CHAPTER X.. Medicines for Epilepsy.

MEDICINES FOR EPILEPSY.

The present chapter gives the results of analyses of three much-advertised medicines for the cure of epilepsy, which show the principal ingredient in all of them, as in five out of the six dealt with in the previous volume, to be bromide. It is not uncommon to find that nostrums for any complaint having well-marked symptoms, such as epilepsy, contain the drugs most commonly used by the medical profession in treating it; but this does not at all deter the proprietors from making scornful references to the usual medical treatment, and intimating that their own preparation owes its marvellous virtues to some new or different substance. In the present instances the usual claims are made of the cure of “frightful cases of long standing, which had been pronounced hopeless by eminent physicians and hospitals, and after everything which had been tried had utterly failed,” and so forth, but analysis does not show the presence of anything but drugs in everyday use; two of the preparations examined consisting of ammonium bromide and potassium iodide, and the third of these substances and potassium bromide, with, in all three, colouring and flavouring agents. The first two bear on the label the words, “Guaranteed free from Bromide of Potassium and Poison,” and a great deal is made, in the pamphlets in which they are recommended, of the absence of this salt, without, of course, any hint that the very similar ammonium bromide is substituted for it. In one of these pamphlets it is stated that “any person who knows anything about epilepsy and fits knows something of the harm done in many cases by Bromide of Potassium. Almost every patient I have had during a long and extensive practice has taken this drug (and in some cases it has been taken for many years), so that I find it necessary to eliminate the ill effects of Bromide of Potassium from the system.” In the case of the third, which is shown to contain 15.6 grains of potassium bromide and 4.2 grains of ammonium bromide in each fluid drachm, perhaps even more effrontery is shown in the statement, “the treatment of Epilepsy and Fits is carried on under some difficulty, as nearly all the great Physicians prescribe the same remedy--Bromide--Bromide--nothing much except Bromide, and so the unhappy sufferer consults many doctors without being cured.” The similarity in composition of the first two of these preparations is not reflected in the prices, 4s. 6d. being charged in the first case for an 8 oz. bottle (without a “patent medicine” stamp) and 2s. 9d. in the second for the same sized bottle, stamped; even at the lower price, as the figures show, the rate of profit is very generous, and, as the article is sold direct to the consumer through the post, there are no intermediate charges to be deducted from what the maker actually receives, except the cost of postage. These two medicines show not only a great similarity of composition, but the pamphlet issued to puff the one of them would seem to have been adapted or paraphrased from that issued in support of the other. A similarity among some of the published “testimonials” is striking, and shows to what great length the arm of coincidence may grow when circumstances are favourable.

J. GILBERT DALE’S TREATMENT, “IMPERATINE.”

This preparation is supplied by J. Gilbert Dale from an address in London. The price was formerly 4s. 6d. per bottle, but it appears, as shown below, that the method of charging for the medicine by the bottle has been abandoned in favour of charging a monthly fee for the “treatment,” supplying the medicine “free.” Apparently the principal difference is that in this way a higher price is obtained.

This preparation is one of those that are not supplied through retailers, but direct from the proprietor through the post. The first three communications received in the case here dealt with are dated 1908, and, like so many of such “letters,” are circulars in imitation of typewriting, with the name and address, the date, and “Dear Sir or Madam” typed in. In the first letter it is stated that:

My remedy contains no Bromide of Potassium, and no Poison, and is perfectly safe for both delicate adults and young children.

It has cured completely and permanently, frightful cases of long standing, which had been pronounced hopeless by eminent physicians and hospitals, and after everything which had been tried had utterly failed.

And in the third that:

If it is simply a case of mony (sic) which deters you, I am prepared to send you the remedy at the following reduced price,

TWO 4s. 6d. BOTTLES FOR THE PRICE OF ONE.

This will give you a month in which to demonstrate the merits of the cure. Of course it must be understood that the subsequent supplies must be paid for at the ordinary price....

I will keep this offer open for one week from this date. Since you first wrote me I have received several striking testimonials from people who applied to me at the same time as yourself, and who commenced to take my remedy at once.

