Other tomes: Potter
The writer does not favor the use of the bromides and never uses them in his practice, as we have less harmful agents that fill their indications. As there are some that occasionally use them or come in contact with cases that have contracted bromism through large doses or long continued use of the drug in its various forms the physiological action as well as indications and use will be given below.
Physiological action: When inhaled are very irritating to the mucous membranes of the respiratory tract, producing hoarseness, cough, and in some cases dyspnea. Internally in large doses bromides will cause severe gastro-intestinal inflammation, general depression, muscular trembling, paralysis of motor then sensory nerves, collapse and even death. The bromides are powerful cerebro-spinal depressants. They are eliminated slowly with every secretion of the body. They reduce the heart's action, respiration, lessen the activity of the brain, diminish sensibility of the peripheral nerves and mucous membrane, impair the sexual function, cause emaciation and pallor, lower the temperature, cause characteristic fetid breath, impair co-ordination. If long continued will produce a rash on the skin, at first papular, later pustular with ulceration, impair mental facilities; in some it will produce melancholy, others hallucination; again in others tendency to suicide and even maniacal excitement. Bromides cause, if continued long or taken in large doses retrograde metamorphosis, insufficient oxygenation of the blood, acting as a depressant on the sympathetic. Lower or impair muscular contractibility. The capillary vessels contract to such a degree as to cause insufficient circulation, arterial tension is lowered, finally anemia of the brain, cord and skin results. Bromide of sodium is the least harmful.
Indication: The bromides are indicated in all cases of nervous excitement which are the result of irritation, marked determination of blood to nerve centers, capillary fullness and any condition where the nerve force is temporarily increased. General cerebral fullness with irritation of the nerve centers. They are therefore indicated in spasms, hysterical mania, delirium tremens, sexual hyperaesthesia, nymphomania, insomnia, with above indications or conditions present. In insomnia the bromide of sodium is preferable. In whooping cough where there is an irregular heart's action as a result, the bromide of potassium is preferable. In lithemia the bromide of lithium should be used. In most conditions we have less harmful and as effective remedies as the bromides, and, for that reason, their use should be limited as much as possible. They should not be taken any length of time and not taken in large doses except in emergencies. The writer never uses them. The bromide of sodium is the least poisonous and least irritating and therefore is preferred in most cases.
The Materia Medica and Clinical Therapeutics, 1905, was written by Fred J. Petersen, M.D.