A MW PROPERTY 
OF THE 
BROMIDE OF POTASSIUM. 
Its power in checking the Reflex Nausea 
induced by the Administration 
of Anaesthetics. 
By ALEXANDER J. STONE, M.D., 
Assistant in Practice to Prof. Horatio R. Stoker. 
BOSTON: 
DAVID CLAPP & SOX, PHI 
Medical and Surgical Journal Office. ( 
1868. I A NEW PROPERTY 
OF THE 
BROMIDE OF POTASSIUM. 
Its power in checking the Reflpx Nausea 
induced by the Administration 
of Anaesthetics/ 
ALEXANDER J. STONE, M.D., 
Assistant in Practice to Prof. Horatio R. Storer. 
Reprinted from the Boston Medical and SurgicalPJaurnal of 
February 27, 18G8. Wv',f -? 
BOSTON: ' 
. DAVID CLAPP & SON, PRINTERS, 
1868. ON BROMIDE OF POTASSIUM, AS COUN- 
TERACTING THE NAUSEA ATTENDING 
ETHERIZATION. 
In bringing before the profession an impor- 
tant and apparently new property of the 
bromide of potassium, it was at first my 
intention to present some details of its his- 
tory, and its physiological effects upon man 
and beast; but I have before me the Rich- 
mond Medical Journal for January, 1868, in 
which there is an article by Hr. A. M. 
Fauntleroy, so able and comprehensive as 
to render any general remarks by myself 
quite unnecessary. I therefore shall con- 
fine myself to an exposition of its use in 
the relief of the nausea and other disagreea- 
ble effects attendant upon the inhalation of 
ether. As will be seen by reference to Case 
I. of those that I give, I owe whatever credit 
may attain from this discovery to Prof. II. 
R. Storer, who suggested it to me, and un- 
der whose advice I have worked the mat- 
ter up. 
There may be those who are unaware of 
the large percentage of cases in which there 
is great functional derangement of the sto- 
mach after anaesthesia. My friend Josiali 
Hale, House-surgeon at the Massachusetts. 4 
General Hospital, informs me that at that 
institution the nausea is invariable after the 
inhalation of ether, while nine tenths of the 
patients vomit freely. The results at Belle- 
vue and Charity Hospitals of New York are 
ascertained to be the same. Prof. W. II. 
Pancoast, of Philadelphia, in a conversa- 
tion which I had with him last winter, bore 
testimony to the same facts in his own city, 
and surgeons everywhere have recognized 
it as the great objection to the use of ether 
as an anaesthetic. In fact, its extreme dis- 
agreeableness in this respect (which the 
more pleasant chloroform to a certain ex- 
tent shares) to both the patient and physi- 
cian, has been the motive which induced the 
indefatigable Richardson to urge upon the 
profession the employment of local, rather 
than general anaesthesia, and in case the 
latter is resorted to, the use of tetrachloride 
of carbon and bichloride of methylin in 
preference to other agents. These unplea- 
sant effects have, I fear, frequently render- 
ed the attending physician guilty of inex- 
cusable neglect in the non-administration of 
an anaesthetic to the woman in travail, and, I 
doubt not, too often caused the employment 
of that more dangerous drug chloroform, in 
general and minor surgery, and in dentist- 
ry, with a consequent loss of many valua- 
ble lives. 
I had at first some little hesitation lest I 
might be presenting as new, an idea that had 
already been testedby experiment. 1 thought 5 
that if the subject had ever been broached, 
Prof. C. E. Brown-Sequard, to whom is un- 
doubtedly due all the credit of bringing the 
drug into popular use ; Prof. Edward H. 
Clarke, of the chair of Materia Medica in 
the Harvard Medical School; Dr. James E. 
Nichols, from his extensive relations with 
the medical profession as a manufacturing 
chemist; or Prof. Austin Flint, Jr., so well 
known as a physiologist, would have heard 
of it. I accordingly wrote to the above- 
named gentlemen, and quote from their re- 
spective answers. 
Prof. Brown-Sequard says:—“I do not 
know positively whether the bromide of 
potassium has or has not been employed 
against nausea. I do not think it has been 
used to that end, and I doubt that it would 
often prove efficacious.” 
It will be noticed that here the doubt is 
expressed as to its efficacy “ against nau- 
sea” I do not claim that it will relieve the 
nausea dependent upon an irritation, me- 
chanical or otherwise, within the stomach ; 
but that, through its action upon the base of 
the brain, the posterior columns of the 
spinal cord and accessory nerves, it may 
control certain nauseas of the stomach 
arising from sympathy, as in the instance 
where ether is conveyed to the nervous 
system through the lungs. Whether it 
may, in the same manner, control reflex 
nausea in the case of sea-sickness or preg- 
nancy, are questions yet to be solved. 6 
Prof. Clarke writes as follows :—“ From 
the ascertained physiological action of the 
bromide on the brain, it would be fair to in- 
fer that it might control the nausea attend- 
ant on the inhalation of ether, but I am not 
aware that any one has yet used it for that 
purpose/7 
From the letter of Dr. James P. Nichols, 
I take this extract:—“ I have never known 
of the bromide of potassium being used for 
the relief of the nausea attendant upon the 
inhalation of ether. I think that with our 
extended personal intercourse and corres- 
pondence with physicians in all sections, 
we should have learned of its employment 
for the purposes stated had it been so em- 
ployed.” 
