Bromium

Scrophulous blondes. Constrictions, glandular induration or membranous formations. Weak and easily overheated, then sweaty and sensitive to drafts. .................... Head congested, fears a stroke. Acrid, burning coryza. Nosebleed. Face seems drawn to a point at nose. Flatus from vagina. Inhaled air seems smoky, cold or raw. Lungs feel coated with down. Wants to take a deep breath, but it excites cough. Suffocative fits; he starts up choked with croupy or wheezing cough, or with palpitation. Asthma. Spasm of glottis. Asthma of sailors going ashore. Deep hoarseness, < if heated. Diphtheritic croup. Colds start in larynx; go upward (Merc. Sep.) and downward. Thick, white expectoration. Even a small goitre oppresses. Nervous palpitation. Cardiac hypertrophy. Slow, glandular enlargement. Boring in bones.

WARM: DAMPNESS. Overheating. Room. Chilled while hot. Sea bathing. Dust. Drafts. Until midnight.

Nosebleed (vertigo, head, chest). At sea. Motion.

LARYNX. RESPIRATION. Heart. Circulation. Glands: Parotid. Thyroid. Ovaries. Mammæ.

Related: Lach. Samb.

Bromium

Bromine. The Element.

It acts best, but not exclusively, on persons with light-blue eyes, flaxen hair, light eyebrows, fair, delicate skin; blonde, red-checked, scrofulous girls.

Sensation of cobweb on the face (Bar., Bor., Graph.).

Fan-like motion of alge nasi (Ant. t, Lyc.).

Sailors suffer with asthma “on shore.’’

Stony, hard, scrofulous or tuberculous swelling of glands, especially on lower jaw and throat (thyroid, submaxillary, parotid, testes).

Diphtheria: where the membrane forms in pharynx;

beginning in bronchi, trachea or larynx, and extending upwards ; chest pains running upwards.

Membranous and diphtheritic croup; much rattling of mucus during cough, but no choking (as in Hepar) ; sounds loose, but no expectoration (Ant. t).

Croupy symptoms with hoarseness during whooping-cough; gasping for breath.

Dyspnoea : cannot inspire deep enough ; as if breathing through a sponge or the air passages were full of smoke or vapor of sulphur; rattling, sawing; voice inaudible; danger of suffocation from mucus in larynx (in bronchi. Ant. t. ).

Hypertrophy of heart from gymnastics in growing boys (from calisthenics in young girls, Caust.).

Physometra; loud emission of flatus from the vagina (Lyc.) ; membranous dysmenorrhoea (Lac c.).

Cold sensation in larynx on inspiration (Rhus, Sulph.) ;> after shaving (< after shaving, Carbo an.).

tions, Chlor., Hep., Iod., Spong.

Hard goitre cured after Iod. failed.

Brom. has cured in croup after failure of Iod., Phos., Hep., Spong. ; especially in relapses after Iod.

“The chief distinction between Brom. and Iod. is, the former cures the blue-eyed and the latter the blackeyed patients.” — Hering.

Lecture XLVIII — Halogens — Bromine and Iodine; and Spongia

Halogens.

-J I Highly irritant to the mucous membranes.

Spasm of the glottis.

Pseudo-membranes.

I Glands, etc.

Halogens. < Bromine. -I Phos., Ant. tart.

Carbo an.

Aeon., Spong., Hep., Kaol.

Kali brom. >Amon. c.

Fluorine.

f Merc, Phos., Sulph., Calc. ostr.

| >Sulph.

Iodine. -{ Ars., Calc, Arg. n.

Spong., Hep., Kaolin.

[ Ant. tart.

>Starch.

>Hepar.

>Arsen.

Chlorine.

