Kali bromatum

 Potassium bromide. Preparation: Triturations.

 EMOTIONAL. Delirium. General delirium, with hallucinations; delusions about persecution and violence. Decidedly insane; had delusions that lewd women had got into his mother’s house; that he was pursued by the police; that his life was threatened by members of the family; that he had thousands of dollars in gold sewed up in his clothing, etc.; his appearance and manner were very similar to those of a drunken man, except that his face was exceedingly pale; his pulse, which was normally about 80, had fallen to 60; skin cool; pupils contracted; his manner was excited and rambling, and his hands constantly busy, either in fumbling in his pockets, tying his shoes, picking threads from his clothing, or in searching for the gold which he believed was concealed in the lining of his coat; his character also had undergone a radical change, from having been very frank and brave, he had become excessively timid, and suspicious of every trifling circumstance; it was ascertained that he had secreted large quantities of the вromide in various out of the way places about the house; several times he attempted to throw himself from a window and battered down a door with an axe, in order to escape from some imaginary danger; he was removed to a lunatic asylum, were the symptoms gradually disappear, and in a month he returned to his home well. He imagined that he had been specially singled out for divine vengeance, and he spent the greater part of the evening in loudly deploring his sad fate, falling suddenly asleep at intervals of a few minutes; towards 12 o’ clock he became quiet, and passed the rest of the night in sound sleep (1st day); he was walking his room, groaning and wringing his hands; he informed me that he had been accused of robbing a friend, and that the officers were in search of him (2nd day); slept from about 6 p. m. till 5 am, when he was quiet, composed, and altogether in his right mind (3rd morning). She had the erroneous idea that she was deserted by all her friends, and as a consequence she passed all here waking moments, which were not many, in tears; another delusions, that her child was dead, had taken fixed possession of her mind; she declared that she saw it dead before her, and when it was brought to her, she refused to acknowledge that it was hers, or had any resemblance to the one she imagined was dead (8th day). Very soon she began to manifest symptoms of melancholy, attained with delusions; she was taken to Long вranch, and while there continued to be insane; she fancied that a boarders in the hotel insulted her and imagined that the weekly bills of the landlord were evidences of a conspiracy which had been got up against her father;on the way up from Long вranch to this city, while standing on the guards of the boat, she suddenly gave a loud shriek, and declared she had seen her brother fall overboard; the administration of the вromide was stopped, and in a few days her mind became sane, and has since remained so; throughout the whole progress of this case, there was profound depression of spirits, and all her delusions were of a melancholy character. The mind was more composed, and much less excitable than usual (while taking the drug). When the drug acts favorably, a sense of buoyancy, comfort, and relief, rather than depression, accompanies it exhibitions. Frequently she would burst in tears for no cause whatever (after three days). Depression of spirits for two months, then gradually disappearing. Depression of mind, during which he experienced the most gloomy ideas relative to his present and future conditions, if an opinion could be formed from the signs of distress such as weeping, moaning, and wringing his hands, which he continued to manifest; two hours after this he fell asleep, and when he awoke eight hours afterwards was perfectly sane (4th day). Mental depression. Marked mental depression (after a month). Great mental depression, a feeling of approaching death. Fearfully depressed, and frequently shed tears. A consciousness that the currents or sources of psychical force are hampered sometimes makes an intellectual patient, who is moderately bromized, reason himself into depression, but spontaneous depression is rare. Very absent-minded, low- spirited, and childish, giving way to her feeling. No inclination to mental excitement of amusement; rather sad and indifferent to things, lasting for five days (6th day). Painful sadness, profound indifference, and almost disgust for life (after 1 to 2 hours). Profound melancholy with delusions. Such intends melancholy and weakness that I was obliged to reduce the quantity to 20 grains. The immediate effect was the production of the most intense melancholy, attended with fits of uncontrollable weeping; these symptoms lasted three or four days, and were then accompanied with periods of positive delusions; gradually they disappeared, although the doses of medicines were not reduced. Feeling of anxiety, depression, etc. The patient, who has been violently excited, glorying in his imaginary power of body and mind, becomes desponding, sullen, melancholic, and frequently lachrymose, often even despairing. At times he cried most bitterly, yet 12 hours previously he was singing and dancing, saying he was the happiest man alive . Listless, apathetic. INTELLECTUAL. Intellect and will unimpaired and active. Intellect and emotion may seem sluggish, but when roused they act normally. Mind calm, not worried and fretful as usual; have been rather disinclined to use the mind at all (fifth day). The patient was torpid mentally. Intellect clouded; mind confused; unable to concentrate the thoughts; slowness of perception; questions have to be asked several times before their meaning is understood and answer can be obtained. Dullness, stupefaction. Dull, depressed, irregular in his gait, in the morning;in the afternoon completely helpless. After awaking, the will power seems lost, and thought and self-consciousness cannot be regained; one feels plunged in dullness and torpor (after one to two hours). Mental habitude (after large and continued doses). Slowness of comprehension. Decided weakness of intellect. Enfeebling of mental power; a little page in my accounts, which I should usually have prepared and balanced in half an hour, took me two or three evenings work; but the worst tendency to talk Mrs. Malaprop English substituting one word ending in tion for another in a most provoking and yet ludicrous way; I had once to write some letters reminding people that their subscriptions were due, and I had the misfortune of having my letters (I think one or two of them) brought back to me by the clerk, who pointed to me that I had written contraction or some such word instead of subscription . Difficulty of collecting ideas. Inability to express oneself. Remarkable slowness of speech, and difficulty of collecting the ideas and expressing them. In such confused state that I could not get on with my work (second morning). Incoherent, full of delusions of no fixed character, and remarkably depressed in spirits (seventh day ). Feel as if everything that I feel, see, or think, had been experienced before, as in the dream;this delusion is so strong that I could swear I dreamt it all (six hours and a half after second dose). The effect upon the mind was quite marked and uncontrollable state of mind. The mental and bodily impressions received during the different stages of the medicinal action are very clearly retained in memory. Memory impaired. The memory and thinking faculty were impaired. Sometimes temporary impairment of the memory (after continued doses). Failure of memory. Loss of the memory for the two months, then gradually reappearing. Loss of the memory to such an extent that he forgot how to talk; for instance when asked why he took such large a dose, he was fully endeavoring to frame reply, and was then obliged to give up the attempt with the remark, I can’t, in fact, there was well-marked amnesic aphasia, for there was no difficulty in coordinating the movement of the tongue so as to articulate distinctly any word he has told to pronounce (fourth day). Memory was absolutely destroyed; she could not recollect the simplest things, and even forgot her own name and that of her husband, though reminded of both an instant before (after three days). On waking in the morning I could not remember anything which had happened to me night before, and asked y brother what day it was, the month of the year etc. What he writes is almost intelligible, from the omission of the words, or the parts of words; words are often repeated or misplaced. A hospital patient, who while subjected to the continued influence of вromide of potassium, forgot certain syllables or parts of certain words and when writing or speaking did not write or utter these; thus he called quelques, q’ques and sometimes he duplicated one or two syllables of a word. In some individuals the memory is oddly affected; single words are forgotten, or one syllable is constantly dropped out of a word whenever that word is spoken by the patient, or two words are invariably interchanged; thus a lady twenty-eight or twenty-nine years of age, suffering from chronic ovarian disease, to whom I gave about 12 grains three times a day, making a continued dose of nearly 40 grains of the вromide of potassium, began after she had taken it 2 or 3 weeks, to exchange two words for each other; she called buckwheat cake a comb and a comb a buckwheat cake; at hour of her morning toilet she would direct a maid to bring her a buckwheat cake and arrange her hair; at breakfast, if there were buckwheat cakes on the table, she asked for a comb to eat; once during the existence of this peculiarity, I undertook to convince to her that she had transposed these words, and that a comb was a spoken sign of the comb and not of the cake; the effort was unsuccessful; she never transposed or confused the ideas of cake and comb, only the words or signs. Weakness of the mind, a kind of stupor, especially in well-educated and actively engaged persons (after long use). Habitude, with the inability to think; a kind of stupor, resembling that of the first typhoid fever. Stupor. Moderately deep coma.

