural. [Allen], [Clarke], [Boericke]

Ringings with irregular pulse and head-congestion; hearing over-sharp during excitement, then dull with drowsiness. Sudden sounds when dosing precipitate startings and panic (10b). In delirious states noises are misinterpreted—the ticking clock becomes footsteps. Ears burn and feel hot to the touch while fingers are cold. Quiet and steady low sounds (fan) sometimes mask the over-irritability and permit brief sleep. [Allen], [Clarke]

Dry, hot nose during head flushes; sensitive to odours at night; sneezing fits with itching face/eyes. No constant coryza, but stuffy rooms oppress and provoke a desire for an open window. Occasional epistaxis with violent head-congestion in toxic states. [Allen], [Clarke]

Scarlet, suffused, or mottled, especially forehead and malar regions; sweat beads on the upper lip during terrors. Lips dry, sometimes blue in collapsic moments. Expression aghast during the start; vacant afterward. Pimply, urticarial, or eczematous eruptions may stud the cheeks; scratching excoriates. Colour improves as the heart steadies and skin cools. [Clarke], [Boericke], [Allen]

Dry mouth in the night; parched tongue with a white coat after bad nights; taste flat or metallic. Thirst in small sips accompanies faintness; large draughts disturb the stomach. Talking of the night’s images re-triggers fear; patient prefers silence and cool water held in the mouth. [Allen], [Hale], [Clarke]

Dry mouth in the night; parched tongue with a white coat after bad nights; taste flat or metallic. Thirst in small sips accompanies faintness; large draughts disturb the stomach. Talking of the night’s images re-triggers fear; patient prefers silence and cool water held in the mouth. [Allen], [Hale], [Clarke]

Dry, burning fauces on waking; voice hoarse from sighing and crying; swallowing momentarily quiets a panic by restoring breath rhythm. Throat symptoms are functional and track the vascular state more than catarrh. [Allen], [Clarke]

Oppression about the precordia; sighing respiration; snoring with sudden gasp and start from sleep. The chest feels too hot while hands are cold; loosening garments helps; propping the head relieves (10a). Palpitation accompanies panic; quiet and cool air soothe. [Clarke], [Boericke]

Weak, irregular, intermittent pulse; tendency to syncope on sitting up; precordial anxiety with dread of sleep (Heart ↔ Sleep). Flushes alternate with collapse; cold extremities despite a burning head. Cardiac steadiness returns as nights calm; relapse follows emotional evenings, alcohol, or over-warm rooms (10b). Compare Digitalis (slow, blue, motion-averse) and Camphora/Carbo veg. (collapse). [Hughes], [Boericke], [Clarke], [Nash]

Irregular, stertorous in heavy dozes; sudden stoppage with start and gasp; sighing frequent. Worse lying flat, in stuffy warmth; better head high, cool air (10a/10b). Fear of suffocation on dropping asleep is a leading complaint. [Clarke], [Hale], [Allen]

Nausea with faintness after a run of poor nights; occasional vomiting in toxic states; aversion to food but relief from small, frequent feedings (10a). Warm drinks may soothe, though many prefer cool sips for the hot head. Gastric burning accompanies anxiety; alcohol markedly aggravates insomnia and delirium. Appetite returns as sleep consolidates and itching abates. [Hughes], [Hale], [Clarke], [Nash]

Gut feels atonic; wind and uneasiness in wakeful nights; abdomen cool to touch when the head is hot (vaso-motor imbalance). Spasmodic belly-aches in frightened children during night terrors; stool irregular from sleep loss and worry. Improvement follows regular feeding-routine and cooler nights. [Allen], [Clarke]

Constipation from broken rest and nervous strain; stools dry, infrequent. In some, a loose, hurried morning stool follows a terrible night. Anal itching may accompany general pruritus; scratching aggravates. [Allen], [Boericke]

Constipation from broken rest and nervous strain; stools dry, infrequent. In some, a loose, hurried morning stool follows a terrible night. Anal itching may accompany general pruritus; scratching aggravates. [Allen], [Boericke]

No proven information

Sexual power depressed after sequences of bad nights; emissions with lascivious dreams in toxic states; not a primary sexual remedy. [Clarke]

Sexual power depressed after sequences of bad nights; emissions with lascivious dreams in toxic states; not a primary sexual remedy. [Clarke]

Aching between shoulders after tossing; small of back weak; chill runs along the spine at the start of a night terror, then heat in head. Rest and cool sponging relieve. [Allen], [Clarke]

Cold, damp hands and feet with hot head; trembling, twitchings and jactitations in half-sleep; choreic restlessness of legs at night. Cramps in calves toward morning. Better from uncovering, cool air, and stretching. [Allen], [Hering], [Boericke]

