Reference to this subject has been made on more than one occasion in the pages of this Journal, but the matter is of sufficient importance to call for further notice. Dr. Laufer considers as proved that hypochlorisation, i. e. the reduction of the chlorides in the dietary, enhances the efficacy of the bromides in the treatment of epilepsy. This method of treatment we owe to Drs. Ch. Richet and Toulouse. The object of the present paper is to explain the modus operandi. It is pointed out in the first place that, without the addition of an atom of salt, the dietary, provided that it is a physiological one, contains a sufficiency of NaCl, that the customary use of salt as a condiment and as a culinary addition furnishes a luxus supply, and that the withdrawal of this luxus, without producing any harmful effect, makes itself felt as a slight reduction in the NaCl exchange of the tissues. Next reference is made to the tendency of bromides to accumulate in the tissues generally, and in particular in those of the liver and brain, observers differing as to the greater relative affinity of these two organs for the bromide. We are then asked if it would be surprising that in the presence of a deficiency of chlorides such kindred salts as the bromides should fix themselves in the tissues in greater quantity after the manner of a substitution. That such substitution does in fact obtain has been proved by various observers by the demonstration, e.g., that hydriodic and hydrobromic acids appear in the stomach, and to some extent replace hydrochloric acid when animals are given iodides and bromides in appreciable quantities; and yet more directly it has been shown that the administration of bromides during hypochlorisation may raise the bromide contents of the tissues above that of the chlorides even (Nencki and Schumow Simanowski).
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