This last paragraph, in a circular, points to the remarkable coincidence that whenever an inquiry about the medicine is not followed up by purchase, several other people apply at the same time, commence to take the remedy at once, and send striking testimonials within a few weeks. An alternative explanation, of course, is that the statement is simply not true.

The notepaper used for these communications was headed “Specialist in Epilepsy and Nervous Diseases. Dale’s Remedy for Epilepsy. Trade-mark ‘Imperatine’ (Reg.),” and also bore the words, “Advice by Post Free. Personal consultations by appointment, One Guinea; including one month’s treatment Free.”

Various pamphlets were sent at one time or another. In one of these, entitled “Epilepsy and its Cure. A few facts. J. Gilbert Dale, Specialist in Epilepsy and Fits,” it is stated:

I have no degree, having never sat for any medical examination. My name does not, therefore, appear on the Medical Register, and I cannot legally call myself a Doctor; but my long and varied experience of this dread disease qualifies me to treat Epilepsy and nervous diseases, of which I have made a special study.... I always advise my patients to send for their family doctor when they are suffering from any other ailments than those I treat.... During the nine or ten years that I have been treating cases in all parts of the United Kingdom and abroad, I have had to deal with every form of this terrible disease. There is no form of the complaint which I have not had the opportunity of studying very closely, and my experience of these cases (particulars of which have been supplied to me in detail) has been most valuable, and gives me qualifications for treating Epilepsy that I could not have obtained in any other way.

The method appears to be: Do not sit for a medical examination (requiring long and expensive training), but set up as a Specialist in Something and advertise. You will then get cases from all parts of the country, and particulars will be supplied. From the experience obtained in treating them you will become qualified to treat others. It certainly seems simple.

Another of the pamphlets was entitled Epilepsy and its Treatment. The similarity between this and the pamphlet sent out by another firm and referred to below is remarkably close, as a few extracts will show:

Of the very many diseases which afflict humanity, few, if any, are more dreadful than Epilepsy, or Falling Fits. This disease has existed for centuries, for we read in St. Matthew’s Gospel, chapter 17 (revised version), verse 15, “Lord, have mercy on my son: for he is epileptic, and suffereth grievously: for oft times he falleth into the fire, and oft times into the water.” Also in St. Matthew’s Gospel, chapter 4, verse 24, we read, “And they brought unto Him all that were sick, holden with divers diseases and torments, possessed with devils, and epileptic, and palsied, and He healed them.”

Epilepsy has claimed for its subjects persons of the highest rank, as well as of the lowest. Some of the greatest of the earth have been afflicted by it. Cæsar, Henry IV. of England, Napoleon, Peter the Great, Mohammed, Byron, Sheridan, the great Duke of Wellington, and others whose names are written on the pages of the world’s history, are said to have been afflicted by this terrible disease....

I honestly believe it to be the finest treatment in the world for epilepsy. It is not a Cure-all. It cures epilepsy and some kindred diseases, but this is all I claim for it....

“Imperatine” is a Nerve Food. It is as much a food and as necessary to epileptics as ordinary food. Some medicines ARE foods, and are found in the foods we eat.... As we do not get these nerve foods in correct proportions in the food we eat, they have to be supplied in the form of medicine....

Other medicines recommended in this pamphlet are “Dale’s Imperatone Pills” and “Dale’s Powerones.”

A considerable interval elapsed between the receipt of these pamphlets, etc., and the next step. When finally an order for a bottle of “Imperatine” was sent, together with 4s. 6d., a letter was received in reply, signed “W. Bunn, Secretary,” stating that:

We do not, however, charge for medicine, but Mr. Gilbert Dale charges a fee for treating the case, as each case is treated individually, and medicine is prescribed separately for each patient.

We shall be glad if you will fill in and return the enclosed form and your case will then be carefully gone into, and a fee for treatment will be quoted.