To-day we begin the study of the chemical elements termed halogens; Iodine, Bromine, Fluorine and Chlorine are the elements in this group. As a group the halogens may be remembered by this great characteristic symptom, they all act upon the larynx and bronchial tubes, and in fact upon mucous membranes generally. They are decidedly irritating to the mucous membranes, producing violent inflammation, rawness and excoriation, as anybody can testify who has once inhaled the fumes of Chlorine, Iodine or Bromine. They all produce spasms of the glottis and this is most marked in Chlorine, although they all have it. They all tend to produce pseudo-membranous formations on the mucous membranes. All excepting Chlorine tend to produce croupous membranes; Chlorine tends more to diphtheritic than pure croupous membrane. All of the halogens act upon the glandular system, producing enlargement, induration and even abscess in glands. Thus we find them all useful in scrofulosis, especially Iodine, which leads the list. Cyanogen also belongs to this group chemically, although it is properly considered as belonging to organic chemistry. It has many similarities to these drugs, and, like Chlorine, is useful in diphtheritic deposits. Thus we use Hydrocyanic acid and Amygdala Perska (which contains Hydrocyanic acid) for diphtheritic sore-throat, and we may use the Cyanide of Mercury, for some of the worst forms of diphtheria. The same is true to a less degree of Cyanide of Potassium. These general characteristics of the halogens lead you at times to say: "This patient needs one of the halogens, which shall it be?" To answer that question we must study these four elements separately and by comparison.

Bromine.

I will first call your attention to Bromine. Bromine produces a rather peculiar effect on the sensorium, causing a sort of vertigo, which is worse from running water. Anything moving rapidly produces this vertigo. It is associated with a peculiar anxious state of mind. Now this anxiety belongs to all of the halogens. It hardly originates in the mind, probably coming from some defect in the body, itself. It is a common symptom in heart and lung affections, and it is probably thence that the symptom springs. This anxiety is expressed in this way: the patient expects to see objects jumping about or he feels as if on turning his head he must see something or some one. This is an effect of Bromine, and those of you who are familiar with Bromide of Potassium will recognize whence it gets its anxiety. The vertigo is relieved by nose-bleed, showing at once that it is congestive in character. Another symptom indicative of congestion under Bromine is this: after dinner there is sensation deep in the brain as though a fit of apoplexy were impending. The patient feels as if he would lose his senses.

The Iodine mental condition is more marked than that of Bromine. It is a decided erethism, during which the patient is very excitable and restless, moving about from place to place, now sitting here, now sitting there; he fears that every little occurrence will end seriously. In his anxiety he shuns every one, even his doctor. He has a great dread of people. At times he becomes quite excited and delirious, with vertigo, red face and anxiety. In children with tabes mesenterica here is a characteristic irritability, screaming when looked at. Next, the lymphatic system. Like all the other members of this group, Bromine attacks the glands and causes enlargement and induration of the glands. Hence it is called for in scrofulosis. It is particularly suited to scrofulous patients, children usualh , when the parotid gland or glands are indurated, when there is a tendency to suppuration, with excoriating discharge, persistent hardness of the gland around the opening, and undue amount of warmth or heat in the gland. I have merely mentioned the parotid gland for purpose of illustration. Bromine also affects the mammary gland, for cancer of which it has been a very useful remedy. You may perhaps remember that I told you the other day that it was similar to Carbo animalis. Like Carbo animalis, it has induration of the glands in the axilla with burning pains. But 'Bromhie also has cutting pains. The breast is hard and on palpation, a dull subdued sort of throbbing may be felt in it. Sometimes the drawing or cutting is so marked that it feels as if a string were pulling from the gland into the axilla, a symptom more often calling for Croton tiglium or Paris quad.

The testicles are acted upon by Bromine. We find them swollen, hard and perfectly smooth and unduly hot. The pain is worse from jarring. You will find that glandular affections yield to Bromine, especially in persons of light complexion, with fair skin and light blue eyes. I mention this symptom here to make use of it in a few moments as a symptom of comparative value. I do not mean to say that every scrofulous child with blue eyes must have Bromine, but I do mean that this symptom is of use to enable us to distinguish

Bromine from the other halogens.

The tonsils, too, are affected in Bromine. Thus we find them deep red and swollen and covered with a network of dilated bloodvessels. They are worse when swallowing, and are accompanied usually with swelling of the glands externally. There is a feeling of rawness in the throat with this tonsillitis. This, too, as you know, is common enough in scrofulous children. Many have a strong temptation to excise the tonsils, but this is not good practice, for you can often cure this trouble by internal medication. In some cases, this enlargement of the tonsils may be looked upon as a forerunner of tuberculosis. We find Bromine indicated in enlargement of another gland, namely the thyroid gland, and curing what has been termed bronchocele or goitre.

