During the early months of 18911 made some rough notes on the treatment of insane patients suffering from epilepsy under my care in the Dallanda Asylum for natives of India, and it has occurred to me that the cases might be of interest in themselves, without discussion or apology for deficiencies. My notes were transcribed from the asylum records. During the years given in the tables showing relation of body weight to the number of fits per month, the cases were under my own observation. As regards any general conclusions I am convinced that in a large number of cases of insane epileptics we do not reap the same benefit from treatment by bromides, as is seen in the same number of epileptics who are not insane. At the same time the steady use of these drugs often leads to improvement in reference to the violence of the fits and the accompanying excitement, though the actual number of fits may not be in any way affected. Of the bromides, I prefer the bromide of potassium. The ammonium salt is also very useful, but I do not think that bromide of sodium is of much value. Borax has not given any satisfaction, and I have not yet tried the nitrate of silver treatment. The question of staining is not one of much importance; nitrate of silver will not materially alter the colour of a native of India. With regard to the use of sulphonal and morphia, I have found them most useful in diminishing the grave excitement often occurring before and after the epileptic attacks. The mixture given in full in the notes of Case II. is elsewhere spoken of as the “Bromide Mixture.” The Table relative to each case shows, I think, that apart from excitement or intercurrent disease, the body weight is not affected by the number of fits in each month, and shows no alteration or particular improvement during the months in which no fits occurred. This Table also leads me to believe that the bromides may be taken in large doses for long periods without affecting the body weight. Symptoms of “bromidism” are but very rarely observed among the patients under treatment in the Dallanda Asylum.
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