Kalium bromatum

Volume I — Special Symptomatology

Pharmacology. — This Salt is prepared by adding a solution of pure carbonate of potassa to a solution of bromide of iron. The iron is pre cipitated and the bromide of potassium remains in solution, from "which it is obtained by evaporating. It forms white, pearly, transparent crystals. They are without smell, and have a sharp saline taste resembling that of common salt, but more pungent. They are unchanged by exposure to the air, and precipitate when heated. It is wholly soluble in water, but sparingly in alcohol.

Officinal Preparations.— Aqueous tincture, ( 3 i to 3 ix,) dilutions to the 3 x in dilute alcohol: Triturations in pure sugar of milk.

Analogues : — Bromides of Ammonium, Sodium, Lithium; Gelseminum, Conium, Chloral, etc.

Mind.

.Remarkable slowness of speech, and difficulty of collecting the ideas, and expressing them. (Turnbull.)

• Profound melancholic delusions. (Dr. Wm. A. Hammond.)

He imagined that he had been specially singled out for Divine vengeance, and he spent the greater part of the evening in loudly deploring his sad fate, — falling suddenly asleep at intervals of a few minutes. (Ib.)

He walked the room, groaning and wringing his hands; he thought he had been accused of robbing a friend, and that the officers were in search of him; with unsteady gait; hands and fingers in constant action; face pale and' pupils contracted. (Ib.)

Loss of memory. He forgot how to talk; for instance, when asked what made him take so large a dose (sixty grs.) he was fully two minutes endeavoring to form a reply, and then was obliged to give up the attempt, with the remark " I can't." (Ib.)

Amnesic aphasia, — there was no difficulty of co-ordinating the movements of the tongue, so as to articulate distinctly any word he was told to pronounce. (Ib.)

Gloomy ideas relative to his present and future condition, with weeping, moaning, and wringing of hands. {Ib.)

She fancied the boarders in the hotel insulted her. ( Van Beren.)

Imagined the weekly bills of the landlord were the evidences of a conspiracy got up against her father. {Ib.)

While standing on the guards of the boat she suddenly gave a loud shriek, and declared she had seen her brother fall overboard. (Ib-)

Profound depression of spirits, with melancholy delusions. {Ib.)

She is very absent-minded, low-spirited and childish. {Hammond.)

Mental depression, with feeling of approaching death and

great weakness. {Thomas.) Feebleness of intelligence. {Pletzer.)

Decided lack of will and mental activity. {Brown Sequard.) 0 liemoves the delusions during and after delirium tremens. {Begbie.)

0 Acute mania, with fullness of the blood-vessels of the brain. {Ib.)

0 Frightful imaginings at night (in pregnant women during the latter months); they are under the impression that they have committed, or about to commit, some great crime and cruelty, such as murdering their children or husbands. {Ringer.)

c Night terrors of children, (not from indigestion,) with screaming, unconsciousness of what is occurring around them ; cannot recognize, nor be comforted by their friends; sometimes followed by squinting. {Ringer.)

° Somnambulism in children. {Ib.)

° She is very fretful, crying at trifles, constantly brooding over the loss of a daughter; is almost crazy. From fretting, loss of rest, and want of nourishment, is seized with nervous dysentery. Cured by Bromide of Potassium^ seven grains, every two hours. {Caro.)

° Spasms, from emotional or moral disturbances. {Browne.)

° Puerperal mania. {Hale.)

mania as in the " nervousness " which precedes it. (Begbie.) " Great despondency — in men and women, — they " feel as if

they should go out of their minds." [Ringer.) *Deep depression, with painful delusions, with persistent

sleeplessness, and dread of impending destruction of all

near to her. (Begbie, Wesselhceft.) Insanity, disappearing on suspending the use of the drug.

(Hammond.)

Delusions that lewd women had got into his mother's house. He imagined he was pursued by the police. (Ib.) He imagined his life was threatened by members of his family. (Ib.)

He believed he had thousands of dollars sewed up in his clothing. (Ib.)

He appeared like a drunken man, except that his face was very pale,:, pulse sixty, skin cool, and pupils contracted, (-lb.)

Manner exciting and rambling; his hands constantly busy, either fumbling in his pockets, tying his shoes, picking threads from his clothing, or in searching for the gold which he imagined was concealed in the lining of his coat. (Ib.)

His character had undergone a radical change; from having been frank and brave, he had become excessively timid and suspicious of every trifling circumstance. (Ib.)

He several times attempted to throw himself from the window, and battered down a door with an axe, in order to escape from some imaginary danger. (Ib.)

Her memory was absolutely destroyed; she could not recollect the simplest things, and even forgot her own name and that of her husband, though reminded of both an instant before. (Ib.)

Frequently she would burst into tears for no cause whatever,

and often from purely imaginary causes. (Ib.) Incoherent, full of delusions, of no fixed character, and Remarkably depressed in sp/irits. (Ib.)

(This was the most prominent symptom.) She had the erroneous idea that she was deserted by all her

friends, and as a consequence, she passed all her waking moments, which were not many, in tears. (Ib.)

A fixed delusion that her child was dead; she declared she saw it dead before her; and when it was brought to her, she refused to acknowledge that it was hers, or had any resemblance to the one she imagined was dead. (lb.)

Most intense melancholy, attended with fits of uncontrollable weeping, in a man. (Ib.)

Positive delusions of various kinds.

Brain.

It lessens the amount of blood circulating within the cranium and produces a shrinking of the brain from this cause. (Hammond.)

Heaviness of the head, with confusion of the head. (Pletzer.) In a case of epilepsy, caused by cerebral-anaemia, each dose of

20 grs. caused an attack. (Hammond.) Vertigo, both slight and extreme, with dullness ot the head.

(Noac.)

Drooping of the head; difficulty of holding it erect (Brown Sequard.)

