MR W RIGDEN, Physician’s Assistant at University College Hospital, sent these notes on a patient under Dr Russell Reynolds in which chloral was used to treat delirium tremens.

Clergyman aged 40, unhappy with his wife

A clergyman, aged 40, has been a drunkard for years, but worse since his marriage three and a half years ago to a woman beneath him in station, and with whom he does not seem to have got on well.  He has been in the habit of taking all kinds of drinks and has had delirium tremens several times, the last bad attack being a little more than a year ago. Sometimes he has gone for six months without taking any drink. His father died of paralysis from disease of the brain. The history of insanity is uncertain.

On May 3rd, 1870, having been pretty steady for six months, he began to drink, brandy especially, and on May 8th he had become so violent that the doctor in attendance placed a keeper over him; he still continued to take some beer and brandy.

May 11th  When he was admitted, the keeper said he had not slept for a week till the night before, when the doctor  gave him a dose of a new medicine (probably chloral), and he had seven hours’ sleep.  He had been very tremulous; taken very little food; very violent at times, especially on seeing his wife.

On admission his tongue was a little coated, slightly tremulous; there was slight tremor of arms; pulse was a little over 100, moderately full. He complained a great deal of his wife, whom he threatened to kill, and of his being detained at the hospital.

He  was ordered good diet; 30 grains of chloral at bed-tme, and of haust. domest. the first thing in the morning.

May 12th He went to sleep immediately after the chloral, and slept for three hours, when he was awoke by a noise in the ward, and after being awake for an hour the dose was repeated, with the result of sending him to sleep immediately. The house medicine has acted freely. Patient is this morning pure and rational; complains of no headache, only a sense of faintness and weariness; pulse 88, moderately full; appetite very defective.

May 14th  Is quite well; takes his food well; being inclined to be restless at night, be has had chloral repeated every night. Discharged.