Epilepsy. Falling Sickness. 59 



chloride) and silver salts (nitrate) and arsenic have been used, 

 often with excellent results. Borax strongly recommended for 

 man ( i to i ^ drachm daily) by Pastena is worthy of a trial for 

 dogs. It is given largely diluted in syrup to avoid gastric irri- 

 tation. 



Of all agents employed up to the present the bromides still 

 . claim a foremost place. They should be given in a large dose, , 

 on an empty stomach and at such a time as to occupy the system 

 at the hour when the seizure is exp.;cted to recur. Thus for 

 morning attacks the dose may be given at night, while for night 

 attacks it may be given in the afternoon. Miiller uses sodium 

 bromide in the dog as least liable to disturb the stomach, while 

 Peterson for man, advises the potassium salt for the same reason. 

 For man, McLane Hamilton advocates a combination of the 

 sodium and ammonium salts, Eulenberg adds the potassium com- 

 pound, while Berkley uses strontium bromide, and Bourneville 

 camphor monobromide. 



Given at night in full dose (30 grs. for dog) the bromides tend 

 to secure a quiet sleep, with brain rest and recuperation. If 

 beneficial they should be repeated daily until a cure or other sign 

 of bromism appears. This may be somewhat checked by arsenic 

 or chloral hydrate. 



Wesley Mills finds potassium iodide useful in some dogs when 

 bromides fail. Bromohydrate is advocated by Miiller. 

 Flechsig and others have had excellent results in man from the 

 opium bromide treatment. Full doses of opium given three 

 times a day for six weeks, when they are replaced by full doses 

 of bromides four times a day. 



Improvement should be shown in the shortening of the con- 

 vulsions and the lengthening of the intervals between them. 

 Should the bromides fail in this, resort may be had to other treat- 

 ment. 



Toulouse, Clark and others find that privation of salt, in man, 

 allows the bromine salt to replace the chlorine one in the tissues, 

 and the hydrobromic acid the hydrochloric in the gastric juice, 

 and in this way the bromine can be introduced safely in larger 

 amount into the tissues and is longer retained, though given in 

 half the doses. 



