As respects its chemical constitution bromoform is a terbromide of formyl, as chloroform is a terchloride of formyl. If for the chlorine in chloroform bromine is substituted, the resulting compound is bromoform. It is a transparent, colorless, oily liquid, having an ethereal odor, a sweetish taste, and a specific gravity more than twice that of chloroform, or 2·9. It is slightly soluble in water, and freely in alcohol and ether. When exposed to the light it becomes brownish in color and bromine fumes are given off. The dose ranges from two minims for an infant to three to five minims from two years up to five, and in the same proportions for older children, and for adults ten to fifteen minims, three or four times a day. It is best administered to children in sirup, to adults in capsules.

As regards physiological action, bromoform corresponds closely to the other bromides. It acts on the reflex centers to inhibit their functions, and also on the centers of conscious impressions to induce sleep and insensibility to pain. It is, therefore, an anaesthetic, like its congener, chloroform, but it is too dangerous to be so utilized. It lessens the depth and frequency of the respiratory movements, and also the force and tension and rate of the pulse, ultimately in sufficient quantity paralyzing both.

Bromoform is not actively toxic. Some cases of poisoning by accident and overdoses have been reported, but they were restored by the use of stimulants and the antagonists of the cardiac and respiratory depression (Stepp).

The indications for the therapeutical employment of bromoform are the same as for the alkaline bromides, but experience has shown that there is a special field for its powers. The evidence of its utility in the treatment of whooping-cough is conclusive. Stepp, who was the first to make use of this remedy, reports on one hundred cases in which it proved to moderate the violence and shorten the duration of the disease without a failure. The duration of the treatment varied somewhat, but it ranged from two to four weeks. The number of paroxysms began to diminish after a few days' treatment. L5wenthal, assistant in Senator's clinic in Berlin, also tried it in one hundred cases of whooping-cough, and with most gratifying results. The first symptom to yield was the vomiting, and in three to five days the nosebleed ceased, and the paroxyms of coughing rapidly lessened in number and severity. Schippers, who prescribed the remedy in no less than two hundred and fifty cases, concludes that bromoform in the indicated doses is free from harm, that it diminishes the number and severity of the paroxysms, stops the vomiting and the nasal haemorrhage, and materially shortens the duration of the disease. Dr. Fischer, of New York, also reports favorably on the effects of bromoform in whooping-cough, which he maintains is the best remedy hitherto proposed for the relief of this disease.

Bromoform is an admirable remedy for ordinary coughs from catarrhal affections of the broncho-pulmonary mucous membrane. In combination as follows it is now much prescribed by French physicians: Rx Bromoformi, 3 ij; codeinae sulph., gr. viij; acet. scillae, oz ss.; syr. tolu, oz iijss. M. Sig.: A tea-spoonful every four hours for an adult. For a child, the quantity of bromoform and codeine should be one fourth to one eighth of these amounts respectively.

Bromoform is an effective remedy for the relief of the cough of phthisis. It may be combined in the form given below, and used by inhalation as a remedy for the cough of phthisis: Rx Bromoformi, 3 j; pyridin., 3 ij; ethyl, bromidi, 3 v. M. Sig.: Ten to twenty drops by inhalation. The administration may be made by dropping on a handkerchief, or on a sponge placed in a small funnel or in a vial. The patient should be directed to inhale the vapor frequently if the cough is troublesome, or several times a day if an impression is to be made on the local disease. There is reason to believe that this combination approaches the dignity of a curative agent, since under its use the bacillus is inhibited, even destroyed.

Bromoform has also been used with more or less success in other spasmodic diseases, as asthma, singultus, laryngismus stridulus, etc. A severe attack of asthma may be aborted by the subcutaneous injection of five minims. As it is not irritating to the tissue, this procedure may be resorted to without risk of subsequent mischief, besides the immediate distress accompanying the subcutaneous injection of an ethereal compound, which, however, is of short duration.

The author has had good effects from its administration in cases of headache, in vertigo from reflex causes, and in various abnormal sensations in the head belonging to neurasthenia. In certain cases of intestinal catarrh with reflex vertigo and occipital headache it has apparently done much good. It well deserves a trial in hepatic colic, in renal colic, and in the colic-like attacks that occur during the course of chronic intestinal catarrh.

As a remedy having the properties of a bromide, and possessing by combination with formyl certain sedative powers, bromoform is a promising expedient for epilepsy, and already some experiences have shown it to be well worthy of attention. The more recent the epileptic seizures, the more promising the remedy. It is also an efficient remedy in the treatment of excitement in the insane. Dr. Angrisani employs for this purpose a solution of bromoform in glycerin flavored with oil of cinnamon, and begins with a dose of fifteen minims, increased to thirty minims if desired. The sedative effect is rapidly manifested, and no unpleasant after-effects have been observed except some diarrhoea, which was readily controlled. It follows from these observations that bromoform may be utilized in place of the bromides of the alkaline bases in cases in general to which these are applicable.

Authorities referred to:

Fischer, Dr. The New York Medical Record, September 6, 1890. Lowenthal, Dr. Berliner klinische Wochenschrift, No. 23, 1890.

Neumann, Dr. Therapeutische Monatshefte, July, 1890. Schippers, Dr. Ibid., December, 1890, and January, 1891. Stepp, Dr. Deut. medicin. Wochemchrift, Nos. 31 and 44, 1889.