In reply to this a leaf was sent from one of the pamphlets quoting “Imperatine” at 4s. 6d. per bottle, three bottles 13s., etc., with a letter pointing out the inconsistency, and demanding a bottle of the medicine or the return of the money. The following was then received:

Dear Sir,

Mr. Gilbert Dale has requested me to acknowledge receipt of your letter. As you can easily understand, epilepsy is a disease that is best treated by specially varied medicines for each case, therefore it has been found desirable, rather than to sell the bottle for each person, to take each case under the Treatment at so much per month, all medicines being supplied free. This is done so that the medicines may be prepared at our own laboratory, and patients may not be tempted to make the medicine last a longer period.

Under the circumstances if you would send the enclosed form filled in so that the medicine may be prepared we are willing to send a special bottle at the 4s. 6d. I should strongly advise you to take the Treatment at say 10s. 6d. for a month, this would include all medicines required for Epilepsy.

Yours faithfully, W. BUNN, Secretary.

According to an earlier letter, quoted above, two 4s. 6d. bottles would last a month, therefore a monthly fee of 10s. 6d. represents an increased charge. But the use of the expression, “say 10s. 6d.,” and the general tone of the letter seem to suggest that if it had not been for the dispute referred to a higher fee might have been charged. Another reason for the fiction that all medicine is supplied free may be a desire to avoid paying stamp duty, which would amount to 6d. on each bottle.

The “consultation form” was then filled up and sent; the questions asked, with the replies given (in italics), were as follows:

CONSULTATION FORM.

The information supplied on this form will be treated as of a strictly private character. It is generally better for a relative or friend of the sufferer to fill up this form.

Date ...................................

Name of patient (in full) ........................................

Address (in full) ................................................

1 Age?--28.

2 Married or single?--Single.

3 Occupation?--Clerk.

4 Pale, ruddy, blotchy or sallow complexion?--Pale.

5 Thin or stout?--Medium.

6 Weak or strong?--Fairly strong.

7 Height?--5 ft. 8.

8 Weight?--10 st. 7.

9 Is patient of weak intellect?--No.

10 How long suffered with fits?--Occasionally for about 12 years: fits have only been frequent for a year.

11 Do you know the cause? If so, what was it?--No.

12 How often do attacks occur?--From once a week to once in 4 or 5 weeks.

13 During night or day?--Usually evening.

14 Do the fits generally occur at a certain time? If so, about what hour usually?--Usually between 6 and 8 in the evening.

15 How long unconscious in attacks?--3 to 5 minutes.

16 Is there any warning? If so, what?--None, except often a severe headache.

17 Do the bowels act regularly without opening medicine?--Yes.

18 Is appetite normal?--Yes.

19 Is digestion good?--Yes.

20 Does the patient pass a normal quantity of urine?--Yes.

21 Is it natural in colour and free from sediment?--Yes.

22 Is monthly health normal (females)?

23 Does the patient sleep well?--Fairly.

24 Is the patient languid during daytime?--No.

25 Is the patient nervous? If so, in what way?--Not generally, but rather apprehensive in regard to attacks.

26 Has the patient any other disease?--No.

27 Does the patient suffer pain at times? If so, when and in what part?--No.

28 Is the patient usually despondent or of a cheerful disposition?--Fairly cheerful.

29 Does the patient worry?--Not particularly.

30 Has the patient had any other serious illness? If so, give particulars.--No.

31 Does the patient take intoxicants? If so, to what extent? One glass of beer with mid-day meal.

32 Does the patient smoke? If so, how much per week?--Yes, about 1¹⁄₂ oz.

33 Give date of last attack?--April 26th.

34 What doctors and remedies have been tried, and for how long?--None.

35 What results from them? Please answer fully.

Give any further particulars which you think necessary. If you have a recent photograph, please send it. I will return it with the medicine. If you have not a photograph, it does not matter. Answer these questions as well as you can, and describe as far as possible the character of the patient’s fits, according to the statements of those who witnessed the attacks. It will help me if you will also say what is the patient’s mode of life; such as, what time meals are taken, and what they consist of; what time the patient goes to bed, and the time of getting up; and so forth:

Rises 7.30. Breakfast, bacon or eggs, or fish, etc., bread and butter, tea. 1.0: Dinner, meat, vegetables, cheese, ¹⁄₂ pint beer. 6.30: Plain tea. 9.30 to 10.30: Bread and cheese and (in winter only) cocoa. Bed about 11 to 12.

