Arsenicum Bromatum

COMMON NAMES, Arsenous or Arsenious Bromide; Arsenic Tribromide.



PREPARATION.--Add one drachm each Arsenious acid, Carbonate of Potassium

and Tartar to eight ounces of Distilled Water; boil until entirely

dissolved; after cooling add sufficient water to make eight ounces. Then

add two drachms of pure Bromine. Clemens.



(The following paper was translated, 1888, from the

German (Deut che Clinic, March, 1859) of Dr. Th.

Clemens, by the late Dr. Samuel Lilienthal):



Arsenious acid, Arsenic blanc, Arsenic oxide, Flowers of Arsenic (AsO3)

is commonly used as the only preparation in which it could be

assimilated. In the Solutio Fowleri we find a combination with Kali

carbonicum e Tartaro, a combination which allows to the Arsenious acid

its full destructive power. Now comes Spiritus Angelicae comp. and the

pure chemical preparation smells like Theriac, but it ought hardly ever

be allowed to add something to a pure chemical preparation in order to

give it taste, color, and use. This Spir. Angel. comp. is made up of

Anglica, Siordium, Juniper berries, Valerian, Camphor, and Alcohol, and

Solutio Fowleri is prepared even to this day in the same manner, and

ought therefore be expelled from every pharmacopoeia, especially as it

is sure to spoil in the pharmacies if kept too long on the shelves.

Looking, therefore, for a better preparation, I prescribe now for the

last decade: [Symbol: Rx]. Arsen. albi. depurat. pulv., Kali carb. e

Tartar. [=a][=a] [Latin: ezh]j., coque cum Aqua destill. lb 1/2 ad

perfect. solutionem, refriger., adde aqua destil. q. s. ut fiat solutio

[Latin: ezh]xii., Dein adde Brom. pur. [Latin: ezh]ii. This solution,

which during first eight days is frequently shaken, becomes colorless in

the fourth week, and is then ready for use. It must be kept in a dark,

cool place.



I will now give my reason for choosing Bromine as a combination. The

study of mineral waters is an old pet of mine; many of them contain

Arsenic in combination with Bromine, and are all well known for their

roborating and alterating qualities. I begun, therefore, my experiments

with minute doses of Brom. arsen.; gradually these were increased, and

I felt astonished what large doses were well borne, and how long I could

use this preparation without injurious consequences. After a few drops

of my solution I could prove Arsenic in all secretions, an experiment

easily made by Marsh's test. Experiments on animals with toxic doses of

either solution (Clemens and Fowler) showed that the same quantity

Arsenicum brom. is less poisonous (one has to be careful with the

selection of animals, as many of them, especially ruminants, bear very

large doses of Arsenic without injury). My preparation gives a rapid,

not destructive, but roborating action on every part of the body.



In doses of two to four drops daily, always to be taken in a full glass

of water, it always shows its specific action as an antipsoricum.

Herpetic eruptions and syphilitic excrescences or exanthemata dry up and

heal up, while simultaneously the relaxed and thoroughly infected body

steadily increases in turgor vitals. Glandular tumors and indurations of

dyscrasic origin, where any other treatment has failed, are scattered by

the long-continued use of my preparation. I have in suitable cases given

it for years without noticing any hurtful sequelae, and after my patients

were cured I kept them under observation for years afterwards, and know,

therefore, that nothing injurious followed. This cannot be said of the

usual arsenical preparations, and old Heim, a great admirer of Arsenic,

opposed a lengthy use of it; he rather preferred larger doses, which is

rather a dangerous procedure. Given for a long time for carcinoma, it

stops the rapid progress of this fearful disease, and though at the same

time Chloride of arsenic was used externally, a real cure remained an

impossibility. My best successes were in obstinate cases of lues

inveterata, in the first stages of tabes dorsalis (ataxie locomotrice),

in the reconvalescence from exhausting acute diseases, in gastric

suppurations, inactivity of bowels, tardy digestion, constipation. In

cases where Chininum sulph. failed in intermittent fevers, I prescribe

Brom. arsen. twice daily, four drops, each time in a full glass of

water, gradually diminishing it to one daily dose, and in four weeks

even the most obstinate cases yielded to this treatment. The patient

feels encouraged by his increasing vigor, the fever-cakes disappear, the

bowels move regularly, and appetite leaves nothing to be desired. Those

mean obstinate cases of intermittens larvata, often appearing in the

form of unbearable neuralgiae, yield more rapidly to it than to the

Quinine. It is often quite astonishing what good results can be obtained

by the daily use of only one drop of this solution, kept up for a very

long time in dyscrasic constitutions, who spent a fortune to regain

their health and failed with every other treatment. Its full solubility

and rapid assimilation are the reason that it can be used without

injury, but it must be taken largely diluted. Let me give you a few

cases for elucidation.



St., 46 years old, contracted syphilis several years ago and was

relieved of it by mercurial treatment and Zittman's decoction. About six

years ago he felt out of sorts, and a papular eruption appeared on

forehead, temples, and especially at the root of the nose. Though

treatment was immediately instituted, still in a few weeks the face of

the patient was covered by an ugly, foul-smelling crust. Cod-liver oil

was now taken internally, and applied externally till the scuffs fell

off and the eruption concentrated on three points. For six months that

treatment was kept up, but after being omitted for a few weeks, the

eruption spread again to its former extent. Every treatment was tried in

rotation without the least benefit. In the spring 1856 he entered my

clinic. In the centre of the forehead, at the root of the nose, on both

eyebrows, on the temples and right cheek there are moist herpetic

eruptions covered with crusts, exuding on least pressure an acrid ichor

and easily bleeding. Around these eruptions the skin is injected,

reddened, interspersed with a large network of veins. Cough and

expectoration hint to a beginning of tuberculosis, an heirloom in the

family. Little appetite, disturbed digestion, tardy defecation, and

evening fever. He is ordered Solutio arsen. brom. twice a day, four

drops in a glass of water, and already after two weeks the eruption

begins to dry up, appetite returns, and bowels are regular. A generous

diet and fresh meat several times a day are accessories to an arsenical

cure. After two months two crusts fall off and the skin under them is

soft, shining, somewhat red. About July all eruption had gone, and the

cough greatly improved. A few months ago I saw the patient again, and I

feel sure that the disease is eradicated.



