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]

Historically used by allopaths as a narcosis-inducing hypnotic and anticonvulsant; overuse/poisoning produces collapse, delirium, dermatitis/urticaria, and idiosyncratic nightmare-states—toxicodynamics that prefigure the homœopathic indications. [Hughes], [Hale], [Clarke]

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]

• 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]

• Cold applications/air to the hot head and pruritic skin; cool room improves sleep. [Clarke], [Boericke]
• Propped-up posture in bed; head high for breath and heart comfort. [Clarke]
• Gentle persuasion/soothing company in night terrors and delirium tremens. [Tyler], [Clarke]
• Quiet, darkened room (after the start of the attack) to reduce sensory storms. [Allen], [Clarke]
• Slow, steady sips (warm or neutral) in faintness; small, frequent nutrition. [Hale], [Nash]
• After a brief doze once the terrors pass; short naps restore tone. [Clarke]
• Cool sponging for flushes and itching. [Boericke]
• Uncovering the hot head while keeping limbs lightly covered. [Allen]
• Regular routine (fixed times for bed/food) eases recurrent insomnia. [Farrington]
• Open window at night if not draughting directly on the patient. [Clarke]

• 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]

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]

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]

• 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.