0 The flushed face, the throbbing of the carotids and temporals, the suffusion of the eyes, the feeling of fullness of the head, all disappear, as if by magic, under its use. (Hammond.)

0 Violent headache, from concussion of the brain. (Ib.) 0 Mercurial headache. (Roberteau.)

° Convulsions — during acute meningitis, after the inflamation

has declined, leaving serious damage. (Ringer, Hale.) 0 Delirium tremens; it relieves the delirium (not furious)

removes the delusion, and produces sleep. (Begbie, Hale.) 0 Bad results from overtaxing the brain by intense study; too

close attention to business; grief; anxiety. (Ib.) ° Calms excitement, removes the giddiness, noises in the ears,

and perversions of the external senses from diseases of

the brain. (Ib.) ' Cerebral irritations during cholera infantum; pupils dilated,

eyes sunken, eyeballs moving in every direction without

taking any notice; feet and hands blue and cold; pulse

imperceptible. Fifty cases treated — no deaths. Dose one-half grain every hour. (Dr. Caro.)

°Head hot, feel as if in a furnace, with coldness and chills, etc., etc. See " Abdomen." (Caro.)

° A feeling of " lightness " and exhilaration takes the place of heaviness and depression. (Simpson.)

° Incipient basilar meningitis. A delicate thin female child aged five years, had complained for several weeks of severe headache, nearly all the time, worse at night. She would play a few minutes with other children, then lie her head down on a chair or other support, and cry with the headache. She grew weak, emaciated, dull, heavy-eyed; had no appetite; did not sleep well nights; when sleeping it was disturbed by groans, grinding of the teeth, starting up as if frightened; complains of terrible headache; tongue clean; pulse 90 to 100, quick and wiry; constipation; scanty urine, and too much heat about the head. A careful homceopathist had given Belladonna, Hyociamus, Cina, Bryonia, and other apparently well chosen remedies, without effect. I at first gave Belladonna, 200, then Sulphur, 200th, which mitigated the pain a short time. Agaricus 3d was tried without much effect. Finally Kali brom. one-half grain every three hours for a few days, — no perceptible improvement; then one grain every three hours, when decided improvement in all respects set in, and in three weeks she was quite well. As soon as decided improvement occurred the medicine was given at longer intervals. (Hale.)

Eyes.

Sight impaired, weak vision, with greatly contracted pupils.

Diminution of sensibility in the occular conjunctiva, so that the finger may be passed with impunity over the surface of the eyeball without causing winking. (Turnbull.)

Weak sight, with intoxication and deafness. (Stille.)

Dilated pupils, with extreme vertigo and confusion of the head. (Hering.)

Pupils prominent. (Noac.)

Pupils dilated, and contract very sluggishly under the influence of a very strong light. (Turnbull.) Lusterless eyes. (Baziro.)

0 Squinting, after night-terrors of children. {Ringer.) 0 Dilated pupils and sunken eyes (in cholera infantum.) (Caro.)

° Eyeballs moving in every direction, (lb.) 0 Photophobia (as a collyrium, 2 parts to 30 of water.) (Cambron and Rosignol.)

Ears.

Diminution of hearing. (Hammond.) ° Pinging in the ears. (Begbie.)

Nose.

° Erythematous swelling of the nose.

Mouth — Tongue— Fauces. Loss ot speech. Amnesic aphasia. (Hammond.) Much difficulty in talking. (Ib.)

Slight redness of the buccal and pharyngeal mucous membranes. (Pletzer.)

Slight tracheal and bronchial catarrh. (Ib.)

The fauces do not contract when touched, tickled, or even cut with instruments. (Ib.)

0 Tongue pale and cold. (Ib.)

0 Tongue red and dry (in cholera infantum.) (Ib.)

0 Infants are choked every time they attempt to drink fluids, although they can swallow solids without difficulty, — no malformation of the throat. (Ringer.)

0 Hot, dry mouths of teething infants. (Caro.)

Face.

A papular rash on face and nose, with heat and itching. (Mc- Gregor?)

Successive crops of small boils in the face, with troublesome

itching. (Bazire.) Acne-like eruption on the face, neck and shoulders. (Brown

Sequard.) 0 Expressionless face. (Bazire.) ° Acne, in young persons. (Hale.)

Jaws and Teeth. 0 Difficult dentition of children. (Caro.) (See Brom. Calc.)

1VJ

° Odontitis in children. " I have never failed to relieve the

child by its local application." (-To.) "After the first rubbing on, the gums, from being turgid,

swollen, and red, they assume their natural color, and a

certain amount of ease is felt. {Ib.) ° The salivary secretion is restored (in teething children), and

as if by enchantment, agitation, carpopedal involuntary

motion, vomiting, and looseness of the bowels disappear.

{lb.)

Mouth.

Irritation of the mucous membrane of the mouth and fauces, painfulness of the tongue, prominent pupils, rough and burning sensations in the whole buccal cavity as if burnt with caustic. (Noac.)

Increased secretion of saliva and mucus, (lb.)

Short-lasting titillation in the fauces. {Ib-)

A state of insensibility of the larynx and palate,' the fingers may be carried to the base of the tongue, touch the amygdalae and posterior nares, d-nd tickle the uvula, without inducing any effort at vomiting or deglutition. {Euett.)

° .Restoration of the suppressed salivation in teething children.

{Caro.) * * Foetid breath; a peculiar sickening odor. {Hale.) White tongue, involving the edges as well as the dorsum, and

not necessarily furred, with great languor, sleepiness, and

anorexia. {Ib.)

Gastric Symptoms.

Increased appetite. {Noac.) Thirst in the afternoon. {Ib.) Repeated repulsive eructations. {Ib.)

Violent nausea and efforts to vomit, with vomiting of a small

quantity of mucus, with salt taste in the mouth. {Ib.) ° Troublesome pressure at the stomach after dinner. {Ilering.) ° Loss of appetite. {Noac.)