Miss W., 42 years old, passed her childhood in the West Indies, and

brought from there a peculiar skin disease. When I saw her for the first

time her features looked old for her age, skin gray and sallow, hair

gray, rough, full of dandruff, and moisture oozing from the ears and

forehead. The scalp feels hard and thickened. The cervical glands are

indurated all around the neck. On the left chest an herpetic eruption of

the size of a dollar, and on the mamma a hard tumor of the size of a

fist. For a year past this tumor began to be painful and sensitive to

pressure, and my advice was sought for relief of all her ailments,

especially as her hands were also in a fearful state, where the eruption

looked as if she had the itch. The nails were discolored, knobby, easily

bleeding and covered with a gluey eruption. She had to wear and to

change gloves every day. For nine years she never entered society, as

the exhalation from her body disgusted even herself, and was hardly

bearable, though sponging the whole body and daily renewal of linen was

strictly adhered to. In such an obstinate chronic psoric case treatment

with small doses is at first necessary, and Arsen. brom., two drops

twice daily, ordered, and her cold bath continued. After four weeks the

dose was doubled, and after nine weeks the first glimmer of improvement

could be seen. The tumor in the mamma was smaller and painless, and

where before it was so sensitive as to be covered with oil-silk she

could bear now the pressure of her clothing. After four months steady

continuation of four drops twice daily, she was able to go without

gloves. The scalp also was cleaner, less hard, and the ears more dry.

But with the return of spring the eruption gained new vigor. The head

and hands became covered with suppurating nodules and small exuding

herpetic spots, which became confluent and itched terribly, a most

classic picture of the herpes of the ancients. Though for years she had

been accustomed to an aggravation in the spring, she never witnessed it

in such severity. I now omitted the drug and ordered head and hands

frequently washed with cold water. After eight days the storm calmed

down, and it was remarkable to witness the steady decrease of the

induration in the cervical glands and mamma. After four weeks the old

treatment was renewed. During the summer months she took regularly her

four drops twice daily, and in the beginning of autumn the dose was

reduced to two drops, and so continued during the whole winter. The

following spring crisis was the mildest one she ever experienced. During

the summer she took her four drops, during fall and winter two drops.

The third spring aggravation came with full severity, but lasted only

three days, when desquamation followed. Another year of the same

treatment and the fourth spring eruption showed itself slightly only in

small papules behind the ears and between the fingers, and were hardly

worth noticing. She now felt a slight weakness in right arm, which from

childhood up was rather weaker than the other one. After the

disappearance of the induration in the mamma the arm seemed to regain

its former strength and the patient felt therefore rather astonished at

the reappearance of the weakness when its cause seemed removed, but it

yielded readily to a mild constant current applied a few times, and some

faradic shocks each time from the shoulder through the arm, and in

September she went to Nizza in order to use sea-bathing, with the advice

to take for a whole year one drop daily of her solution. She considered

herself now well, but still her skin was flabby, especially on the hands

where the epidermis often desquamated, and the nails remained hard,

brittle and without lustre.



I may here remark that I found repeatedly Arsenic in the urine of such

patients. A case of obstinate intermittens larvata, characterized by

vomiting of chyme, also yielded to Arsen. brom. One case more must

suffice. A young man went to America but failed in his trade, and became

barkeeper on a Mississippi steamer, which place he had to give up on

account of intermittent fever. We find him then as hostler in Chicago

where he was laid up with an attack of cholera, and as he did not fully

recover his strength he returned to the old home again. When I saw him

for the first time the diagnosis seemed to be first stage of Bright's

disease. Anamnesis, aetiology, and present state, albumen in the urine,

justified the diagnosis. Patient is pale, bloated, oedema pedum, no

appetite, white tongue, thin feverish pulse, swollen spleen, watery

diarrhoea alternating with constipation. Every drug produced vomiting,

and he perfectly abhorred the old Quinine powders. I ordered four drops

Arsen. brom. and a full meat diet. Improvement followed with the

continuance of the treatment. After three weeks the spleen was reduced

in size, his face showed better color, hardly any oedema. To

strengthen the skin he was advised to take pineneedle baths, and after

three months' treatment he could be discharged, a well man. He was

advised to take for a few months one drop daily of his solution, and to

take often an airing in the pineries which abound around Frankfort.

Though he returned to America the latest reports from him are that he

feels again as well as ever, but he keeps his drops about him.



Arsen. brom. is also a powerful remedy in diabetes mellitus and

insipidus, for I cured cases with it where the patient had already been

reduced from 138 pounds to 98, and where the urine could be condensed,

by boiling, into syrupy consistency. Mixed diet may be allowed, though I

insist upon large quantities of fresh meat during treatment with

Bromide of arsenic. Let the patient take three drops thrice daily in a

glass of water, and after a week the insatiable burning thirst will be

quenched, and these doses must be continued till the quantity of sugar

in the urine is reduced, when the drug might be taken twice a day and

continued for a long time. A diabetic patient needs fresh pure air if he

wishes to get well; confinement in a room or in the office prevents the

action of any treatment, for it needs ozone to reduce the sugar of the

blood into carbonic acid and water.