We next have to speak of Bromine in its action on mucous membranes. Beginning with the nose, we find that it is useful in coryza or in nasal catarrh, when the discharge is profuse, watery and excoriating. The nostrils, alternately, seem to be stopped up. There is peculiar headache associated with this coryza, a heavy pressure in the forehead which seems to be pushing the brain down and out at the root of the nose. The nose is very sore inside and also around the alae. This is a smarting soreness, just such as you would expect the fumes of Bromine to cause. Later, ulcers form in the nose, with the escape of crusts or scabs, which are blown out and which are always blood} . Every attempt to blow the nose is followed by a discharge of crusts and blood. This you know is common enough with scrofulous children.

Coming now to the throat and lungs, we find Bromine indicated in spasm of the glottis, sometimes called laryngismus stridulus. This is a very difficult disease to cure. It is often central in its origin. It commences by sudden closure of the glottis. The child turns blue in the face, and its body becomes convulsed. One spell ceases only to be followed by another. In the second stage, general convulsions appear, followed by emaciation. The trouble may be reflex from dentition, or from indigestion, or from enlargement of the thymus gland. If it can be found to be the result of enlargement of the thymus gland, then^ Iodine is clearly indicated. When it has been caused by retarded dentition, I think that Calcarea phosphorica promises better than anything else. Dr. Dunham records a case that had been given up by an allopathic physician, but, knowing the symptoms of Chlorine, which, above all other remedies, will produce this spasm of the glottis, he generated some Chlorine, and allowed the child to inhale the fumes, with almost instantaneous relief and final cure. All the halogens are useful in this condition, but Chlorine is here the best of them all. Their symptoms differ but little so far as the local symptoms are concerned. We may also think of Sambucus, Antimonium tartaricum, Belladonna, Lachesis, Arsenicum and, in some cases, Phosphorus.

Lachesis is particularly indicated when the patient awakens from sleep with it.

Ignatia, whenever a cross word or correcting the child brings on the spasm.

Another remedy is Cuprum, especially when the spasms are general and the child clenches its thumbs.

Ipecacuanha may be of some use in some cases, but I have no confidence in it.

Nor have I in Sambucus, because, under Sambucus, I think the trouble is more in the chest, whereas, with Cuprum, the halogens, Calcarea phos., Lachesis and Belladonna, the trouble is in the larynx itself.

This spasm of the glottis often comes in the course of croup, in which disease Bromine may be the remedy when inspiration seems to be exceedingly difficult; the child is suddenly aroused from sleep as if choking. These symptoms are relieved by a drink of water, which seems to quiet the spasmodic condition. In membranous croup Bromine is indicated by the following symptoms in addition to the spasm already referred to: the child has at first a deep, rough voice, which, in the evening, amounts almost to aphonia. It cries with a hoarse, husky voice. The membrane seems to come up from the larynx into the throat. Every inspiration provokes cough, especially every deep inspiration. Breathing is hoarse, rasping and whistling, as though the child were breathing through a sponge or through some loose metallic substance which is vibrating. This is caused by the vibration of membrane as it is deposited more or less uniformly over the interior of the larynx. Later, there is rattling in the larynx. When the child coughs it seems as if the larynx were full of the loose rnucus. Antimonium tartaricum is very similar to Bromine in croup. It has rattling and wheezing, extending down the trachea as well as in the larynx.

Now, I wish to say a few words about other remedies in connection with croup, especially concerning Aconite, Hepar, Spongia and Kaolin. Kaolin is a kind of porcelain-clay, a combination of lime and silica, and has proved very useful in membranous croup. The relation which these remedies hold is this: Aconite is useful in the beginning of croup, whether spasmodic, catarrhal or membranous. It is indicated by the child suddenly arousing from sleep as if it were smothering. There is great restlessness. The skin is hot. There must be some anxiety present. Breathing is dry. There is no sound of mucus. Soon the child seems better and falls asleep, only to be aroused again. Arnica is especial^ indicated in these cases if the symptoms have followed exposure to drjr, cold winds. Do not stop your remedy too soon. If you do, while the child will be better in the morning, the symptoms may return with renewed violence the next night, and, before you know it, the mucous membrane of the larynx and trachea will take on fibrinous exudation and you lose your patient.