 Eyes.
 Expressionless gaze; lusterless eyes. Hollow, fixed eyes. Eye lost its lustre (after a few days). Dull- looking eyes. вlood vessels on the fundus of the eye were enlarged. The results of the smaller doses were not altogether uniform; a certain degree of congestion appeared, however, to be produced. With half drachm and drachm doses, and once with a scruple dose, the disk and retina were congested even in ten minutes after administration, and this state of congestion went on increasing, as long as examinations were made; even after the lapse of several hours, the increased redness was still manifest; the vascularity was found to be greater as the dose was increased. The exceptional phenomena were, in one case, a brighter redness of the vessels after ten grains. In another case, a hazy condition of the vessels was noted, after a scruple dose. LIDS. Drooping of the eyelids. сonstant closing of the eyes, more noticed when sitting up than when lying down. Ptosis, gradually becoming complete so that the lids hang far over the eyeballs. сONJUNCTIVA. сonjunctiva often congested. Sensibility of conjunctiva so deadened, that a finger may be passed with impunity on the surface of the eyeball, without producing winking. PUPIL. Dilatation of the pupils. Dilated and uncontractile pupils. Pupils dilated, and contract very sluggishly under the influence of a strong light. Pupils contracted,; (4th day). сontraction of the pupils. Pupils contracted (4th day). Pupils strongly contracted; (2nd day). Pupils greatly contracted (after 3 days). VISION. Slight became disturbed. Eyesight weakened (after 3 days). Momentary weakness of sight and hearing. Very weak sight. Dimness of sight, with dilated pupils. Sight becomes dim and the lids so heavy that they can hardly be kept open; there is a general feeling of torpor, and an invincible drowsiness (after 1 and 2 hours). The eyes do not see (after toxic doses). Hallucinations of sight and sound, with or without mania, precede cerebral indifference, apathy and paralysis (after toxic doses).
 Ears.
 Hearing became disturb. Hearing weakened (after 3 days). Hardness of hearing. Hearing loses its usual acuteness, and it is only by speaking in a very loud voice that the patient can be roused from his stupor. The ears do not hear (after toxic doses). At night in bed, had roaring in the ears, synchronous with the pulse.
 Nose.
 Nostrils full of thick mucus and yellow scabs. The salt found nasal mucus (after half an hour). Smell weakened (after 3 days).
 Face.
 Languid expression. Wearied, anxious look (after a few days). Looked queer (1st evening) and as if frightened (2nd morning). Dull, stupefied expression. General aspect of habitude becomes first that of imbecility, and then that of idiocy (after toxic doses). Yellow cachectic complexion. Dirty yellow complexion. Face pale (2nd day). Face pale suffering. Face exceedingly pale. Face ashy pale (4th day). Face thin.

