Other tomes: Petersen
Bromum, Bromine,—is a liquid, non-metallic element, having the symbol Br., obtained from sea-water and from certain saline springs; a dark, brownish-red, very volatile liquid, of strong and disagreeable odor. Its solution colors cold starch-water yellow. [Iodine colors it blue.] Bromine is only used by inhalation and locally as an escharotic.
Bromides and their Preparations.
- Potassii Bromidum, Potassium Bromide, KBr,—colorless, cubical crystals, soluble in 1.6 of water, and in 200 of alcohol. Dose, gr. v-ʒj.
- Sodii Bromidum, Sodium Bromide, NaBr,—colorless, monoclinic crystals, soluble in 1.2 of water, and in 13 of alcohol. Dose, gr. v-ʒj.
- Lithii Bromidum, Lithium Bromide, LiBr,—a white, granular, deliquescent salt, very soluble in water and in alcohol. Dose, gr. v-xx.
- Ammonii Bromidum, Ammonium Bromide, NH4Br,—colorless, prismatic crystals, soluble in 1 ½ of water and in 30 of alcohol. Dose, gr. v-xx.
- Calcii Bromidum, Calcium Bromide, CaBr2,—a white, granular, deliquescent salt, very soluble in water and in alcohol. Dose, gr. v-ʒj
- Strontii Bromidum, Strontium Bromide, SrBr2 -colorless crystals, very deliquescent, very soluble in water and in alcohol. Dose, gr. v-xxx.
- Zinci Bronzidum, Zinc Bromide, ZnBr2,—a white, granular, deliquescent powder, very soluble in water and in alcohol. Dose, gr. ss-ij.
- Camphora Monobromata,—see Camphora, page 119.
- *Bromoformum, Bromoform, Tribromo-methane, CHBr3,—a clear and colorless liquid, of pleasant odor and taste, readily soluble in alcohol and in glycerin. Dose, ♏v-xx.
- Acidum Hydrobromcum Dilutum,—an aqueous solution containing 10 p. c. of absolute HBr Acid. Introduced into medicine as a substitute for the bromides. Dose, ♏x-ʒij.
Physiological Action of Bromine. It is an active and painful escharotic, a deodorant and an antiseptic, setting free ozone. Its vapor is highly irritant to the respiratory mucous membrane and the eyes, producing cough, hoarseness and dyspnoea. Internally, it is an active, corrosive poison, causing violent gastritis, depression and collapse.
Physiological Action of the Bromides. They are pre-eminently depressants of the cerebral and spinal functions, also alterative, antispasmodic and hypnotic. The Potassium salt is especially a cardiac and muscular paralyzant. They have a saline taste, and are very diffusible, but slowly eliminated. They are decomposed in the blood, and re-formed at the points of elimination (fauces, bronchi, intestines, skin and kidneys), where they irritate the mucous membranes. Continued for some time, they produce severe gastric catarrh. They reduce the number of the respirations, and the heart's action and force; and though diminishing the calibre of the arterioles, they lower arterial tension. They lessen the activity of the brain cells, producing somnolence; diminish the sensibility of the peripheral nerves, causing anaesthesia of the skin and mucous membranes. They impair motility and the sexual function, cause great pallor and emaciation, lowered body-temperature, acne on the face and upper extremities, fetid breath, dysphagia, sluggish reflexes and defective coordination; and if long continued may even impair the mental faculties, producing hallucinations in some cases, in others melancholia with suicidal tendency; also incompetence of the sphincters and paralysis, beginning at the periphery and extending to the centres. The general result of their action is termed "Bromism," and is heralded by the acne and lowered faucial sensibility. It is probably due to the sedative influence of these agents on the sympathetic system, causing general anaemia of the brain, spinal cord, sexual organs, and skin.
Differences in Action between the principal Bromides.
- Potassium Bromide is the most toxic to the heart and the muscular system, and is the least hypnotic. It contains 66 per cent. of Bromine.
- Sodium Bromide is the least toxic, but the most hypnotic, and acts most energetically on the circulation. It contains 78 per cent. of Bromine.
- Ammonium Bromide resembles the Potassium salt in action, except that it exerts less influence on the heart and muscular system, and is somewhat more stimulating.