Liver.

0 Enlargement of the liver; under the use of half a grain three times a day, the belly rapidly assumes the natural size.

{Magendie.)

Stomach.

Slight catarrh of the stomach. (Pletzer?)

Peculiar pressure in the region of the stomach, succeeded by

violent colic. (Hering.) Weakness of the stomach, for some time, (lb.) ° Vomiting when the ganglionic system is affected. (Begbie.) 0 Vomiting during pregnancy. (Cersoy, Hale.) ° Vomiting in whooping cough. (Dr. Bearfoot.) ° Vomiting of meconium. (Caro.) 0 Vomiting, with intense thirst. (Ib.) ° Vomiting of drunkards after a debauch. (Hale.) ° Chronic morning vomiting of drunkards. (Ib.) ° Vomiting, diarrhoea, cramps, coldness and collapse in cholera

infantum. (Ib.) ° Vomiting with diarrhoea of teething children. (Caro.) 0 Cholera infantum, — many cases (160 cases treated); only

three deaths. (Ib.)

Spleen.

° Enlargement of the spleen.

° Small tumor in the region of the spleen. (Turnbull.)

Abdomen. 0 Ascites of hepatic or splenic origin. ° Constipation of years continuance. (Hale.) Obstinate constipation. (Pletzer.)

Sensation of warmth in the abdomen. (Heimer dinger.)

Flatulence; frequent rumbling. (Ib.)

Frequent soft stools, preceded by colic. (Ib.)

Several papescent and afterward liquid stools. (Ib.)

° Bloody muco-purulent diarrhoea, with intense thirst, vomiting, eyes sunken, pupils dilated, skin corrugated and spotted blue, body cold, tongue red and dry, pulse imperceptible, urine suppressed. (Caro.)

0 Colic in young children; the walls of the belly are retracted and hard, while the intestines can be seen at one spot contracted into a hard, lump, of the size of a small orange, and the contraction can be seen through the abdominal wall to travel from one part of the intestines to another; these attacks are frequent and excruciating;

are unconnected with diarrhoea or constipation, but are often associated with an apthous condition of the mouth. {Ringer, Hale.)

0 Periodic colic, in infants, occurring about 5 p. m. every evening, with the above symptoms. {Hale.)

0 Abdomen sunken, almost stuck to the vertebral column, in cholera infantum. {Caro.)

0 Retention of meconium, with vomiting of all food, and obstinate constipation; in a child three days old, cured by 1-50 of a grain every hour. (Caro.)

° Painless diarrhoea, fifteen or twenty passages in twenty-four hours, with great chilliness, even in a hot room; burning in the chest; abdomen cold internally; pulse one hundred, weak; urine scanty, dribbling a few drops at start. "At every evacuation felt as if my intestines were sinking from me. I was restless and shaky as if from palsy." Dose five grains; after the second dose fell asleep for six hours, perspiring profusely. {Caro.)

0 Summer complaint, or cholera infantum, is not an inflammatory affection, but arises from an over excitement of the nervous and vascular systems, and therefore the b. of p. is a specific. {H>.)

° Asiatic cholera, in the first stage, arrests the vomiting, the cramps, and the rice-water discharges; restores the secretion of urine; the warmth and color to the previously cold and livid skin. (Dose twenty grains every hour.) Its use should be suspended when reaction or fever sets in. {Begbie.)

0 Discharge of a considerable quantity}' of tar-like substance (decomposed blood), having a foetid smell; accompanied with tenesmus in animals. {Noac.)

° Spasmodic stricture of the sphincter ani. {Horn. World.) Sexual Organs. (Men.)

Diminution of sexual desire. {Huett et al.)

Absence of sexual desire, with impotence. {Ib.)

Semen is not secreted. {Pfeiffer.)

0 Nocturnal emissions , with amorous dreams and erections.

{Hale.)

0 Chordee, during gonorrhoea. {Ib-) 0 Satyriasis. (Thiallman.)

° Sensual and lascivious fancies and dreams. (Hale.)

The anaphrodisiac power of the b. of p. is due to contraction

of minute afferent vessels of the corpus cavernosus.

(Pelvet.)

Sexual Organs. (Women.)

Abolition of all sexual feelings. (Hale.)

Loss of enjoyment during coition. (Ib.)

0 Nymphomania. (Hale, Couch, Hammond, et al.)

0 Excessive sexual desires during the menses. (Hale.)

° Erotomania, a few days after the menses. (Ib.)

° Nymphomania during the puerperal state. (Ib.)

6 Voluptuous itching, tingling and irritation in the external

genital organs. (Ib.) 0 Epilepsy from ovarian irritation.

0 Epileptic attacks at or near the menstrual periods. (Lay cock.)

0 Enlargement of the uterus ("sub-involution") after parturition, with abnormal discharges. (Simpson.)

° Diminished the size and alleviates the pain in fibrous tumors of uterus. (Ib.)

0 Menstrual ailments. Before the menses: headache; during the menses: epileptic spasms, nymphomania, itching, burning and excitement in the vulva, pudenda and clitoris; after the menses: headache, insomnia, and heat in the genitals. (Hale.)

0 Metrorrhagia from reflex irritation, or of nervous origin. (Ib.)

0 Menorrhagia at the climacteric period. (Garrod.)

0 Sterility from excessive sexual indulgence. (Hale.)

The menses are more scanty.

Urinary Organs.

In a few cases the urine contained albumen. (Pletzer.)

Pain in the region of the kidneys, spreading in the direction of the colon ascendens; afterwards copious secretion of urine. (Noac.)

Diminution of the sensibility of the urethra. (Caro.)

Profuse urination, with thirst. (Hering.)

Thin, yellowish- white, copious urine. (Heimerdinger.)