The medicine was then received, with a little book of “General instructions to patients, and diet tables,” and two copies of “Report of Progress Form,” with a request that one of these should be filled up and sent in after 12 days. The directions on the label were:

Two small teaspoonfuls (exactly two drachms) to a wineglassful of cold water on rising each morning and on retiring each evening.

The bottle contained eight fluid ounces. Analysis showed the presence of ammonium bromide, potassium iodide, a little sugar and alcohol, and a small quantity of iron. After determining the amounts of the various ingredients, about 1 per cent. of matter was unaccounted for; the liquid was of a very dark brown colour, and no active ingredient was found possessing such colour; the appearance was best matched by means of burnt sugar, and this would account for the additional solid matter, but it is not possible to say positively that some “extractive” other than caramel was not present, and a minute trace of basic substance, possibly alkaloidal, was found. The alcohol may have been due to some tincture having been added, or it may have been employed to dissolve a little oil of sassafras, the mixture having a sassafras-like aroma. Sulphate was present, and the iron may have been added as ferrous sulphate, but there was no direct evidence as to the form in which it was used. The formula arrived at was:

In one dose (2 drachms) Potassium iodide 1·55 parts 1·7 grains Ammonium bromide 15·78 „ 17·4 grains Iron, calculated as ferrous sulphate 1·0 part 1·1 grain Alcohol 4·15 parts by measure 5 minims Sugars 6 parts Burnt sugar Oil of sassafras trace Water to 100 parts by measure

The estimated cost of the ingredients for eight fluid ounces of this mixture is 4d.

FITZKURE.

“Fitzkure” is supplied by “The London Medicine Co.”; the price of a bottle containing eight fluid ounces was 2s. 9d.

An undated circular sent out by this firm commences:

Believing you to be specially interested in the treatment and cure of Epilepsy, Fits, etc., we have taken the liberty of sending you particulars of “Fitzkure,” which cures Fits, Falling Sickness, Hysteria, and kindred Nervous Diseases. May we request that you give the enclosed booklet your careful consideration.

The reason for supposing the recipient of this circular to be specially interested in the treatment of epilepsy is not at first apparent; but the fact that the London Medicine Co.’s booklet and the composition of their medicine are so similar to those of J. Gilbert Dale, described above, and that this circular was sent to a person who had previously written to Mr. Dale for particulars of his “Imperatine,” suggest that the one business may be the offspring (legitimate or otherwise) of the other. There is also a curious resemblance between some of the “testimonials” published; for example, in one of Dale’s pamphlets there is one marked “Mrs. W.,” from which the following are extracts:

I am now in perfect health, and am only too pleased to speak for “Imperatine.”... When I went to sleep I never expected to wake again. But the fits stopped with the first dose of your medicine, and I was soon able to get up, and am now able to go anywhere by myself with comfort.... Three weeks before I commenced your medicine, when I took to my bed, I was in fits day and night, first screaming, and then laughing, and got so strange that my friends dared not leave me a minute.

And the London Medicine Co.’s circular gives one marked “Mrs. F. W.,” from which the following are extracts:

I am in perfect health, thanks to your wonderful cure.... When I went to sleep I never expected to wake again.... I can go anywhere now with comfort. About 3 weeks before I started with Fitzkure I had to take to my bed, and was in fits day and night, first screaming and then laughing, and I got so strange that my friends dared not leave me a minute. The last I had was on the Friday morning that I got your medicine. I took a dose straight away, and it seems too wonderful to be true that I have not had one fit since.

Thus there are two women, both having surnames beginning with W., one taking “Imperatine” and the other “Fitzkure,” both taking to bed “in fits day and night, first screaming and then laughing,” both taking the respective medicines just three weeks after taking to bed, both cured by the first dose, and both using the same phrases in writing about it. Is it merely an extraordinary coincidence? or is one woman writing a testimonial about the same case, with a few verbal alterations, on behalf of two different medicines? or has the one advertiser “lifted” the testimonial from the other, altering the name of the medicine? or, finally, is the whole thing a fabrication and imposture?