You will need to change to Spongia when you have these symptoms present: breathing during inspiration is hard.and harsh, as though the child was breathing through a sponge. The cough has a decidedly hard, barking, ringing sound. As yet the sputum is scanty. Spongia follows Aconite, especially after exposure to dry, cold winds, and in light-complexioned children with blue eyes. The symptoms are usually worse before midnight. Suppose this fails you, then you may have recourse to Hepar sulpharis calcarea.

Hepar usually is worse after midnight and towards morning. The cough has the same harsh, croupy sound, but there is a great deal of moisture with it. This is the indication for Hepar. It, too, is worse from exposure to dry, cold winds. Sometimes all these drugs fail, and we have to resort to the halogens, especially to Bromine and Iodine. I have already given you the symptoms of Bromine; let me tell you how to distinguish it from Iodine. Iodine is particularly indicated after the failure of Hepar, when the membrane has formed; inspiration is exceedingly difficult, both from spasms of the throat and occlusion of the lumen of the larynx by the membranous formation. Inspiration is wave-like or in jerks. The cough is moist but harsh, just as you found under Hepar. The voice is almost extinct from the hoarseness. The child grasps its throat to relieve the pressure, throws its head far back so as to straighten the route from the mouth to the lungs and favor the passage of air. It is particularly worse in the morning. Iodine is especially adapted to dark-complexioned children with dark hair and eyes. This in itself is a great distinction between Iodine and Bromine. That is why I spoke of the use of Bromine in light-complexioned children, because this fact has been proven to be a good distinction between these two drugs, and hence, as a comparative symptom, is one of great value to you. Iodine is particularly adapted to cases that come from damp weather. Long-continued damp cold weather will produce just such a cough as Iodine will cure. Do not change the remedy in these cases too often. Do not change your remedy on account of alarming symptoms that spring up, unless you are certain that they indicate a change.

Kaolin has been used successfully for membranous croup even when the membrane dips down deep into the trachea. There is extreme soreness of the chest. The patient does not want anything to touch him. He will not permit you to use steam or hot cloths, because the chest is so sore.

Returning to the study of Bromine, we find it useful in affections of the lungs. It is indicated in asthma, when the patient feels as if he could not get air enough into his lungs, consequently he breathes very deeply. The explanation of this lies not only in the lungs, but also in the constriction of the glottis. Although the patient expands his chest well, air does not go in on account of the narrowness of the opening in the larynx. It is especially indicated in asthma coming on, at or near the seashore.

We also find Bromine useful in pneumonia, particularly when it affects the lower lobe of the right lung, hence lobar pneumonia. We often find nose-bleed as a concomitant symptom when Bromine is indicated in these cases. The patient also has the symptom just mentioned under asthma, "seems as if he could not get enough air into the chest; " while there seems to be plenty of mucus, the patient does not appear to be able to expectorate it.

We also find Bromine indicated in tuberculosis of the lungs, particularly when the tubercular deposit is more manifest in the right lung. The patient suffers frequently from congestion of the head and chest, which is relieved by nose-bleed. Notice how often that symptom occurs under Bro?ni?ie. There is also pain in the mammary region going up into the axilla. The eyes seem to be affected along with the chest symptoms giving rise to a chronic conjunctivitis. Bromine produces a very characteristic picture of uncomplicated hypertrophy of the heart, by which I mean, muscular enlargement without valvular lesion. The patient finds it difficult to exert himself on account of the oppression about the heart. He has palpitation when he begins to move and when he gets up from a sitting to a standing posture. The pulse is full, hard and rather slow, which is just the character that belongs to an over-active enlarged heart. It has cured many cases of this hypertrophy of the heart. I think it was Dr. Thayer, of Boston, who cured many cases of this trouble with Bromine. It may also be used in cardiac asthma, especially when the asthmatic paroxysms are better at sea than on land.* You here find Bromine similar to Aconite, but it lacks the anxiety of that remedy. Both remedies are suited to uncomplicated cardiac * Professor Farrington refers above to the asthma of Bromine as coming on at or near the seashore, and here he speaks of cardiac asthma better on sea than on land. Both may be right, for being at sea differs from being at the seashore* where you may have land breezes.—S. 1^.

hypertrophy, but Aconite has fear and anxiety. The patient fears that he will drop dead in the street.

It is also similar to Aconite and Rhus tox., both of which remedies have uncomplicated hypertrophy of the heart from over-exertion.