Pale, thin urine, having a peculiar foetid smell. (HFoac.)

Diminished secretion of urine. (75.)

° Convulsions from Bright’s disease.

0 Abnormal irritability of the urinary passages. (Ib.)

° Nocturnal involuntary emissions of urine. (Hewson.)

° Suppression of urine in cholera infantum. (Caro.)

° Diabetes millitus. (Two cases.) Symptoms: emaciation; paleness; skin cold and dry; pulse rapid and feeble; tongue red and tender; gums spongy and bleeding; thirst excessive; appetite voracious; bowels constipated; urine pale, frequent, large quantity, of high density, and loaded with sugar; liver tumid and tender. (Twenty grs. b. of p. three times a day.) All the symptoms disappeared in six weeks; no relapse. (Begbie.)

° .Neuralgia of the neck of the bladder. (Pfeiffer.)

0 Spasmodic affections of the neck of the bladder. (Hale.)

° [The b. of p. is found in the urine two weeks, even four weeks, after it was taken in an animal.] (Boberteau.) Larynx.

Loss of sensibility in the larynx.

Hoarseness, extremely painful and disagreeable. (Hering.)

Hacking cough, with dullness and confusion of the head. (Ib.)

0 Hyperesthesia of the laryngeal nerves. (Jfayhofer.)

0 Whooping -cough, uncomplicated by other affections.

° Laryngismus stridulus, uncomplicated. (Mayhofer.)

0 Diphtheria, with quick pulse; fever; dry tongue; offensive

breath; highly injected and dusky-red fauces; with

patches of wash-leather exudation on tonsils or pharynx.

(Snelling, Belcher.) 0 Follicular and catarrhal laryngitis. (Mayhofer, of Nice.) 0 Membranous croup, with whitish exudation. [Kali bich.,

when yellow.] (Tb.) [A solution of b. of p. dissolves false membranes.] (Laboulbene.)

4 Whooping-cough — the spasmodic action disappears in about

five days, leaving a simple bronchial catarrh. It removes the anxiety and the vomiting; improves the appetite, and increases the strength. {De Beat/fort.)

8 Nervous cough during pregnancy, threatening abortion; the cough was dry, hard and almost incessant. Auscultation or percussion gave no evidence of disease of the head or lungs. Opium, Belladonna, etc., were tried for two months, without benefit. Bromide of Potassium, thirty grains a day, cured in two days. {Dr. Cerson.)

° Spasmodic croup, as the chief remedy, almost to the exclusion of other articles. {Dr. G. T. Elliot, Hale.) Chest,

Slight bronchial catarrh. {Pletzer.) Tightness of breathing. {JVoac.)

Violent congestion of blood to the respiratory organs, occasioning spitting of blood.

° Asthma of a nervous origin. {Begbie.)

° Breath hot and hurried, with burning in the chest. {Caro.)

J Breathlessness, with nervous headache, and want of sleep, {Begbie.)

° Spasmodic asthma of children. In one case, great dyspnoea, no sleep, urine suppressed, general oedema, six grains every two hours; remarkable improvement now set in; the dyspnoea subsided; the lividity of the face and oedema disappeared, secretion of urine returned, and sleep was obtained; cured in seven days. In another case the result was similar. It did no good in old asthmatics. {Hebr.) Browne.)

" The respirations are affected in a secondary manner only." It appears to be influenced only mechanically, that is to say, its muscles are paralyzed, like the other muscles, more or less rapidly; early in frogs, and at the moment of death in birds and rabbits. {Demourette and Pelvet.) Lower Extremities.

Debility of lower limbs; step tremulous and uncertain. {Stille.)

Loss of sensibility in lower limbs; pinching and burning causes no pain. {Pache.)

Extremities cold, pulse slow and very weak. (Turnbull.)

° Legs and feet cold and blue, and on being touched would leave the white impress of the fingers for more than twenty-five seconds, — in cholera infantum. (Caro.) Sleep.

Extreme drowsiness. Tendency to coma. {Hammond et al.) She slept all night, and would often fall asleep in her chair,

and in most uncomfortable positions. (Ib.) He falls suddenly asleep at intervals of a few minutes. (Ib.) A kind of stupor resembling that of the first stages of typhoid

fever. (Bazire.) ° Deep, profound and quick slumber, (from twenty to thirty

grains). (Hammond.) ° Obstinate insomnia, in case of mercurial poisoning. (Rob.

erteau.)

0 Sleeplessness during convalescence from acute diseases. (Begbie.)

0 Night terrors of children; horrible dreams. (Ib.) 0 Waking with severe headache, in a child. (Hale.) ° Grinding of the teeth during sleep, with moans and cries.

Skin.

An elevated, dark red eruption made its appearance on the right elbow, from which it diffused itself over the whole body, rapidly becoming pustular. The pustules were very numerous, isolated, distended with pus, and frequently cupped, so as to present a very fair counterfeit of the eruption in discrete variola. They were generally somewhat oval in outline, and varied from two to four lines in their longest diameter. When maturation had taken place there was no apparent base nor areola, and the intervening skin was healthy. If not interfered with desiccation followed, and scabs were formed and thrown off, and leaving the integument beneath reddened but sound. The pustules continued to appear for four or five weeks; the discoloration of the skin, however, remained for as many months. (Dr. J. C. Merrill.)

An eruption similar to discrete variola; a dark red elevated eruption, rapidly becoming pustular; pustules very numerous, isolated, distended with pus, often cup shaped.

Heart and Pulse.

The minute blood-vessels contract immediately in the region of injection, and later throughout the organism, and the contraction is succeeded by dilation. {Pelvet.)

The heart alone survives many hours (in animals); when it stops, its irritability can be again aroused for some instants, to disappear at last totally. But from the commencement of the physiological or toxic action, the capillary circulation is diminished, and the pulsations of the heart are retarded. {Damoeyette and Pelvet.)