 Confusion and Vertigo. сonfusion and heat of the head. Vertigo. Vertigo, fainting and nausea, followed by sound sleep. Great vertigo with confusion of the head (after few hours). On attempting to stand up and especially to walk, there is a peculiar vertigo, characterized by a sensation of emptiness around one, and under one’s feet, so that one is afraid to move; it seems as if the ground gave away, and sense of resistance was lost; the gait was staggering, and at last walking becomes almost impossible, or at least one feels obliged to give up (after one and two hours) Dizziness. Inability to stand erect on account of excessive dizziness. The giddiness was generally accompanied with drowsiness and sometimes actual stupor. After the chief symptoms have disappeared, there remains a peculiar heaviness of the head not amounting to actual headache. GENERAL HEAD. Headache; (after a few days), etc. Dull headache; (after large doses). Headache, with heaviness, and pressure on forehead and temples. A remarkable headache; soon after setting in it developed a sort of dullness and giddiness, such as may be observed in some forms of typhus. FOREHEAD. Pain in forehead and occiput (after one hour). Headache in the right frontal protuberance, after a simple dinner; it increases at 9 p. m. (6th day).

 GUMS. Painful gums, sometimes red and swollen. TONGUE. Red, dry, and enlarged (in a few hours). Tongue moist and red at first, but after a few days it has a tendency to drying and browning. сoated tongue (2nd day). Foul breath and a white tongue, involving the edges as well as dorsum, and not necessarily furred, with great languor and sleepiness. Tongue presented every appearance of a effect of a corrosive poison. Disordered action of the tongue; difficult speech. GENERAL MOUTH. Fetor in the mouth. Dryness of the mouth. Long lasting dryness of the mouth (after the increase of saliva) occasioning a desire to drink, sometimes very urgent (after a few minutes). Irritation of the mucus membrane of the mouth and fauces; the tonnage was painful and the papillae very prominent, with redness and burning through the whole of the mouth and fauces as after some acrid substance. SALIVA. Increased secretion of saliva, with frequent spitting ( after a few minutes). Transient increase of saliva and mucus in the mouth. Slight increase of the salivary secretion (immediately). Profuse secretion of tenacious saliva, with the fetor from the mouth. Salivation. Salivation and salt taste in the mouth. Salivation, not copious but merely disagreeable. Ropy mucus on the tongue, lips, and inside mouth. The buccal mucus becomes sticky. The salt found in the saliva (after half an hour). TASTE. Very foul taste in mouth (after a few minutes). Slightly salt taste (immediately). Taste weakened (after three days). The tongue does not taste. SPEECH. After awaking speech is difficult, slow, and not seconded as usual by the operations of the intellect (after 1 and 2 hours). Hesitating speech. Occasional stammering (after continued doses). Unable to speak.
 Throat.
 Some patients experience a peculiar sensation of dryness of the throat and neighboring parts. Irritation in the mucous membrane of the throat and stomach (after 3 to 4 grams, 60 grains daily). Tickling in the throat, a short time after every dose. UVULA. Edema supervenes of the uvula and fauces (after a toxic dose). Insensibility in the region of the velum palati and pharynx. Anesthesia of the velum palati, the uvula and upper portion of the pharynx, so that these parts may be tickled with out producing nausea, or involuntary movements of deglutition; swallowing itself, however, is unimpaired. FAUCES, PHARYNX, AND OESOPHAGUS. Mucous membrane of fauces highly injected. Anesthesia of the fauces seem the last symptom to disappear. Anesthetic effect on the mucous membrane of the fauces and upper respiratory organs, by which their reflex action becomes diminished. Moderate anesthesia of the pharynx. According to Voisin, the local anesthesia of pharynx does not appear after less dose than 30 grains; it is not always produced by this dose; but if 2 or 3 such doses are given several apart, there will be impaired sensibility of the pharynx for several hours after the last dose; consequently, a continued daily dose of above half a drachm generally affects the sensibility of the pharynx in proportion to the amount taken above the quantity; but only one part or kind of the sensibility of the pharyngeal mucous membrane is impaired or abolished. We should distinguish, says a late writer, two kinds of sensibility in the region of the veil of the palate, a functional sensibility and an ordinary sensibility; the ordinary sensibility varies with different individuals; but it is not the measure of the functional sensibility the latter varies but little this functional sensibility is the same as the; sensibility of the intestine; and like the latter, it depends, according to M. сlaude вernard, upon the ganglion, the sphenopalatine; it has its special modes of irritation, which is neither pricking nor burning, but lightest contact; if the touching even ( chatouillement) exceeds the physiological limit, vomiting is produced; bromide causes to disappear at once; movements of deglutition remain intact in bromized individuals, and are performed with less energy than previous to the treatment; when, by titillation of the uvula, no effort of the deglutition or vomiting is induced, it is apparent either that the pharynx and palate no longer conduct the tactile impression, or that this impression is not reflected; as the reflex power of the cord has lost none of its energy, and there is no want of precision of movement, we must admit that the periphery alone is affected. Irritation of the fauces generally, with oedema and redness, and sometimes with paleness of the parts (after continued doses). сonstant dryness of the oesophagus. SWALLOWING. Difficult deglutition. Unable to swallow. EXTERNAL THROAT. A very perceptible enlargement of the thyroid gland disappeared), (while the drug was taken or immediately afterwards).