Delusion that strange persons are looking over patient's shoulder and that she would see some one on turning. Quarrelsome.

Most marked effects are seen in the respiratory symptoms, especially in larynx and trachea. It seems to affect especially scrofulous children with enlarged glands. Blond type. Enlarged parotid and goitre. Tendency to spasmodic attacks. Left-sided mumps. Sense of suffocation; excoriating discharges, profuse sweats and great weakness. Complaints from being over-heated. Tendency to infiltrate glands, become hard, but seldom suppurate.

Worse, from evening, until midnight, and when sitting in warm room; warm damp weather when at rest and lying left side. Better, from any motion; exercise, at sea.

Megrim of left side; worse stooping, especially after drinking milk. Headache; worse heat of sun and by rapid motion. Sharp pain through eyes. Dizzy when crossing stream of water.

Coryza, with corrosive soreness of nose. Stoppage of right nostril. Pressure at root of nose. Tickling, smarting, as from cobwebs. Fan-like motion of alæ (Lyc). Bleeding from nose relieving the chest.

Throat feels raw, evening, with hoarseness. Tonsils pain on swallowing, deep red, with network of dilated blood vessels. Tickling in trachea

during inspiration. Hoarseness coming on from being overheated. Stomach and Abdomen.––Sharp burning from tongue to stomach. Pressure as of stone. Gastralgia; better eating. Tympanitic distention of abdomen. Painful hæmorrhoids, with black stool.

Swelling of testicles. Indurated, with pains worse slight jar.

Swelling of ovaries. Menses too early; too profuse, with membranous shreds. Low spirited before menses. Tumor in breasts, with stitching pains; worse left. Stitch pains from breast to axillæ. Sharp shooting pain in left breast, worse, pressure.

Whooping cough (Use persistently for about ten days). Dry cough, with hoarseness and burning pain behind sternum. Spasmodic cough, with rattling of mucus in the larynx; suffocative. Hoarseness. Croup after febrile symptoms have subsided. Difficult and painful breathing. Violent cramping of chest. Chest pains run upward. Cold sensation when inspiring. Every inspiration provokes cough. Laryngeal diphtheria, membrane begins in larynx and spreads upward. Spasmodic constriction. Asthma; difficulty in getting air into lung (Chlorum, in expelling). Better at sea, of seafaring men when they come on land. Hypertrophy of heart from gymnastics (Rhus). Fibrinous bronchitis, great dyspnœa. Bronchial tubes feel filled with smoke.

Acne, pimples and pustules. Boils on arms and face. Glands stony, hard, especially on lower jaw and throat. Hard goitre (Spong). Gangrene.

Full of dreams and anguish; jerking and starting during sleep, full of fantasy and illusions; difficult to go to sleep at night, cannot sleep enough in morning; trembling and weak on awaking.

Antidotes: Ammon carb; Camph. Salt inhibits the action of Brom. Compare: Conium; Spongia; Iod; Aster; Arg nit. Avoid milk when taking Brom. Hydrobromic acid (Throat dry and puckering; constriction in pharynx and chest; waves of heat over face and neck; pulsating tinnitus with great nervous irritability (Houghton); vertigo, palpitation; arms heavy; seemed as if parts did not belong to him. Seems to have a specific effect on the inferior cervical ganglion, increasing the tonic action of the sympathetic, thus promoting vaso- constriction. Relieves headache, tinnitus and vertigo, especially in vaso-motor stomach disturbance. Dose, 20 minims).

First to third attenuation. Must be prepared fresh, as it is liable to rapid deterioration.

Bromium

Bromium is one of the routine medicines. It is one of the medicines that the neophyte will make use of for every case of diphtheria and croup, and laryngitis he comes across; and when it does not work he will "try something else." All who prescribe on the name use Bromium as one of their routine medicines; but Bromium is so seldom indicated that most homoeopaths give it up as a perfectly useless medicine. The reason is that they do not take the symptoms of the case and prescribe in accordance with the individualizing method. They do not prescribe for the patient, but for the disease. You may see very few cases of diphtheria calling for Bromium; but when you see a Bromium case you want to know Bromium. There is one underlying feature of the Bromium conditions, they are found especially in those individuals that are made sick from being heated. It there is a diphtheria epidemic and the mother bundles up her baby until she overheats it, and keeps it in a hot room, and it happens to be a child that is sensitive to being wrapped up, and one whose complaints are worse from being wrapped up, look out.