° Pulse imperceptible, with coldness and collapse. (Caro.)

° Pulse 100, weak. Pulse 50, small and feeble. (lb.)

° Neuroses of the heart. (Hale.)

° It has a sedative effect upon the action of the heart. Temperature.

The temperature of the body was reduced one or two degrees centigrade. (Pletzer.)

The temperature is sensibly lessened in warm-blooded animals first, and during many hours in the region injected, and afterwards throughout the organism. The phenomena depends upon the diminution of the capillary circulation, at first local, afterwards general.

° Body cold; skin corrugated and mottled. (Caro.)

"Shivering with cold, and cold skin, although the child was covered with mustard plasters. (Ib-) Generalities.

The gait became staggering; false steps became frequent. Weakness of the muscles of the arms — but no vertigo. (Pletzer.) It paralyzes the nerves of the spinal cord. (lb.) Intoxication, with loss of sight and hearing. (Stille.) * Epilepsy from large doses in a case of cerebral anaemia. (Hammond.)

Unsteadiness of gait; he was frequently taken for a drunken man ; was once arrested for supposed drunkenness. (Hammond.)

Well marked numbness throughout the body, and very decided diminution of sensibility.

Almost constant twitching of the fingers and a busy occupation of them in matters of no importance.

Unable to stand or walk; face ashy pale; pupils contracted;

loss of memory. Great weakness of the extensors of the

legs and feet. Vertigo, fainting and nausea.

Very emaciated, weak, and of a peculiar pallid color. [Turnbull.)

As an agent for lessening reflex excitability, exceeds all other remedies. (Pletzer.)

0 Neuroses involving the brain and accompanied by convulsions. (Ib.)

° Mercurial trembling. (Roberteau.)

° Lead poisoning. (Ib.)

0 Infantile convulsions, during teetl ing, whooping cough or laryngismus stridulus. Spasm of the glottis; it prevents the recurrence of the spasms. {Ringer, Hale.)

• Epilepsy, chiefly grand mal; rarely useful in petit mal.

Restless and shaky, as if from palsy. (Caro.)

It diminishes the abnormal vascularity of the great nervous centres.

Temperature.

The temperature of the body was reduced one or two degrees centigrade. (Pletzer.)

The temperature is sensibly lessened in warm-blooded animals first, and during many hours in the region injected, and afterwards throughout the organism. The phenomena depends upon the diminution of the capillary circulation, at first local, afterwards general.

° Body cold; skin corrugated and mottled. (Caro.)

° Shivering with cold, and cold skin, although the child was covered with mustard plasters. (Ib.)

It mitigates those convulsive movements and spasmodic twitchings, which are the results of the rapid conversion of sensory impressions, or of morbid reflex action through the medulla oblongata. (C. Browne.)

0 Quotidian ague after quinine had been given for two weeks without result. " The sweating stage was unusually protracted and exhausting." "A full dose every three hours during a remission, cured." (Begbie.)

• It removes pathological deposits of fatty matter only, while

the iodide removes normal adipose matter. {Simpson.)

It diminishes the reflex excitability of the nervous centres. {Brown Sequard.) The functions of organic life are not disturbed. {Huett.)

° Epilepsy — especially occurring at or near the menses. {Laycock.)

Epilepsy may be arrested by it, but returns when this drug

is suspended. {Bamshill.) Paralysis agitans. {Hammond?)

° Trembling sensation throughout the whole body. {Hale?)

° Tetanus; a boy 15 years old, from suppuration of finger nail and exposure to cold by sleeping on the grass. Attacked October 8th. Discharged September 10th. Dose 20 grs. every two hours nearly all the time. A few days took 20 grs. every hour. {R. Browne.)

0 Chorea in a female. The tongue protruded with a jerk; muscles of the face, right arm and legs in constant jactitation, quite violent. Eight grains every three hours; cured in two days. {Br. Hume.)

° Chorea in a female, of several weeks. Unable to dress herself or work, and could hardly speak. Face, arm and leg of right side affected. Ten grains every four hours cured her in three days. {Br. Hume.)

• /Symptoms from an affection of vaso-motor nerves, namely:

i. Occasional sudden paroxysmal feeling of "numbness," a

term employed by some to denote the sensation of " pins and needles; " by others that of "deadness " and " weakness," and by a third group an " indescribable feeling of something wrong."

ii. A feeling of " largeness," or "as if the limb were swollen,"

there being at the time of its occurrence no change in the

size of the extremity, in. The occurrence of " aching," of " uneasiness," or of actual

" pain," the latter not very severe, rv. The feeling of " coldness," and occasionally, the obvious

fact of coldness.

v. The fact of sudden "weakness," sometimes termed a "paralyzed " feeling; the patient being unable to retain the grasp of an object, and hastily putting it down, or allowing it to fall. At such times the muscles do not respond readily to the will; the co-ordination of movement is defective. Such acts as writing or needle-work have to be discontinued, and generally such patients rub the limbs by, as it would seem, an almost instinctive impulse.

vi. The occurrence of sensations allied to cramp, or that of

actual cramp, with varying amounts of pain. (J. Russell Reynolds.)

[Aconite, Gelseminum, Platinum, Pulsatilla, Lycopodium, Veratrum album, and Calcarea carb. have many of the above symptoms. (Hale.)']

" The symptoms due to large doses of the Bromide of Potassium may be stated as follows, in the usual order of their occurrence:

1. Contraction of the pupils. 2. Drowsiness. 3. "Weakness of the arms and legs. 4. Depression of mind. 5. Failure of memory. 6. Delusions.

The first three of these are, I think, usual accompaniments of an active dose of the medicine. They simply show a sedative effect due to cerebral anaemia. In adults they never follow a less dose than ten grains. Doses of five grains produce no obvious effects. No permanent difficulty results from very large doses." (Hamm.ond.)