The similarity in the pamphlets, already alluded to, will be seen on comparing the following extracts from Epilepsy and its Cure (The London Medicine Co.) with those given above from Dale’s pamphlet:

Epilepsy is generally acknowledged to be one of the most dreadful diseases which humanity suffers from. For centuries it has existed, and has baffled the skill of the greatest physicians. The medical profession are scarcely any nearer being able to cure it than in the time of our Lord, when, as we read in the Gospel of S. Matthew, Chap. IV. verse 24 (revised version), they brought unto Jesus all that were sick, holden with divers diseases and torments, possessed with devils, and epileptic and palsied, and He healed them. No race is free from this appalling disease, and it is no respector of persons, for many of the great of the earth have suffered with fits among whom may be mentioned Cæsar, Napoleon, Peter the Great, Mohammed, Byron, Henry IV. of England, the great Duke of Wellington, all of whom, among others, are said to have been so afflicted....

Fitzkure is not a Cure-all for every disease, but it does and will cure epilepsy, fits, falling sickness, if steadily persevered with from 18 months to 2 years.... It is not so much a medicine as a Nerve Food, and is as much a food and as necessary to epileptics as ordinary food. Some medicines are foods and are found in the foods we eat ... when we do not get the medicines that we need from the foods we eat, these have to be supplied in the form of medicine....

Fitzkure ... is guaranteed absolutely free from Bromide of Potassium and Poison.

There appears to be some humour in the next paragraph--

The history of the remarkable way in which Fitzkure was invented and developed is indeed a romance which would take too long to describe in these pages. The inventor is not a Doctor.... Our experience in treating these cases has been most valuable, extending over many years.

Other medicines recommended are “Fitzkure Laxative Pills” and “Fitzkure Tonic.”

No “Consultation Form” was sent to be filled up, but in the original circular certain particulars are asked for:

When sending for “Fitzkure” please say what the patient has been taking, and with what result.

Be sure to give the full name and address, also state the age of the patient.

A 2s. 9d. bottle of the medicine was sent for, “for a young woman of 24 years.” It was sent with a circular of directions and diet table, extracts from which are as follows:

The dose which is two small teaspoonfuls or two drachms, must be ... taken in a wine glass of water on waking in the morning, and retiring at night. Persons over 65, and weak delicate persons will need to take a smaller dose, from one to one-and-a-half teaspoonfuls for some weeks till quite used to the medicine. There is a wide difference in the susceptibility of patients to medicines, the ordinary dose being too small for some patients, and too large for others. If therefore the above dose makes you feel poorly or giddy, you must reduce it till these symptoms have passed away. But, on the other hand, if you are feeling well in yourself, and the fits have not ceased, you must increase the dose....

Analysis showed the liquid to contain ammonium bromide, potassium iodide, potassium citrate, a little alcohol and reducing sugar, and a very small quantity of iron; it was flavoured with aniseed, and coloured deep brown, approaching black. The colour appeared to be given by burnt sugar, as in the previous case. The various ingredients were determined quantitatively, and the formula indicated is:

In one dose (2 drachms). Potassium iodide 1.11 parts 1.22 grains Ammonium bromide 26.63 „ 29.3 „ Potassium citrate 1.0 part 1.1 „ Iron, calculated as ferrous sulphate 0.5 „ 0.55 grain Alcohol 1.7 parts by measure 2 minims Oil of aniseed trace Burnt sugar Water to 100 parts by measure

The estimated cost of the ingredients for eight fluid ounces is 4¹⁄₂d.

DR. NIBLETT’S VITAL RENEWER.

This is supplied by C. P. Niblett, London; a bottle, price 4s. 6d., was found to contain four fluid ounces.