You are going to have a Bromium diphtheria. It is indicated also in complaints that come on in the night after a very hot day in the summer. Now, this is as near as you can come to being routine in croup and diphtheria. If the mother has the baby out in a dreadfully cold, dry day, and along towards midnight it wakens with spasmodic croup, you know that it is more likely to call for Aconite than any other medicine. But if the mother has had the baby out in a hot day in the summer, and that baby has been overheated, with too much clothing, and it is a plethoric child, and towards midnight you are called up, and the child has a red face, and your examinations reveal a membrane in the throat, we will see as we study the remedy that this may be a Bromium case.

"Hoarseness coming on from getting overheated."

Loss of voice coming on from getting overheated. A turmoil in the whole economy; with headaches, coming on from getting overheated. That runs through Bromium. So it is in the hot weather, and being confined to a hot room, and after going from the cold into the heat.

But after the complaint comes on, no matter where it is, he is so sensitive to cold that a draft of cool air freezes him; but he cannot be overheated without suffering.

Glands: Bromium has running through it a tendency to infiltrate the glands. The glands become bard, but seldom suppurate. They generally re hard. The glands of the neck, the parotid, the sublingual, the submaxillary, are enormously enlarged and very hard.

The processes of inflammation are slow; they are not that rapid, violent kind like we find in Bell. and Merc.

"Parts that inflame infiltrate, becoming hard." Inflammation with hardness is the idea. It has been very useful in ulcers with this infiltration; very useful in enlarged glands with great hardness, without any tendency to suppurate. Glands take on tuberculosis, and tissues take on tuberculosis. Glands that inflame for a while begin to take on a lower form of degeneration, a lower form of tissue making.

It is very similar to these enlarged, hard, scrofulous glands that we find in the neck; enlargement of the parotid and submaxillary. It has cured enlargement and great hardness of the thyroid gland.

Again, we have emaciation, and when we see the tendency to infiltration it is not strange that it has been a curative medicine in cancer and tuberculosis. There is weakness in this remedy. The legs become weak. Growing prostration, with tremulous limbs.

Twitching; tremulous weakness; fainting. In the catarrhal affections there is a formation, more or less, of membrane.

Membranous exudate is a natural course of events. A natural feature of the mucous membrane is infiltration, so that the mucous membrane appears to exude little grayish-white vegetations, and beneath them is induration. That is true in ulcers, it is true in mucous membrane. And ulcer will form upon the mucous membrane and eat in, and build beneath it a hardened stratum of tissue.

It has febrile conditions along with these catarrhal states. Great nervous excitement. "Icy coldness of the limbs. "

"Heat of the head."

"Dyspnoea, with great sweating."

Croupy manifestations. Running through most of the complaints there is palpitation.

Mind: Palpitation with nausea, palpitation with headache, palpitation with various kinds of nervous excitement. So weak is be gradually becoming that he has an "aversion to every kind of work; to reading.

Takes no interest in household duties." Becomes indifferent. Very tired.

"Great depression of spirits, Low spirited. Sad and discouraged."

Anxiety with most complaints. Headaches from becoming overheated.

"Noise in the ears.

Throbbing and burning in the ears."

And then the complaints of the glands that are so closely associated with the ears. With ear troubles, enlargement of the glands; the parotid becomes enlarged and bard.

Ear: Ear affections following scarlet fever, with discharges from the ears. Pains and aches; inflammation; abscess of the ear.

Suppuration of the parotid gland occasionally, but it is an exception.

"Swelling and hardness of the left parotid gland." The ovaries, testes, etc., are all affected by Bromium.

Nose: Bleeding of the nose. Ulcerations in the nose. Catarrhal affections of the nose. Much sneezing.

Acute coryza, violent, with much burning in the nose, and a sensation of coldness, as if the mucous membrane of the nose were cold from inhaling cold air.

It is useful for June cold, with the first hot weather in June, or if the first hot weather comes in July. Violent coryza once a year, during the hot season. Fluent coryza, with headaches. "The nose is sore and the wings of the nose swell.

Scurf forms on it, with pain and bleeding on wiping it."

Rawness round about the nostrils.

