The long-continued use of the bromide of potassium may produce very serious symptoms of bromism. The remedy must then be greatly reduced in amount or be discontinued, and tonics and restoratives administered until the organism recovers its tone. When there is much susceptibility to the action of the bromides, it is generally better to prescribe the bromide of sodium. This salt is equally effective in epilepsy, while it is much less depressing in its effects. It is not infre-quently desirable to administer iron during a course of bromides. The author has had excellent results from the following: Rx Potassii bromidi, oz j; ferri bromidi, gr. vj; aquae, oz vj. M. Sig.: A table spoon-ful three times a day. Echeverria has made the observation that taking strong coffee with the meals hinders the development of bromism. The troublesome and very disfiguring acne may be, in part at least, prevented by the conjoined administration of arsenic (three to five drops of liq. potassii arsenitis). Brown-Séquard, with that fondness for complex combinations which he has always exhibited, recommends the following formula for epilepsy: Rx Potassii bromidi, oz j; ammonii bromidi, 3 ijss; potassii iodidi, 3j; potassii bicarb., Эij ; infus. calumbae, oz vj. M. Sig.: A tea spoonful before each meal, and three tea spoonfuls at bedtime. There is probably no advantage in this combination, and it is execrable as regards taste. It is true sometimes better results are obtained from a combination of bromides than from the bromide of potassium alone. It is always advisable to combine the iodide of potassium with the bromides, when there is reason to suspect syphilitic cerebral lesions, or when degenerate changes may appear to be taking place.

Vaso-motor disturbances, elsewhere than intra-cranial, are relieved by the bromides. "Such symptoms are, for example, sudden numbness, coldness, deadness, or pricking sensations in one or more limbs; sudden distressing but indefinable feelings in the epigastrium, abdomen, or hypogastrium; or sensations akin to rigor, with much anxiety and palpitation, or 'fluttering,' of the heart. In such cases it may be observed that the local circulation is interfered with; that, for example, the pulse in one arm becomes faltering, irregular in force and rhythm, occasionally intermitting, while that in the other arm may remain unaltered, and the beat of the heart may maintain its normal character."

The painful flushings of the face, and the sense of fullness in the head, which occur so frequently at the climacteric period in women, may often be removed by the bromides.

Certain of the respiratory neuroses are greatly relieved by the bromides. Laryngismus stridulus, when present, may be suspended by the prompt use of full doses, and the tendency to frequent recurrence of the attacks obviated by the steady and continued use of moderate doses of this remedy. It may be combined with chloral: Rx Potassii bromidi, 3 ij; chloral, hydratis, 3 ss; syrup, tolu., oz ss; aquae, oz jss. M. Sig.: A tea-spoonful every half-hour. The bromides greatly relieve the spasmodic element of whooping-cough, but they do not appear to shorten the duration of the disease. A combination such as given above, for a child of two years, may be prescribed in whooping-cough during the spasmodic stage, and in proportionally larger quantity for older children.

In spasmodic asthma very great relief is sometimes afforded by the use of bromides, but these remedies lose their effect very quickly. The best results are obtained from a combination of the bromide with the iodide of potassium: Rx Potassii bromidi, oz j; potassii iodidi, oz ss; aquae, oz iv. M. Sig.: A tea-spoonful in sufficient water every half-hour or hour.

Cough which is merely reflex (stomachal, intestinal, renal, uterine, ovarian) can usually be cured by the bromides. It is said that a gargle of the bromide of potassium will diminish the cough of phthisis. The author has ascertained that it is only occasionally that such a fortunate result can be achieved in this way. Such a diminution of the sensibility of the fauces can be produced by a few large doses of the bromide of potassium, that this expedient has been proposed to facilitate laryngoscopy and rhinoscopy.

In certain neuroses of the genito-urinary organs, male and female, excellent results have been obtained by the use of the bromide of potassium. Abnormal sexual excitement and nocturnal seminal emissions may be checked by this remedy. The condition of plethora is the indication for the bromide. When the sexual organs are much relaxed, the erections feeble, and the seminal fluid watery, especially if there be such a constant stillicidium of semen as to constitute the so-called diurnal losses, the bromide of potassium does harm. The more nearly nocturnal seminal losses approach the physiological type, the more effective the bromides. As they act by diminishing the blood-supply to the erectile organs, it is obvious that they are contraindicated when there is debility, and when the erections are feeble. They prove completely successful when the erections are normal as to character, but teasing and persistent. The various nervous disturbances growing out of unsatisfied sexual desire are quieted by these agents. As a rule, nymphomania and satyriasis dependent on cerebral lesions are not diminished or prevented by the bromides.

Bromide of potassium, in full doses, has been proposed for the relief of chordee. The result is generally disappointing, but occasionally relief is experienced from it. Very large doses (3 j every four hours) are necessary.

Menorrhagia, dependent on ovarian irritation, is usually promptly arrested by these agents. Sometimes metrorrhagia, even when due to a fibroid, is remarkably improved by their use, but success is not invariable.

Various functional nervous disorders associated with, or dependent on, derangements of the sexual system—for example, such as are grouped together under the term spinal irritation—are treated with occasional success by the bromides. It is to be noted, however, that a condition of general anaemia or local spinal anaemia, which usually coexists, is a contraindication to the use of these agents. They are useful in proportion to the degree of plethora present.