In a Press advertisement it is stated that

Dr. Niblett’s Vital Renewer is the result of the most exhaustive research by a London Physician, who for upwards of 35 years made epilepsy his especial study. Confidence can be placed in this remedy, which for years has been used with the greatest success in all parts of the world. The One Remedy that cures.

A pamphlet is also offered free, entitled A Practical Treatise on Epilepsy, its treatment and cure, by S. B. Niblett, M.D., L.R.C.P.Edi.

The name does not occur in the Medical Register for 1912.

On the title page of the pamphlet, however, no “M.D.” appears, but it is represented to be by “S. Berry Niblett, Licentiate Royal College of Physicians, Ed., Licentiate Faculty of Physicians and Surgeons, Glas., Licentiate Society of Apothecaries, Lond.” The “practical” nature of the treatise is, to say the least, rather diluted by such paragraphs as:

This disease is called by the German physicians, Fallsucht; by the French, l’Epilepsie; by the Italian professors, mal caduco, or falling sickness.

Epilepsy was termed by the ancient Greeks “the sacred disease,” on account of the magnitude of the evil, or because persons labouring under it have been thought possessed by demons. It was said that Hercules was subject to it, therefore it was denominated the Herculean disease; but Galen says it was on account of its form or magnitude.

The Romans termed this affection “morbus comitialis,” because it frequently occurred in crowded assemblies in which the passions of the people were often much excited, and it was customary to dissolve the comitia if during the sitting any person should be affected by it.

Many sufferers from epilepsy are possessed of high intellectual power; the classical cases of Julius Cæsar, Mahomet, and the first Napoleon, each of whom suffered from the disease, may be cited as examples.... Epilepsy is a disease which specially attracted the attention of the ancient physicians; it was termed by the Greeks “the sacred disease.” Plato ascribes the use of the term “sacred” to the circumstances of the head or brain being the part of the body affected in epilepsy. Hippocrates pointed out,....

And so on. The section on “Treatment and Cure of Epilepsy” commences:

Few higher duties can devolve on the medical man than to make obscure diseases his special study. It should always be the aim of the physician to cure the disease as rapidly and effectually as possible.... The general tendency of epilepsy, if left to Nature, is certainly to proceed from bad to worse.... Efficient treatment is the very foundation of our art, the alpha as well as the omega.

Suddenly we come to the “treatment”:

My Vital Renewer is a real vital antidote, really stopping the development of the attacks and absolutely curing the disease.... Under the use of my Vital Renewer the fits will immediately become less severe and less frequent.... Patients taking my Vital Renewer will receive explicit directions as to the nature of the food desirable to be taken at each meal.... I am prepared to prove, beyond all fear of contradiction, that my Vital Renewer has cured the most inveterate cases of epilepsy.... The success which has attended the administration of my Vital Renewer I believe to be due not only to the peculiar form in which it is prepared, but also to the unremitting care taken in the skilful manipulation which is required.

In a circular letter sent with the “Practical Treatise” it is stated that:

The treatment of Epilepsy or Fits is carried on under some difficulty, as nearly all the great Physicians prescribe the same remedy, Bromide--Bromide--nothing much except Bromide, and so the unhappy sufferer consults many doctors without being cured.

After prolonged study and extensive experimental research, varying over a considerable number of years, Dr. S. Berry Niblett, of London, discovered a certain remedy for all forms of Epilepsy and Fits.... This medicine is certainly the most valuable contribution that modern science has made to the treatment of Epilepsy.

The directions on the label are as follows:

Shake the bottle previous to use.

Adults: 1 teaspoonful in a wineglassful of water.

Children: 6 to 10 years, 20 drops in 1¹⁄₂ teaspoonfuls of water.

Children: 10 to 12 years, 30 drops in two teaspoonfuls of water.

Children: 12 to 18 years, ¹⁄₂ teaspoonful in 3 teaspoonfuls of water.

About the age of 18 the full dose should be taken.

The medicine must be taken three times a day, two hours after meals until a period of six months has elapsed since the last fit has occurred. At the end of that time it may be taken twice a day only, at 11 in the morning and again at bedtime, for another six months.