Dr. Hammond asserts that to a condition of cerebral anaemia most of the obvious phenomena which follow its administration should be ascribed.

Volume II — Special Therapeutics

This was the first preparation of the Bromides which was presented to the profession. It has been most extensively used and its effects recorded with greater minuteness than any other. Of late, however, the Bromide of sodium, owing to its less irritating effects on mucous surfaces, its pleasanter taste, and some other qualities, is considered preferable. In fact, I think for the most purposes the Sodium salt may be used as a substitute for the Potassium.

The pathogenetic and physiological action of the latter has been so well studied that we may safely allow it a place among our best proven medicines. Already it has been prescribed successfully for its direct primary effects by several physicians of our practice.

No physician can read of its effect upon the mind without being convinced of its great power in causing abnormal conditions of the brain and mind.

It is supposed that the uniform pathological condition caused by its direct effects in large doses is cerebral ancemia. If this condition is kept up, we have deficient nutrition. If the brain has been already diseased, structural or functional disease may become permanent — fixed by its primary or secondary action.

The most prominent, unvarying symptoms of the brain and mind caused by this drug are :

(1.) Profound melancholic delusions, either a religious depression or a feeling of moral deficiency.

(2.) Loss of memory, absent-mindedness, he forgets howto talk, slowness of ideas.

(3.) Delusions of conspiracies against him.

(4.) Illusions, as that of seeing her brother fall overboard.

(5.) Amnesic aphasia ; he could pronounce any word he was told to, but could not speak otherwise.

It does not cause melancholy with belief in approaching poverty and want, but the contrary; a belief that “ thousands of dollars are sewed up in his clothing/’ or that “gold was concealed in the lining of his coat.”

These profound melancholic and other illusions were all caused by massive doses. If, therefore, this medicine is prescribed for the symptoms enumerated as primarily pathogenetic — e. g., mental depression from cerebral anaemia or exhaustion — it must be given in minute doses, 3* to 6*.

Dr. Wesselhoeft, of Boston, and myself have prescribed it successfully in such cases after Cimicifuga, Sulphur, and Veratrum failed.

The secondary pathogenetic effects of large doses are sometimes quite serious. It has been observed that when doses of 40 to 60 grains, several times a day, have been suddenly suspended, one of two conditions sets in : (1) a condition of cerebral irritation, (2) cerebral congestion. In cases of post-mortem of animals to which the Bromide had been given in massive doses, intense congestion of the brain and its meninges were found. This proves that the secondary action of the Bromides is to cause that condition for which it is given successfully. It is, therefore, homoeopathic in rational doses (1 to 20 grains) in cases of cerebral irritation and congestion.

I have collected numerous cures of such cases and recorded them in “New Remedies,” 4th edition, but will here briefly enumerate them, and will add that I have verified nearly all of them in my own practice.

The first or irritative stage of delirium tremens is ordinarily

treated by 5 to 10 grains of Bromide repeated every two or three hours; but the face must be flushed, eyes red, pulse quick and hard, with delirium of active type and horrid illusions. If the face is cold and pale, pulse weak and thready, Digitalis is the proper remedy. I have found these two medicines, aided by Cimicifuga 3*, or Hyoscyamus lx, to control all cases of that fearful malady.

No remedy compares in efficacy with this in the treatment of night terrors of children, from any cause. A few grains, according to the age of the child, given at bedtime, banishes these attacks at once, and often for a long time. If worms are present, a few doses of Santonin lx, during the day, is a valuable adjunct.

Frightful imaginings in pregnant women, usually caused by an engorged condition of the brain, are speedily dissipated by a few doses.

Somnambulism has been cured by it.

Puerperal mania, when attended by ferocious or erotic delirium, is always relieved and often cured by the free administration of this medicine.

Spasms and convulsions from fright, anger, and other emotional causes, occurring in plethoric, nervous people, or in women at the time of the menses. I prefer it to any other medicine.

Epilepsy, when the attacks are attended or caused by unmistakable congestion of the brain, are always alleviated. It has been asserted by our school that it never cures. I know that it has cured many cases of epilepsy of a recent character, and not dependent on constitutional causes. I admit that it will not cure congenital epilepsy, or the syphilitic, but it will modify such cases greatly ; and it is only common humanity to give it for that purpose, even when a cure is not expected.

I must mention one other condition of the brain and mind in which I have often found it useful, namely, in that condition of nervous irritability caused by the severe illness or death of some dear friend, or loss of property, or reputation. The patient is constantly fretting, will not eat, cannot sleep, is very irritable to all around ; the pulse is quick, tongue coated, and breath fetid. In these cases give every hour or two a teaspoonful of a solution of

with the result.

In acute congestions or inflammatory diseases of the brain I confess to a great liking for this medicine. It ranks with Aconite, Gelseminum, Veratrum viride, and Solanum. (I regret to say that I have nearly always been disappointed in Belladonna and Glonoin.)

In active congestion or the first stage of inflammation , before effusion has occurred, I verily believe the Bromides, if promptly and properly given, will arrest the disease. I did not at one time believe this, but repeated failures with our best remedies prompted me to give this a fair trial. I had hundreds of times been mortified and angry at the failure of Aconite, Belladonna, Bryonia, Gelseminum, Glonoin, and Veratrum, aided by hot foot-baths and cold water to the head. The patients would grow worse, and either run into fatal cerebral disease or into the hands of allopaths. I once resolved that the next case that occurred I' would treat boldly with some Bromide. Two severe cases soon came under my care — a child aged 3, and an adult woman of 30. To the former I gave 3 grains, and to the latter 15 grains, every hour for four hours, when I had the satisfaction of seeing a decided improvement, followed by a recovery under smaller doses and less often repeated.