Urticaria, eczema-like irritation, and intolerable pruritus; feels as if scalded; worse warmth of bed and scratching, better cool applications (10a/10b). Hives rise with every heat-flush and vanish as the head cools; sleep is broken by itch-scratching cycles. Dermatitis may follow prolonged drug exposure; homœopathically it points the case when joined to the insomnia/night terror picture. [Allen], [Clarke], [Boericke]

Insomnia & Night Terrors

• Coffea — Mind over-active, delightful ideas, no fear; Chloral when sleep brings terror, startings, and panic. [Farrington], [Clarke]
• Opium — Profound sopor, stertor, insensibility; florid face; fewer itch/urticaria and less fear on falling asleep; Opium dreams are grandiose, Chloral’s horrid. [Kent], [Clarke]
• Stramonium — Night terrors with violence, loquacity, photophobia; more maniacal; Chloral quieter, panicky, pruritic, with weak pulse. [Farrington], [Tyler]
• Hyoscyamus — Jealous, obscene, twitching; insomnia from jealousy; Chloral from fearful images and vascular heat. [Kent]
• Gelsemium — Dullness, drowsy prostration; not picture of startings/terrible dreams; Chloral is hyperexcited yet sleepless. [Farrington]

Skin—Urticaria/Pruritus

• Apis — Burning/stinging, worse heat, oedema; mental part calmer; Chloral has night terrors + hot head. [Boericke]
• Urtica urens — Hives from shellfish/cold; lacks insomnia-fear axis. [Clarke]
• Rhus tox. — Restlessness, better motion, erysipeloid; Chloral restless from panic and itching in bed. [Boger]

Cardio-Respiratory Depression

• Digitalis — Slow pulse, must lie perfectly still, blue face; Chloral pulse irregular, mind fearful, itch prominent. [Nash], [Boericke]
• Camphora / Carbo vegetabilis — Collapse, icy coldness; Chloral has flush–faint alternation and night terrors. [Boericke], [Clarke]
• Amyl nitrosum — Sudden flushing, palpitation, hot head; less sleep/terror and itch than Chloral. [Clarke]

Delirium Tremens / Toxic Delirium

• Hyoscyamus / Stramonium — More talkative/violent; Chloral more panic + collapse with urticaria and hot head/cold limbs. [Farrington], [Tyler]
• Nux vomica — Sleepless from stimulants and business; irritable, chilly; lacks terrible dreams and skin heat-itch of Chloral. [Kent], [Clarke]

• Complementary: Gelsemium — after acute terrors subside, to steady the tremulous, drowsy convalescent. [Farrington]
• Complementary: Avena sativa / Passiflora — constitutional sleep organisers once Chloral breaks the panic-sleep cycle (supportive tradition). [Tyler], [Boericke]
• Compare: Opium, Coffea, Stramonium, Hyoscyamus, Nux, Apis, Urtica, Digitalis, Camphora — see Differentials. [Clarke], [Farrington], [Boericke]
• Follows well: Nux vomica in over-stimulated insomniacs when fear-on-sleep and itch remain. [Kent]
• Precedes well: Sulphur when chronic night itching and heat persist after sleep steadies. [Boericke]
• Antidotal/Practical: Avoid alcohol and over-warm rooms; keep head cool, air the room, and regularise hours to potentiate remedy action. [Clarke], [Boericke]

• Night terrors (children/adults) with startings on falling asleep; hot head, cold limbs. Cool room, uncover head, gentle reassurance; Chloral 30C–200C at dusk or in prodrome; space/stop as sleep consolidates. [Clarke], [Allen], [Tyler]
• Insomnia after overwork or fright; terrible dreams; panic at the threshold of sleep. Keep regular hours, avoid alcohol/warm rooms; Chloral in the evening for several nights then review. [Nash], [Boericke]
• Urticaria/pruritus worse warmth of bed with sleeplessness. Cool sponging, light covering; Chloral nocte; compare Apis/Urtica if hives dominate. [Allen], [Boericke], [Clarke]
  Case pearls:
  • Child wakes shrieking, knows no one, face scarlet, limbs cold; then sighs and sleeps. Chloral 200C nightly × 3 → terrors ceased; sleep quiet. [Tyler], [Clarke]
  • Student’s insomnia after cramming: on dozing, starts with gasp and horror vision; head hot, itch in bed. Chloral 30C at dusk × 5 nights; routine + cool room → steady sleep. [Allen], [Clarke]
  • Delirium tremens with fearful images, flushed face, weak irregular pulse; itching hives. Chloral 30C 2–3× daily with nursing; images faded, pulse steadied. [Clarke], [Hughes]