If no further attack occurs during that time the medicine may then be taken at bedtime only.

N.B.--If the attacks occur at night, one dose of the medicine should be taken at bedtime and twice during the day.

Analysis showed the liquid to contain potassium iodide, potassium bromide, ammonium bromide, a little alcohol, and a very little reducing sugar. It contained sufficient traces of oil of aniseed and chloroform to be recognizable by their odour, and was coloured a dark brown. After the ingredients named had been determined quantitatively, 0.4 per cent. remained to be accounted for by the colouring matter, which appeared to be burnt sugar. A minute trace of a basic substance was present, which might have been alkaloidal, but the quantity was negligible. The alcohol may have been added as spirit of aniseed or spirit of chloroform. The formula indicated by the results is:

In one dose (1 drachm). Potassium iodide 3.75 parts 2.07 grains. Potassium bromide 30.88 „ 15.6 „ Ammonium bromide 7.66 „ 4.2 „ Chloroform trace Oil of aniseed „ Alcohol 2.6 parts by measure. Burnt Sugar Water to 100 parts by measure.

Estimated cost of ingredients for four fluid ounces, 3d.

BROMOCARPINE.

A French preparation called Bromocarpine is said to be fairly extensively used in some districts as a remedy for nervous disorders, more especially epilepsy. A circular accompanying the preparation has the title “The Treatment of Nervous Affections by Bromocarpine”; and it is stated that “the attacks are diminished in number to the extent of 80 per cent.,” and that a “complete disappearance is extremely common. Petit Mal (vertigo) is abolished, and there is a very marked improvement in the mental state during the intervals.” It is further stated that “The nervous system can be quieted by the methodical use of Bromocarpine, continued for many months if necessary. This preparation, of which Pilocarpine is one of the principal factors, determines copious diuresis, free perspiration, and an abundant secretion of saliva. In this form the intensive bromide treatment is well borne.”

The bottle (price 6 francs) contained 16.7 fluid ounces. The liquid was found to contain:

Potassium bromide 8.9 per cent Alkaloid 0.0035 „ Sugar 54.0 „ Glycerine 10.0 „

It was orange-flavoured, and contained a little alcohol, in all probability added in the form of tincture of orange; a trace of some other colouring matter was also present.

The alkaloid agreed in some respects with pilocarpine, or the mixed alkaloids of jaborandi; it did not give the characteristic colour-test for pilocarpine, but this may have been due to some decomposition during the treatment it had undergone, the separation of such a small quantity of alkaloid from a large quantity of sugar and glycerine being a rather troublesome operation.

If the alkaloid is calculated as pilocarpine, the quantity is equivalent to 0.0049 per cent. of pilocarpine hydrobromide. On a small label on the bottle the liquid is stated to contain 10 per cent. of potassium bromide and 0.005 per cent. of pilocarpine “hydrodom,” presumably a mistake for “hydrobrom.” In a circular wrapped round the bottle it is stated that each teaspoonful contains nearly 10 grains of potassium bromide, and a two-hundredth of a grain of pilocarpine; comparing this with the formula on the label it appears that a teaspoonful is reckoned as nearly 100 grains, and the same proportion is given for pilocarpine in the one case and pilocarpine hydrobromide in the other. Actually, 1 fluid drachm of the liquid is 76.9 grains.

Various other substances were tested for, but nothing was found besides those mentioned above, and water.

A GERMAN NOSTRUM.

According to Dr. Zernik,

Roller’s powder for epilepsy is supposed to be a remedy for epilepsy, chorea, hysterical attacks, cramp of the stomach, and of the chest, etc., and is sold by the Dresden “Diakonissenanstalt” for M 3.40 the box. The package contains three 5-grams powders wrapped up in sealed paper capsules. The powder is black, and has the odour of a rancid animal oil. Analysis proved that it consisted of partially carbonized animal substance, which yielded 20 per cent. of brown substances soluble in ether. The preparation is said to be made by burning magpies shot on twelve nights following Christmas. This use of incompletely carbonized animal substance for epilepsy is an ancient superstition.