Face: A Bromium patient is one that is likely to have flushed face, especially those due to acute Bromium conditions.

"Flushed face."

He becomes heated easily. But this is entirely the opposite of the chronic constitutional Bromium condition.

That is true with a good many remedies, especially many of the antipsorics. The old sickly broken-down constitutions, those needing Bromium for chronically enlarged glands, for goitre, for cancerous affections, will have the "gray, earthy color of the face.

Oldish appearance."

It is a sickly face, an ash-colored face. "Face ashy gray."

Then again we have children that are plethoric, with red face, easily overheated. Of course, when the acute condition is on and the breathing has been that of dyspnoea for several hours or many days, then the patient becomes cyanotic, gasping for breath, and choking, the face becomes ashy pale, as it is in diphtheria, in croup, and in laryngeal affections.

"Stony, hard swelling of glands, especially of the lower jaw and throat."

Throat: We find that repeated in many divisions of the subject. Many of the throat complaints that are laid down in Bromium begin in the larynx and creep up into the throat.

Some of them begin in the throat and go down into the larynx; but the two are so closely associated in Bromium that both are likely to be affected; so that diphtheria spreads from one to the other. Diphtheria begins in the throat and goes into the larynx.

Bromium fits the most malignant type of diphtheria. The membrane grows like a weed, shuts off breathing, closes up the larynx, So severe are the cases, that though be has been sick but two or three days and even when Bromium has mastered the case, the patient is left with great prostration. All those that belong to Bromium are of that type.

Great violence; great prostration. Extremely sick, and with deathly weakness. A great many of the cures that have been performed in the throat have been left sided diphtheria, yet it has cured both sides. You will very seldom see Bromium develop in cold dry weather; but in hot damp weather Bromium cases come on; affections in the spring, and in the fall and summer.

Stomach: The chronic cases that will need Bromium are such as have ulcers of the stomach. Suspicious ulcers in the stomach, and suspicious symptoms about the stomach.

Vomiting like coffee grounds, and vomiting with signs of ulceration. Aggravation after eating; either vomiting, or diarrhoea. Cannot take acids. Diarrhoea or cough worse after eating, or after acids.

"After eating oysters, diarrhoea, and a disordered stomach.

Worse from the slightest inhalation of tobacco smoke.

Vomiting of bloody mucus.

Eructations.

" Foul stomach. Pain in the stomach from warm things, from hot tea, hot drinks. "

It is a common feature when there is ulcer in the stomach or when the mucous membrane is about to ulcerate, that hot drinks are intolerable. "Pains from taking hot foods."

Stools and rectum: In studying the stool and rectum symptoms we find exudation.

Membranous formations pass in the stool. Diarrheic stool with membrane.

"Black, fecal stool." Diarrhoea; must go to stool after eating."

We have running through the remedy enlarged veins. These are found also in the rectum. Hemorrhoids protrude from the rectum, burning. Smarting day and night.

"Blind, intensely painful varices, with black, diarrheic stools.

Blind, painful hemorrhoids," and hemorrhoids that protrude.

"Haemorrhoids during and after stool." During the stool the rectum is painful from hemorrhoidal tumors.

Genitals: Swelling and induration of the left testicle. Notice the left sidedness, the left side of the throat, and the left testicle. Then, again, dull pain in the region of the left ovary. "Constant dull pain in the ovary; with swelling and hardness."

There is the same induration of the left ovary. It does seem strange that some medicines single out more particularly the left organs and the left side of the body. Like Lach. in many instances it picks out the left side of the body.

A great many remedies show a preference for one side of the body; the glands in this remedy are more affected upon the left side of the body than the right.

"Swelling of the ovarian region before and during menses."

Suppression of the menses. Loud emission of flatus from the vagina.

Larynx: In the larynx it has produced more symptoms than in any other part of the body. It produces a raw, sore feeling in the larynx from inhaled air.

"Rawness in the larynx.

Loss of voice.

Hoarseness from overheating."

From too much clothing on a warm day, or from keeping on an overcoat in a room that is heated; coming out into the air he cools off. He has laryngitis.

"Tickling in the larynx," keeping up a constant coughing.

Scraping and rawness in the larynx. Scraping mucus from the larynx, scraping and coughing. It is not a hawk, because that noise clears the throat.