Since that time, unless I see very prominent characteristic indications for some other medicines, I give the Bromide (of sodium) generally, and have been perfectly satisfied with the results.

In the reflex cerebral irritations and congestions of children during teething, cholera infantum, or in scarlet fever, it is almost specific. Also in incipient basilar meningitis, many cases of which I have arrested before serious disease fixed itself on the child.

The eye and ear symptoms are important as designating local disorder. The amaurosis, strabismus, squinting, photophobia, etc., the ringing in the ears, and sensitiveness to noise, all point to cerebral irritation.

It causes, and will cure, a peculiar state of the throat, in which the patient is choked every time he tries to drink fluids, although he can swallow solids with impunity.

I have often verified Dr. Caro’s recommendation and practice

VOL n.— 8

in treating difficult and painful dentition of children by its local application. Dissolve a few grains in an ounce of milk or water, and bathe the gums. From being turgid, swollen, and red, they assume their natural color. If the salivation is difficult, it restores it; and the sleeplessness, jactitation, vomiting, and diarrhoea are all relieved.

In the vomiting of drunkards and of pregnant women it often acts magically. It quiets that reflex action, whether arising from the brain or uterus. Give a dose, say 10 grains, at night, and the same amount in the morning before rising. A few days’ trial will suffice to test its value. One of the worst cases I ever saw was cured by enemas of 20 grains, night and morning.

Hysterical women often vomit their food after each meal, especially if they are subject to exciting emotions. A few grains given just before eating will often prevent the recurrence of the vomiting.

Several years ago one Dr. Caro, of New York, made a report on cholera infantum, in which he claimed to have cured one hundred and fifty-seven out of one hundred and sixty cases by the administration of Bromide of potassium, in doses varying from one-fiftieth to two grains every hour.

This report created quite a sensation, and allopathic physicians all over the United States tested its value in that disease. Many homoeopaths, attracted by the “ glittering generalities ” of Caro, gave it a trial, but the results failed to verify Caro’s experience, and the medicine fell into disuse.

Such is too often the case with new remedies in allopathic hands. How shall we explain this discrepancy ? Bromide of potassium does not cause this disease by its primary action, and its secondary action has not been sufficiently studied to show that cholera infantum belongs to the secondary effects. I believe, however, that it would appear if children were the subjects experimented upon.

What is cholera infantum? A disease of the bowels? I believe that true cholera infantum, that kind which comes on suddenly, attended by great prostration, cold hands and feet, hot head, dilated pupils, rolling of the eyes and head, starts, jactitation, spasms, watery, very offensive stools, vomiting of all drinks, and intense thirst,

is nearly always a disease of cerebral origin , or an overexcitement of the nervous and vascular systems. Probably Caro’s cases were all of that character, or nearly all. Certain it is, that when I meet with cases such as above described, I find one of the Bromides to be almost specific in removing those symptoms. I do not rely on it in all cases alone, but alternate Camphor, Veratrum alb., Carbolic acid, or Solanum, as the case seems to indicate. But in the majority of cases I rely on the Bromide alone.

Asiatic cholera has been successfully treated by twenty-grain doses of Bromide every hour. Dr. Begbie says: “ In the first stage it arrests the vomiting, the cramps and the rice-water discharges, restores the secretion of urine ; the warmth and color returns to the previously cold and livid skin.” He suspends its use when reaction sets in. I have never had oppurtunity to treat cholera with this remeday, but from my happy experience in certain cases of cholera infantum I should prescribe it with every hope of success.

Colic in young children of a peculiar character, according to Sidney Ringer, is readily cured by it. I have often verified his recommendation. The special symptoms are: “ The walls of the belly are retracted and hard, while the intestines can be seen at one spot contracted into a hard lump, of the size of a small orange, and the lump can be seen to travel from one part of the belly to the other. These attacks are frequent and excruciating, are unconnected with diarrhoea or constipation, but are often associated with an aphthous condition of the mouth.” I have often observed that the attacks were periodic, coming on in the evening at a regular hour. I give a grain or two of the 1* trituration in water every two hours during the interval, and every fifteen minutes during the attack.

Constipation of years’ standing has often been cured unexpectedly while giving this remedy continuously for other disorders. I cannot pretend to give a rationale of its curative action in such cases ; but the fact is worth noting.

Some anomalous disorders of the rectum have been benefited by the Bromides. Dr. Helmuth cured “polypoid tumors.” I have relieved spasms of the sphincter ani.

Dr. Caro records a cure of a child three days’ old who had retention of the meconium. The infant vomited all food ; no action of the bowels. One half grain of the lx trituration every hour rapidly removed these conditions.

If this medicine was useful in no other sphere, its prompt and beneficent action in

Morbid affections of the organs of generation would give it a high rank as a curative agent. In massive doses it causes a diminution, sometimes absolute, of all sexual desire and power. In this respect it resembles Gel.seminum, Conium, Camphor, Baryta, and Caladium ; but, unlike these drugs, it does not cause this impotent condition in all cases. It does, however, often give rise to secondary effects just the opposite. Pel vet says it causes contraction of the minute afferent vessels of the corpus cavcrnosum (primarily). The reaction against this contraction is, therefore, congestion or fulness, thence erections, etc. It is (primarily) homoeopathic to impotence, with loss of desire or power, or both, with or without atonic spermatorrhoea, and in such cases should be used in the 3d or 6th attenuation. It is (secondarily) indicated in satyriasis, nymphomania, erotomonia (hysterical, with spasms), sensual, amorous, and disgustingly lascivious dreams, nocturnal emissions, with erections and dreams, chordee, etc.

I have made frequent and very successful use of it in all these latter conditions, giving 5 to 20 grains once, twice, or thrice a day, and have never -seen other than good effects from its use.