- Lithium Bromide contains the most Bromine (92 per cent.), and resembles the Sodium salt in action. It has proved better than the others in some cases of epilepsy, and is considered the best hypnotic of the series.
- Calcium Bromide is an efficient hypnotic, but otherwise not very active.
- Strontium Bromide is said to be less apt than the others to produce the acne and other results of bromism.
- Zinc Bromide produces effects generally similar to those of the other bromides, but is violently irritant in large doses.
Antagonists and Incompatibles. Vaso-motor stimulants, as Digitalis, Ergot, Belladonna, antagonize many of the effects of the Bromides, but Morphine is the most efficient antagonist, especially for the mental symptoms. Nitrous Ether is incompatible with Ammonium Bromide, and Acids and metallic salts are so with all the Bromides.
Therapeutics. The Bromides are used as sedatives to the nervous system, to lower reflex activity, to produce sleep, to subdue excitement of the genital apparatus, and to antagonize congestion of the brain. Their use is terribly abused, by patients, nurses, and even by physicians,—as Dr. Hammond well elucidates in his book on Nervous Diseases. They should not be used in anaemic conditions, and never for any length of time without the daily supervision of a physician. The combination of Potassium Bromide with Chloral is very unsafe in cases where fatty or weak heart exists, both drugs being active cardiac depressants. In—
- Convulsive and Spasmodic Affections,—the Bromides are very efficient.
- Epilepsy, especially diurnal seizures,—Sodium Bromide in sufficient quantity to maintain anaesthesia of the fauces, for three or four years. Purgation occasionally, to prevent its accumulation in the system, and Arsenic to antagonize the acne.
- Diabetes Mellitus,—the Ammonium and Arsenic Bromides in cases of nervous origin, have proved curative when long used, probably by their sedative influence on the medulla oblongata.
- Acute Rheumatism,—Ammonium Bromide is an excellent alkali.
- Muscular Rheumatism,—the Lithium salt gives very good results.
- Nervous Erethism,—the Bromides are much used, and with good effect.
- Insomnia with congestion, as from cerebral overwork,—they are useful.
- Infantile Colic,—Sodium Bromide in five-grain doses, with a little Oil of Anise, is considered excellent.
- Cholera Infantum,—the Bromides check the vomiting and purging.
- Vomiting of cerebral origin,—they are extremely useful.
- Cardiac Irritability, when not due to anaemia,—is calmed by the Bromides.
- Melancholia,—occasionally the Bromides give great relief.
- Whooping-cough, and other reflex coughs,—the Bromides as palliatives, or Bromoform in daily doses of 5 to 20 minims, administered in glycerin or alcoholic solutions.
- Diphtheria,—inhalations of Bromoform have been used successfully.
- Ozaena and tuberculous and other ulcers of the larynx,—Bromoform locally, as a deodorizer, disinfectant and analgesic.
- Seminal Losses, if plethora exists,—are well treated by bromides.
- Nymphomania,—these agents have almost a unique power.
- Tetanus,—Potassium Bromide is antagonistic in large doses.
- Subinvolution of the Womb, and Menorrhagia,—the Potassium salt is considered to have specific power thereon.
Therapeutics of Bromine. It is not much used. In—
- Chancre, Hospital Gangrene, etc.,—Bromine locally is the best escharotic.
- Diphtheria and Membranous Croup,—a solution containing 8 drops to the used internally, and inhalations of the vapor, have been used successfully in the most severe cases.
Hydrobromic Acid may be used as an alternate substitute for the Bromides in almost all their affections, except epilepsy. In—
- Neurasthenia and post-hemiplegic convulsions,—it should entirely supersede the Bromides, being more efficient in these conditions.
- Coughs of spasmodic and reflex character,—it is excellent, but is best employed in conjunction with other remedies.
- Tinnitus Aurium and similar subjective noises, whether due to Quinine or Salicylates or not,—are removed by this acid.
- In Quinine Solutions, ♏ij to each grain,—it aids the solubility, and neutralizes the effects of the alkaloid upon the ears.
- Cerebral Disturbances of continued fevers,—it does good service;—also in subjective cerebral symptoms, as "swimming of the head," etc.
A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.