BROMUM. 117 



free in the "blood, but no special action or therapeutic applica- 

 tion can be referred to this circumstance. 



3. SPECIFIC ACTION AND USES. 



The bromides pass through the organs as such or as 

 bromide of sodium, and have a very definite specific action upon 

 them, which, speaking generally, is one of depression. 



The nervous system is specially affected. Loss of reflex 

 excitability in connection with all the sentient surfaces of the 

 body follows the administration of full medicinal doses. This 

 result is due partly to depression of the peripheral (sensory) ner- 

 vous filaments, but -chiefly to reduced activity of the nervous 

 centres in the brain and cord. At the same time the motor 

 nerves are also soothed, and the muscular power (which we may 

 conveniently consider along with the nervous), is much 

 weakened. The phenomena of this general nervo-muscular 

 depression are as follows, beginning with the highest centres : 

 (1) The bromides lessen mental activity, readiness to react to 

 emotional stimuli, and sensibility and irritability of mind gene- 

 rally, thus inducing a condition of brain favourable to the 

 advent of sleep. They are thus indirect hypnotics, not acting 

 like opium and chloral, but so reducing the patient's sensibility 

 of his surroundings, bodily condition, or circumstances, as to 

 prevent distraction, and allow natural sleep to intervene. It is 

 uncertain whether the bromides act upon the nerve cells direct!}', 

 or upon the cerebral blood-vessels. The soothing and hypnotic 

 effects of the bromides are very extensively employed in 

 restlessness and sleeplessness from mental strain, whether 

 emotional or intellectual, in the acute specific fevers when 

 similar symptoms are urgent, in acute alcoholism, and in 

 mania. In the three last conditions a certain amount of chloral 

 or opium may be advantageously combined with the bromides. 

 Bromide of lithium, the most active hypnotic of the bromides,^ 

 will sometimes remove the insomnia of gout. The most im- 

 portant application of the soothing action of the bromides is in 

 epilepsy, which is now almost exclusively treated with these 

 salts, unless they be contra-indicated. Hysteria, infantile con- 

 vulsions, whooping-cough, general "nervousness," hypochon- 

 driasis, and the low despondent condition so common in women 

 with uterine irregularities, are also relieved by bromides, 

 although not with the success obtained in epilepsy. 



The great vital centres of the medulla are depressed by 

 bromides. Respiration becomes slower and is weakened, whence 

 possibly part of the value of the drug in whooping-cough. The 

 heart is also slower and weakened in its action ; chiefly, how- 

 ever, by depression of its nervo-muscular substance, not of the 