Mind

• Fear on falling asleep; starts up in terror. Core selection sign. [Allen], [Clarke]
• Night terrors; sees frightful images; recognises no one at first. Pathognomonic. [Tyler], [Clarke]
• Delirium tremens with panic, visions. Toxic–clinical sphere. [Clarke]
• Irritability from heat/itching; begs for cold. Vaso-cutaneous link. [Allen]
• Confusion on waking; memory slips. Post-paroxysm. [Allen]
• Dread of being alone at night. Consolation better. [Kent]

Sleep/Dreams

• Insomnia with cerebral excitement. Keynote. [Allen]
• Startings on going to sleep; jerks. Motor sign. [Allen]
• Dreams, frightful, of suffocation and falling. Content rubric. [Clarke]
• Snoring; breathing stops, then gasp and start. Apnœa-echo. [Clarke]
• Sleeplessness from itching, worse warmth of bed. Skin–sleep axis. [Boericke]
• Best sleep towards morning but unrefreshing. Pattern. [Allen]

Head

• Congestive headache with hot face, cold extremities. Vaso-motor inversion. [Clarke]
• Throbbing carotids; bursting sensation. Objective sign. [Allen]
• Headache worse warm rooms and motion; better cold applications. Modal map. [Boericke]
• Giddiness on rising, with faintness. Orthostatic weakness. [Hughes]
• Neuralgia with scalp tenderness during flushes. Pain type. [Allen]
• Wants head uncovered in bed. Behaviour. [Allen]

Heart/Respiration

• Pulse irregular, weak; syncope on rising. Cardiac depression. [Hughes], [Boericke]
• Precordial anxiety at night. Stage. [Clarke]
• Breathing stertorous; sighing; threatened apnœa in sleep. Respiratory signature. [Clarke], [Hale]
• Worse lying flat; better head high. Postural rubric. [Clarke]
• Flushes of heat alternating with faintness. Vaso-motor alternation. [Clarke]
• Oppression in close, warm rooms. Environment. [Clarke]

Skin

• Urticaria with intolerable itching, worse warmth of bed, scratching. Grand keynote. [Allen], [Boericke]
• Burning as if scalded; wants cold applications. Sensation. [Allen]
• Eczema-like eruption with insomnia. Terrain. [Clarke]
• Sweat with itching at night. Chronobiology. [Allen]
• Eruptions after drugging; suppression aggravates nerves. Causation. [Clarke]
• Face mottled/flushed with hives. Objective. [Clarke]

Generalities/Modalities

• Worse night, before midnight; warmth of bed; sudden noises; emotional excitement; alcohol; lying flat. Master aggravations. [Clarke], [Allen]
• Better cool air, cold sponging, uncovering head, propped posture, quiet company, small frequent sips. Master ameliorations. [Boericke], [Clarke]
• Cold extremities with hot head. Key polarity. [Allen]
• Jactitation, twitchings during sleep. Motor unrest. [Allen]
• Tendency to collapse; faintness on rising. Failure signs. [Hughes]
• Symptoms alternate: flush ↔ faint; image ↔ blank. Remedy dynamic. [Clarke]

Nervous System/Extremities

• Trembling from nervous excitement at night. Restless frame. [Allen]
• Choreic movements in half-sleep. Involuntary motions. [Hering]
• Cramps in calves toward morning. End-of-night sign. [Allen]
• Cold, damp hands and feet in bed. Peripheral clue. [Allen]
• Startling from slight sound/light while dosing. Trigger. [Allen]
• Weakness after bad nights; staggers on rising. Outcome marker. [Clarke]

Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): full drug picture—insomnia/terrors, hot head–cold limbs, irregular pulse, urticaria; modalities and clinical states (delirium tremens).
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): provings—startings, frightful dreams, night terrors, jactitation, headaches, pruritus; sleep/skin rubrics.
Hughes, R. — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology—cardiac/respiratory depression, vaso-motor effects, collapse; gastric irritation.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—insomnia with fear, urticaria worse warmth of bed, hot head, cool applications, weak irregular pulse.
Hale, E. M. — New Remedies: Clinical and Pharmacological (1864–1891): clinical use in delirium tremens, insomnia; respiratory oppression; supportive nursing measures.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): confirmations—choreiform jactitations, night terrors in children; generalities.
Farrington, E. A. — Clinical Materia Medica (1887): comparisons—Opium, Coffea, Stramonium, Hyoscyamus, Digitalis; selection by fear-on-sleep vs stupor vs over-excitement.
Kent, J. T. — Lectures on Materia Medica (1905): miasmatic colour; mental differentials (fear at night, desire for company) and contrasts with Nux/Opium.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): practical guidance for neurasthenic insomnia, small feedings, and collapse management.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): vivid cases of night terrors and Chloral insomnia; paediatric notes.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modalities (warmth of bed <, cold sponging >), environment, and generalities.
Phatak, S. R. — Concise Materia Medica (1977): condensed keynotes—night terrors, startings, hot head, urticaria with heat; clinical pointers.