Prof. Flint very kindly looked the matter 
up, and writes :—“ I have never heard of 
bromide of potassium as a remedy for the 
nausea consequent upon the administration 
of ether. I delayed a day or two in reply- 
ing to your note, in order to make inquiries 
among those whom I thought would be 
likely to have heard of such a thing, if it 
was done in New York, but I have not seen 
any one who has ever used the remedy in 
question in such cases.77 
To fix my point certainly, I have care- 
fully reviewed, so far as I have been able, 
the medical journals of this country, and 
the more prominent ones of Europe, and, 
though I find the drug frequently spoken of, 
and many hints thrown out as to its use 7 
and abuse, I have never, even in the ex- 
haustive treatise of Dr. Fauntleroy, above 
mentioned, found any hint which would lead 
one to the use now indicated. In present- 
ing the following cases, I have borne in 
mind the doubtfulness of statistics, a doubt- 
fulness so plainly shown in the variance be- 
tween the experience of Dr. Johnson, of 
Boston, lately reported in the Boston Medi- 
cal and Surgical Journal,* and my own. 
Dr. J. states that, in the past seven years, he 
has given it (the bromide) in more than a 
hundred cases, and in many (quoting cases) 
he has seen very peculiar results. In Prof. 
Storer’s practice I have, within the past 
four months, been obliged to prescribe it for 
various symptoms attending uterine dis- 
ease, such as insomnia, hysteria, epilepsy, 
and other forms of mental and nervous de- 
rangement, more than one hundred and fifty 
times, speaking within bounds, and with 
the single exception of the resulting acnoid 
eruption, which passes away voluntarily 
when the medicine is discontinued, I have 
been so fortunate as not to have seen any 
ill result, while Dr. Johnson, in his smaller 
series of cases, reports having seen several. 
Dr. Storer has been led, by advice from 
Dr. Brown-Sequard, to exhibit it in larger 
doses than is ordinarily given ; his ordinary 
prescription being potassii bromidi §i. in 
ch. no. xij., though in different cases the 
* Loc. cit., January 16, 1868. 8 
dose will vary from thirty to ninety grains. 
In case it is to be given after the use of 
ether, I would recommend the exhibition of 
either thirty or forty grains every thirty, 
forty-five or sixty minutes, as may be found 
advisable. It might seem that a remedy 
apparently so efficacious in checking the 
nausea, would act well as a prophylac- 
tic, and in one case I tried it with most 
pleasing results (or coincidence ?). It has 
been my endeavor to have my patients as 
nearly resembling one another in hygienic 
condition as possible ; always, when able, 
having ordered the patient to make the 
meal last preceding the etherization as 
light as possible, that the anaesthetic might 
be given upon an almost empty stomach. 
The operations have all been performed at 
about the same time of day, i. e. from 10, 
A.M., to 3, P.M. I have neglected to give 
the bromide, either as a prophylactic or 
remedy, in Dr. Storer’s cases of section for 
ovarian tumor, or in other serious opera- 
tions, since I have been with him, being 
unwilling to add to the already sufficiently 
great risks of the operation, those of the 
possible unfavorable symptoms resulting 
from the use of the drug, as described by 
I)r. Johnson, either of which might turn 
the scale against the patient. I am inclin- 
ed to think, however, from the results of a 
somewhat extended scries of experiments 
made with this drug by Dr. Storer upon 
himself, and communicated to me, that 9 
there is little or no risk of gastric, nervous 
or other irritation from its use, even in 
doses that might seem enormous, provided 
the bromide is exhibited in at least twice 
the amount of water required to dissolve it. 
There are many points of value and inte- 
rest which have arrested my attention in 
witnessing Dr. StoreUs manner of exibit- 
ing ether, and of preparing the patient for 
it, in his almost daily employment of anaes- 
thesia for operations, and it seems to me 
that the general practice of surgeons could 
be radically changed for the better. I may 
at some future time speak of this point at 
length. 
The following instances will be found il- 
lustrative of the effects I have described 
from the use of bromide of potassium. As 
will perceived, they are not selected 
cases. 
Case I.—Wednesday, October 9th, 1867, 
Miss , of Utica, N. Y., 2.1 years of age. 
Never taken ether. After applications of 
potassa fusa a year since, by a well- 
known surgeon, quite firm bands of adhe- 
sion had been formed from the anterior and 
left side of the cervix to the vaginal wall, 
which bands held the uterus in a lateral 
retroversion. To right the womb, and relieve 
the patient of the disagreeable symptoms 
usually attendant, Prof. Storer decided to 
sever these bands. Accordingly, I adminis- 
tered the ether in about fifteen minutes, and 10 
the operation was quickly performed, with 
Atlee’s guarded knife. After the operation, 
Dr. Storer requested me to prescribe potas- 
sii bromidi §ss. in ch. 'no. vi., one powder 
to be taken hourly, commencing when there 
was sufficient reaction from the ether, with 
the hope of quieting her nervous, hysterical 
state. She took the first powder at 4, P.M. 
