Case of bromoform poisoning success fully treated by giving the child an emetic and an hypodermic injection of grain of strychina. The bromoform precipitated in the mixture and the greater part of it was consequently given in the last dose. W. F. Cheyney (Archives of Pediatrics, Feb., '97).
Treatment of Bromism. — This con sists, first of all, in suspending the drug; next in, promoting excretion by the emunctories, the kidneys and skin espe cially, coupled, if need be, with ing treatment to heart and general cir culation, and endeavors to restore to normal the status of the nervous sys tem. The mercurial salts are often of marked value, especially the iodide as found in combination with arsenic in Donovan's solution. Occasional purges by large doses of calomel are also very effective, and, when given to the amount of 30 to 50 grains at bed-time, this drug is not only without depressing after effects, but tends to stimulate the kid neys and emunctories to renewed ac tivity.
Theoretically, pilocarpine, or jabo randi, would be considered of use; but to an economy already generally de pressed, with circulation and nervous system suffering from the poison, these might prove boomerangs; atropine and belladonna arc much more preferable and reliable.
Therapeutics.—The chief use to which the bromides, especially bromide of po tassium, have been devoted is the treat ment of epilepsy, but the weight of evi dence tends to show that while they may decrease the number of paroxysms, they positively never afford other relief, and many times the condition resultant upon their use is worse than before treatment began. Again, at least 5 per cent. of epi leptics cannot bear any bromide, even in small doses.
Use the three salts in epilepsy—am monium, potassium, and sodium—in combination in doses of from 40 to SO grains morning and evening. in strictly
nocturnal seizures one close at night only. Treatment should be persisted in for at least three years. Arsenic is a valuable adjunct to the bromides. Eulenberg (Timer. Monats., Nov., Dec., '92).
When a bromide is given in conjunc tion with borax the action is better than with either salt alone. Alexander (Liverpool Medico-Chir. Jour.. July, '93).
Twelve cases of epilepsy: S male and 4 females, of ages ranging from 10 to 50 years; no predisposition, no syphilis. In 4 the fits occurred at least once a week, in the other S at intervals varying from 1 to S weeks. Bromide of stron tium, 20 grains. with 5 to 10 grains of bromide of ammonium or sodium, were given night and morning, largely diluted with water. Strontium increased rap idly to GO grains twice daily when the smaller doses failed to control the at tacks. The majority took the latter drug without any depression, but gen erally with the production of acneic rash on face. Fowler's solution of ar senic added to the mixture controlled the rash and increased appetite. The number of attacks in all cases was materially decreased, and in 8 there was no return after intervals of from 4 to 16 months. Roche (Med. Press z.nd Circ., Aug. 12, '92).
It has been recommended to combine adonis vernalis and codeine with bro mides in the treatment of epilepsy, but careful investigations on the part of many observers are not at all assuring in this direction.
The cures do not appear to be in any way effected save by the bromides alone, and the combination does not, in any way, prevent the complications and dis agreeable symptoms which arise from the use of bromide salts. Taty (Lyon Mad., Dec. 29, '95; ibid., Jan. 5, 12, '96).