The first potash preparation we will consider is KALI BROMATUM or Bromide of Potassium. We find that this drug is antidoted by Hepar mainly. It has some few analogous or concordant remedies, AMBRA GRISEA, HYOSCYAMUS, STRAMONIUM, TARENTULA and MYGALE.
Bromide of Potassium acts mainly upon the nervous system and acts, too, in two opposite directions. Primarily it decreases reflex action ; secondarily, it depresses the mind. This property of the drug to modify reflex action has led to its extravagant use in the treatment of epilepsy. It is given in progressively increasing doses until the system is affected by what is known as bromism. When the system has become saturated with the drug, then it is discontinued for awhile. The first effect of the drug seems to be to increase reflex action, particularly reflex motor action, and it is on this quality of the Bromide of Potassium that the allopath bases his prescription. Every little disturbance in the periphery of the nerves, every little alteration in the function of an organ, is at once reflected to the nervous centres, and produces some other disturbance, either an uncomfortable sensation, twitching of muscles, anxiety, headache, or even absolute convulsions. This is the first condition of the Bromide of Potassium. You know that this is the starting point of almost all convulsions. Witness for instance, a case of eclampsia, where the pressure of the child on some of the nerves in the pelvis or against an undilating os, causes spasms; or still, another ease, where some indigestible substance in the stomach produces convulsions. This reminds you at once of STRAMONIUM, in which a bright light, by affecting the retina, reflects the irritation to the brain and causes convulsions.
As a result of this oversensitiveness to external impressions, we have quite a number of characteristics of the Bromide of Potassium. Many of these are symptoms of the drug calling for its exhibition in acute mania, when there are sleeplessness and strange imaginations. The patient imagines that he will be poisoned; that he is pursued by some demon; that he is hated by everybody, or that his honor is at stake. Some such impression acts on the mind irresistibly, and causes him to resort to violent procedures; thus, he will try to commit suicide in order to avoid the supposed danger. All this time, the pupils are dilated, and the face bright red and expressive of anguish and fear. The body trembles, and the muscles twitch in various parts of the body. You see how this resembles HYOSCYAMUS, both being parallel remedies in this form of disease.
Kali bromatum has also acted very well in the night-terrors of children, when from over-excitement of the brain, whether it be reflex from dentition or worms, or even from affection of the brain itself, the child shrieks out in its sleep, and if old enough, will complain of seeing hobgoblins, ghosts, or something of that kind. Even when that symptom occurs in impending dropsy of the brain, Bromide of Potassium may be the remedy.
We have another condition calling for Kali bromatum, and this seems to be an irritability of the nerves, not only of the brain, but of the whole body. This irritability is expressed by the following symptom : The patient is nervous, and cannot sleep, and feels better when engaged at some work. He is either busy playing with his fingers, or he is walking about, or in some way occupying his mind or body in some exertion ; then he feels better. Simple sleeplessness will not be relieved by Kali bromatum, unless there is this relief from activity or motion.
In this respect I find it similar to TARENTULA, which also has this irritation of the periphery of the nerves relieved by exercise and by rubbing. The patient plays with her dress, or with her watch-chain, as if to work off this over-irritation of the peripheral nerves. Even in the case of the headache of this remedy, the patient rubs the head against the pillow for relief.
Another remedy which is similar to Kali bromatum in this over-excitability, is AMBRA GRISEA, which has this same sensitiveness to external impressions, the slightest influence causing excitement and difficulty in breathing. Ambra grisea, however, almost always has some sort of vertigo associated with its other symptoms. It is a very quick-acting drug.
Conversely to this primary action of Kali bromatum, we have another, one of great depression of the cerebro-spinal nervous system. Thus we find it producing absolute loss of memory. The patient cannot remember words particularly. Associated with this symptom, we find a distressing melancholy; everything looks dark and gloomy. He cares nothing for anybody or for his occupation. This condition of things often follows excesses in venery, in which case Kali bromatum is an excellent remedy.
There is also a sort of ataxia developed. The patient seems to be unable to manage his legs as he should. There are numbness and tingling in the legs and in the spine; this symptom being accompanied, in the first stages, by an increase in the sexual appetite, but as the case advances it is associated with absence of erection and, too, frequent nightly emission of semen, thus increasing the melancholy.
You will find Bromide of Potassium indicated for business men who have worked long and hard, who have pored over difficult problems until they have this dizziness, this staggering when they walk, and this benumbed feeling in the brain. It was only yesterday that I prescribed it for a business man on Third Street, who has been working himself almost to death. I expect that it will relieve him promptly and effectually. He said that when he had been working at his books he would get a numbness in the back of the head, and a certain indescribable terrified feeling, as though he was going to lose his senses. Good results might also be obtained in this case by the galvanic current, the positive electrode being applied to the cervical region and the negative on the vertex. But Kali bromatum will give a more permanent relief.
Now, a word about Kali bromatum as an anti-epileptic remedy. I do not believe that it ever cured epilepsy. In almost all cases in which it has been given, it has not cured but simply suppressed the disease, and thus has produced a worse condition than the one previously existing, namely, imbecility.
Kali bromatum produces lesions of the skin. Its long-continued use gives rise to little, hard, dark red papules on the face, surrounded by little vesicles, and ending in suppuration. We may, therefore, use the drug in acne, particularly that resulting from masturbation.
Another form of eruption which the Kali bromatum produces is a livid blotch as large as one's thumbnail, covered with scales, and having in its centre a yellowish appearance as if it were suppurating. After awhile it does suppurate and discharge, leaving a central depression, something like that of the small-pox pustule.
Still a third form of eruption, is an eczema which evidently arises from the action of Kali bromatum on the sebaceous or sudoriferous glands, causing an abscess in each of these, and developing a scaly eruption.