In some of the menstrual ailments it is specific, namely, when they are preceded or attended by epileptic spasms, catalepsy, headache, and congestive heat, burning and irritation of the genitals, nymphomania, erotic fancies, lascivious dreams, sleeplessness, spasms of the uterus, pains in the ovaries, menorrhagia, and many disagreeable reflex symptoms.

I have records of many cases cured promptly by giving a few grains daily through the mouth, and every hour or two during the menses.

Ovarian disorders, such as irritation, neuralgia, swelling, and even tumors, have been cured by the Bromide. It has a specific influence on those glands, and ought to be used more in the reflex disorders caused by ovarian diseases.

Enlargement of the uterus, especially that kind called by Simpson “subinvolution,” or a failure to return to its normal size after labor or miscarriage, speedily resolves under the use of this medicine. It has even relieved the pain and diminished the size of fibrous tumors of the uterus. This, with the Iodide of baryta and Ergotin, will, I believe, prove to be the best treatment for all tumors.

Among the few pathogenetic symptoms recorded by homoeopathic provers, we find “ profuse urination, with thirst, copious, yellowish-white, thin urine, having a peculiar fetid smell; the urine sometimes contains albumen.” These symptoms would appear to indicate it in diabetes, and Begbie reports two cases of diabetes mellitus which he cured in six weeks by giving 20 grains three times a day. The symptoms were pronounced and unmistakable. The inquiry may arise, Why did such large doses cure? When it is remembered that if a man with the ague takes 20 grains daily of Quinine, the urine will contain the 20 grains, yet the man is cured of his ague (see Grauvogl), we can say the same of the Bromides. It is all, apparently, eliminated by the urine, yet the patient is cured. Maybe one grain or less would have cured the two cases, but if the 20 grains cured without injury, where is the harm ?

Nocturnal enuresis has been cured by the Bromides. I cured several children of this troublesome disorder when giving them this medicine for “ night terrors,” which sometimes has some connection with the bladder difficulty.

In whooping -cough it often acts as well as the Bromide of ammonium.

Spasmodic croup is often relieved promptly, especially when it occurs suddenly in the night, and is the result of reflex irritation from teething or worms, rather than a catarrhal irritation.

Dr. Snelling once treated many cases of diphtheritic angina and membranous croup successfully with this Bromide; but for some reason his use of it was not adopted extensively.

(The Bromide of mercury will probably prove a better remedy.)

Dr. Carson relates an obstinate case of nervous cough during pregnancy, threatening abortion. The cough was dry, hard, and incessant. No disease of lungs or throat. Opium and Belladonna were tried for two months uselessly. A few doses of the Bromide

of potassium cured. I have cured several similar cases, even when occurring in children ; a peculiar barking, brassy, incessant cough, which Kali bich. ought to have cured, but did not.

It ought to cure in high potencies, loss of sensation in the glottis and larynx, but I have had no experience with it in such cases. *

Spasmodic asthma in children (asthma of Millar), according to Hebra and Londahl, has been cured promptly by this Bromide, even when suppression of urine, oedema, lividity of the body, and great dyspnoea had set in.

Cardiac neuroses are often among the most obstinate and difficult of all the maladies the physician is called upon to treat. Medicines which have a special affinity for the heart, such as Digitalis and Cactus, exercise but little influence in these affections, unless the disorder has its origin in the ganglia of the heart itself.

The majority of cardiac neuroses have their origin remote from that organ, namely, in some irritation or atony of the brain, spinal cord, liver, or reproductive organs. They are kept up by reflex irritation, or nerve enervation.

The Bromides, if judiciously prescribed, will act curatively in that class due to irritation of a reflex character, especially when that irritation is in the uterus, ovaries, brain, or spinal cord. If the disorder is due to nerve enervation, the most useful remedies are Phosphorus, Zinc, Ferrum, Ignatia, Nux vomica, Lilium, etc.

I can give no characteristic symptoms. The best guide for its use is in the general indications above given. All kinds of excited action , irregularity, palpitation , etc., when unattended by local lesion, come under the sphere of its usefulness.

In sleeplessness, no medicine has been more abused. It is not useful in all cases. In fact there is but one pathological state in which it is useful, namely, an overfulness of the cerebral bloodvessels. When we have this condition, the Bromide, in doses of 10 to 20 grains, restores the normal calibre of the bloodvessels, and sleep comes of itself, i. e., it is not forced. The remedy acts in a physiological (homoeopathic) manner.

Sleeplessness from this cause may arise from various causes, namely, mental anxiety, excessive intellectual labor, hysteria, pregnancy, teething, the exanthemata, typhoid fever, erysipelas,

and a general “nervous irritability;” also anger and various exciting emotions.

Sleeplessness may arise from an anaemic state of the brain, and then demands Opium, Hyoscyamus, Ignatia, or Digitalis, aided by food and a low position of the head.

The action of Bromide of potassa on the shin is quite decided and specific. It seems to cause, invariably, after it has been taken some time in large doses, (a) an eruption of small boils, in successive crops, chiefly over the face and trunk, with troublesome itching ; ( b ) a papular rash on the face, with heat and itching ; (c) acne, chiefly on face, scalp, and shoulders, not very painful, varying in size from a millet-seed to a large pea; (cl) pustular eruptions of malignant aspect, much resembling varioloid; (e) corroding ulcers. Nursing children have had the characteristic acne, from the taking of a Bromide by the mother, showing that it is taken up into the milk.

It ought, therefore, to be homoeopathic to these cutaneous affections. My clinical use of the Bromides in skin diseases has been confined to the treatment of acne in young people of gross habits of eating, in which disorder it has seemed to act beneficially in the 3d trituration.

I have used it successfully in the following general nervous affections : paralysis agitans, tetanus, chorea. In that condition known as hysterical spinal irritation, and in anomalous disorders of the vasomotor nerves, it is worthy a thorough trial.