The foregoing statement of the results obtained by M. Puche was given by MM. Rames and Huette, in a thesis upon the subject, and is contained in the Traite de Therapeutique et de Matiere Medicate of MM. Trousseau and Pidoux (4th ed., i. 237-8). Viewed in the light of more recent experiments, it appears to me highly probable that the constitutional effects, described as resulting from the bromide of potassium, were really ascribable to some alcoholic drink which the patients may have surreptitiously taken with their medicine.

Prof. Roberts Bartholow, of Cincinnati, gives the following results of his experimental researches into the physiological action of the bromide of potassium. 1. it is irritant in large doses to the gastric mucous membrane. 2. it rapidly enters the blood, and may soon afterwards be detected in the urine. 3. it is sedative to the nervous centres, causing a depression of their functions with sleep. 4. it diminishes, and at length, if long continued, entirely subdues the venereal appetite. 5. it weakens the nervous system. [Med. and Surg. Reporter, Jan. 6, 1866, p. 11.) it appears that these researches, though generally in the same direction with the conclusions of M. Puche, are very far from supporting them in their whole extent.

In an elaborate memoir contained in the Archives Generates (Juillet, 1865, p. 81), Dr. Charles Lasegue, after reviewing what had been done in reference to the physiological effects and therapeutic application of bromide of potassium, gives, as the result of his own researches and experience, a very different account of the medicine from that above presented, and probably much nearer the truth. According to Dr. Lasegue, it is incapable in any degree of paralyzing the fauces. Nor have its assumed antaphrodisiac properties been confirmed. Though inadequate to the powerful anaesthetic effects assigned to it, the bromide of potassium is a moderate sedative to the nervous functions generally, and throngh this property may often be of ever, and that upon which it mainly depends for its therapeutic virtues, is that of a gentle sedative to the nervous system, depressing moderately the nervous functions, without possessing, like the nervous sedatives classed as such in this work, as digitalis, aconite, veratrum viride, etc., any real narcotic power, or any disposition, so characteristic of the class mentioned, to produce nausea and vomiting in large doses. On the contrary, it is in general perfectly acceptable to the stomach, and, though probably slightly excitant to the peristaltic movement, seldom disturbs the bowels. The appetite and digestive function are usually unimpaired, even when it is given in large doses. Whether it has any special influence upon the throat, or on the genito-urinary organs may be considered doubtful. That it is capable of quieting irritation in these parts is highly probable if not certain; but its effects may be explained through its general sedative influence, without the necessity of supposing that it exercises a special influence over the functions of the fauces, or those of the generative organs.

Therapeutic Application

Bromide of potassium is now little used as an alterative and deobstruent, having been found greatly inferior to iodide of potassium in the treatment of bronchocele, scrofulous diseases, and chronic tumefactions generally, and altogether inadequate to the cure of secondary syphilis, in which it was at one time recommended. in chronic rheumatism of the joints, in which bromine was employed by Andral, and found to have a remarkable influence in relieving the pains of that disease, the medicine probably acted by its yet undiscovered sedative powers; and it is highly probable that bromide of potassium would prove similarly useful. indeed, it is in reference to its remarkable sedative properties that this medicine is at present almost exclusively employed. All the morbid states in which experience has shown bromide of potassium to be useful, are those in which the prominent indication is to relieve nervous irritation; and it may be stated, as a general rule, that it is capable of beneficial application in almost all cases in which nervous disorder arising from an excess of action is a prominent feature. The chief exceptions are those in which the disease is so deeply rooted as to defy all but the most powerful remedies; such as tetanus, the cramps of cholera and those of the more violent forms of colic, those which depend on acute inflammation of the brain and spinal marrow, as the tonic spasms and convulsions of cerebral or spinal meningitis, and, great advantage in moderating and calming nervous excitation. He gives it to the average amount daily of from 2 to 4 grammes (gss to gi); but has increased it to 10 and even 12 grammes (^ijss and giij), without appreciable injury.

Drs. Brown Sequard and Ramskill used it in the treatment of epilepsy in the dose of 20 grains three times a day; and, though continued in this quantity for a year or two, it never produced any other observable effect than some sleepiness and dulness of intellect, which may have been the result of the disease, and a feeling of fatigue. {Lancet, March 10, 1866, p. 250.) - Note to the third edition.

finally, all those which have their origin in organic disease, as tumours, etc. in the brain, in which though it may relieve some of the symptoms, it is quite inadequate to the cure. Spasmodic and convulsive affections of a purely functional character, whatever may be their seat or degree; disorders of sensation, whether special, as of sight, hearing, etc., or general, as neuralgic pains, tingling, formication, general uneasiness, and various anomalous affections of a similar character; and, finally, numerous nervous disturbances not belonging to the above categories, as restlessness, sleeplessness, mental irregularities, hyperesthesia of the genital functions, the disordered feelings of melancholia and hypochondriasis, even the paroxysms of insanity, and the almost infinite diversities of hysterical disorder; all these call for the use of bromide of potassium, and may be expected to be more or less relieved by it. But it will be proper to call a particular attention to the several recognized forms of disease in which the remedy is used.