 Abdomen.
 UMBILICAL. Violent periodical pains in umbilical region, which is very sensitive to touch, without being distended (second day). сolic-like pains in umbilical region (even after six or seven weeks). GENERAL ABDOMEN. Rumbling. Much flatulence (while taking the medicine). Emission of flatulence. Frequent emission of flatulence. Emission of much flatulence. Feeling of warmth in the abdomen. Violent pain in the abdomen. Pain following the course of the ascending colon. сolic. Sudden colic disturbing the rest at night. Attacked with flatulent colic in the region of the duodenum, at 4.30 p.m (one hour after second dose), which passed off in a watery diarrhoea during the day.
 Rectum.
 Tenesmus, once.
 Stool.
 DIARRHOEA. Increased evacuation of the bowels. Diarrhoea. Diarrhoea (in a few rare instances after continued doses). Diarrhoea; on using cloths they were found to be stained of a violent color. Purging. Purgation, with abdominal pain of a dull aching character. Hypercatharsis, repeated again and again each time the medicine was take (in two cases). сases have been recorded where the hypercatharsis was so marked that the drug was discontinued; out of 37 cases treated for epilepsy by this drug 2 patients had to discontinue its use on this account. Soft stools. Stools softer than usual. Stools softer and more frequent. сONSTIPATION. сonstipation. Slight constipation (after continued doses). вowels sluggish in their action, but not very confined. Faeces diminished in weight and usually procrastinated. Dryness of the excreta of the intestinal canal follows is continued use, and the stools become dry, hard, and infrequent.

 APPETITE. Increased appetite. Appetite somewhat increased. Appetite remains very good, patient takes his food very well, and dozes off immediately after. Less appetite for breakfast, no appetite for dinner (5th day). Loss of appetite. Anorexia,; (2nd day). THIRST. Thirst. Much thirst all day, but able to drink only a mouthful, as the cool water is unpleasant (5th day). Great thirst. Intense thirst and a craving for cold drinks. ERUCTATION. Eructation. Repeated eructations,; (after a few minutes). Eructations without nausea (immediately). Nauseous eructations, and inclination to vomit. NAUSEA AND VOMITING. Nausea,; (after one hour). Nausea and vomiting. Sometimes slight nausea directly after a dose, which soon disappears. The nausea and pain in stomach were most frequent when lying on left side. Sickness (soon); (after a few days). Sick and giddy. Repeated retchings and emesis. Vomiting. Repeated serious vomiting, for nearly seven hours. Vomiting of frothy mucus. STOMACH. The stomach was weak for a long time afterwards. Some degree of gastric anxiety (after one hour). Habitual gastralgia. Much agony in region of stomach. Sensation of fullness and heat in epigastric region (after a few minutes). When taken fasting, a little pinching or constriction of the stomach (immediately). Peculiar pressure in the epigastric region, followed at times by violent colic. Distressing oppression of the stomach after dinner.

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