Every medical should go through all the noises he hears others make, and try and observe as much as possible what feeling is accompanied with that noise, so that he can put himself in the other's place.

Each one is accompanied with its own sound, and the instant you hear it you realize the exact place he is drawing mucus from and just where the irritation is.

If you allow the patient to describe it he always calls it by the wrong name. The patient knows very little about this part except that it is the throat, and if he is drawing mucus from the throat, or scraping it from the larynx, he always calls it the throat.

But the physician must waive all that and observe as to sound. So let each one go alone by himself and make all these noises that he bears people make, and then realize for himself what part it is he is scraping.

It may seem ludicrous, but how else will you learn about it? It is just as important to figure out these sounds as it is to figure out what a child needs by its sounds and motions. It is impossible to get the symptoms and wants of a child except by interpreting its motions. Every motion it makes indicates something. An astute observer, one who has been watching children for a number of years, will understand the child, and will hardly have to ask the mother a question. He will know at once where the child is sick by what it does.

The child is like the animal. You never have to ask a horse or dog where he feels pain, because he will always tell by his motions. So does the infant.

The hoarseness comes on after being overheated. Remember that.

"Rough, dry cough; pain in the larynx." jumping up for want of breath.

"Gasping and suffering for breath, with wheezing and rattling in larynx.

Sensation as if air passages were full of smoke." Now we have all these rough sounds; rough breathing; croupy breathing; rasping breathing different ways of describing different forms of croup.

You cannot individualize a remedy by these because one child will croup in one pitch, and another will croup in another; but to get at the constitution of the child and the mother is the important point.

"Voice hardly audible."

"Spasm in the glottis."

In the croupy condition it is really a membranous formation upon the inflamed surface, very often extending downward through the trachea into the bronchial tubes, and producing a croupous pneumonia.

Bromium has that in its nature. But without any membranous formation at all Bromium constricts the larynx. It has constriction of the larynx; just like a clutching, a spasm.

"Tickling in the larynx, with irritation to cough. Scraping and rawness in the larynx.

Sensation of coldness in the larynx." That is a very peculiar symptom with Bromium. In laryngitis, where the patient says the feeling is as if it was covered with down.

I have heard them describe it as if it was covered with velvet, but it feels so cold.

The air breathed, feels cold, just like it was the air blown off from snow or ice.

Sensation of coldness in the larynx.

"Constant sore pain in the larynx."

This means that the larynx is painful to touch. Phos., Bell., and Rumex have soreness in the larynx, sore to touch; but the Bromium soreness is commonly below the larynx and in the throat pit as well.

"Sensation as if the air tubes were full of smoke." Some patients, will describe that as sulphur fumes, or as of smoke from tar. After the first few hours mucus begins to accumulate in the larynx and trachea, and a constant expectoration keeps up, of a whitish thick mucus, and he coughs and scrapes the larynx constantly, and there is no peace.

This is often present in laryngitis without any membranous formation. Bromium is not given as often as it is indicated in voicelessness, in irritation of the larynx, in rawness of the larynx because it is uncommon for persons to have laryngitis and hoarseness in the larynx from being overheated.

Many of those cases would be cured promptly by Bromium. But where it is thought of by the routine prescriber is where there is croup or diphtheria.

That was never taught by Hahnemann.

"Much rattling of mucus in the larynx. Inspiration very difficult.

Larynx drawn down."

This would take place in croup, after the formation of the membrane.

"Cough hoarse, crowing, suffocative; breathing sawing, whistling.

Spasms of the larynx; suffocative cough. Membranous formation in larynx and trachea. Croupous inflammation formed by exuberant growth of fungi."

"Asthma of sailors as soon as they go ashore;" relieved again as soon as they are at sea. Difficult breathing with rattling throughout the chest. Bronchitis and pneumonia. Bromium is often the remedy when whooping cough is prevailing in the spring, towards the hot weather, and membranes form in the larynx.

The cough gets immediately worse from dust. Handling old books from the shelf aggravates. Sneezing, hoarseness, irritation in the respiratory tract from picking up and handling dusty things. "Cough, with sudden paroxysms of suffocation on swallowing."

Bromium is full of catarrhal conditions, especially of the breathing apparatus. It has hepatization of the lungs; infiltration is one of its most natural features.