When I saw her in the evening, she had 
taken the six prescribed, and, to my sur- 
prise, told me that she had experienced no 
nausea since taking the first, and requested 
permission to drink a cup of tea. On see- 
ing her the following morning with Prof. 
Storer, he connected the non-appearance of’ 
the almost invariable symptom with the ex- 
hibition of the drug, and advised me “to 
work up the point carefully, as it might 
prove of some importance.” 
Case II.—Thursday, Oct. 10th. Mrs. 
, of Cambridge, set. 43. Never taken 
ether. Was very nervous, and usually 
easily nauseated. Ate a light breakfast. I 
occupied some fifteen minutes in the etheri- 
zation. Prof. Storer then evacuated a large 
cyst of one of the labia. The cyst having 
been laid open by a free incision, its wall was 
dissected up, and the wound kept open by a 
cotton tent, with the hope of getting union 
from the bottom, and thus an obliteration 
of the sac. The ether was then removed, 
about forty-five minutes after its first inha- 
lation, and the patient allowed to regain 11 
sensibility. In about half an hour, she had 
partially reacted, and though somewhat de- 
lirious, complained of great nausea and a 
desire to vomit. I gave thirty grains of 
the bromide dissolved in half a tumbler of 
water, and repeated the same in half an 
hour. I then left, with orders to give her 
two powders (aa gr. xxx.) during the eve- 
ning, with narceine gr. There was no 
vomiting, andnofarther complaint of nausea. 
Case III.—Friday, Oct. 11th. Miss 0., of 
Illinois, set. 20. Never taken ether. Had eat- 
en a hearty breakfast. Not easily nauseated. 
Extremely nervous. Etherization occupied 
ten minutes. Dr. Storer then removed 
several fringes or outgrowths from the vulva, 
also two external haemorrhoids, and rup- 
tured the sphincter ani for the cure of a 
small fissure or linear ulcer. The ether was 
removed in about thirty minutes. Her un- 
cle, a physician, being present, I requested 
him to give the bromide in thirty-grain 
doses hourly, three times. He kindly con- 
sented to do so, and, in answer to my inqui- 
ries that evening, reported that she had felt 
some nausea, but did not vomit. 
Case IV.—Friday, Oct. 18th. Mrs. L., 
Roxbury, get. —. Had never taken ether. 
Ate a light breakfast. Very nervous. 
Etherized her thoroughly in twenty min- 
utes. Prof. Storer performed hysterotomy 
for the relief of sterility. A flexible block- 12 
tin bougie having been left in the cervical 
canal and the vagina plugged, the ether was 
removed, and in half an hour thirty grains 
of the potassium administered, being repeat- 
ed twice at intervals of forty-five minutes. 
The nausea, which was at first felt, was 
entirely relieved. 
Case V.—Friday, Oct. 25th. Mrs. P. A., 
of Brooklyn, N. Y. Had taken ether twice, 
each time with great hysteria, much nau- 
sea and vomiting. Etherization commenced 
at 11, A.M. She was rendered completely 
insensible in fifteen minutes. Prof. Storer 
then removed three large external haemor- 
rhoids by the ecraseur, and two or three 
smaller internal ones with scissors; also 
ruptured the sphincter ani, to prevent the 
great tenesmus usual after the operation, 
and the possibility of concealed haemor- 
rhage. She was kept fully etherized about 
an hour, during which time she vomited once. 
About twenty minutes after the removal of 
the ether, I gave her bromide of potassium, 
gr. xl., dissolved in about two ounces of 
water, and morph, sulph. gr. \ every half 
hour, till sleep was finally attained after 
the exhibition of morphia gr. i. There 
was no vomiting, though slight nausea, 
after the exhibition of the potassium. 
Case YI.—Saturday, Oct. 26th.—Miss 
■ , Northboro/ set. 28. Had never taken 
ether. Gave it at 10,15 A.M. She was 13 
completely under the ansesthetic in ten 
minutes. Dr. Storer then operated for 
sharp, double anteflexion, by Emmet’s me- 
thod, slitting up the cervix posteriorly with 
scissors, and cutting the sharp flexion an- 
teriorly with Emmet’s universally jointed 
knife. The operation was completed, and 
the ether removed in thirty minutes. A 
few minutes afterwards, I gave the patient 
twenty grains of the bromide and left her. 
There was vomiting two or three times. 
Case VII.—Saturday, Oct. 26. Miss 
Mary B •, Boston, set. 40. Never taken 
ether. Eaten lightly. Very nervous. Ether 
given, and vulval fringes removed by Dr. 
Storer,to check the haemorrhage from which, 
one of Sims’s glass dilators was introduced. 
Gave eighty grains in three hours. There 
was great nausea which was decidedly re- 
lieved, and no vomiting. 
Case VIII.—Tuesday, Nov. 5. Miss M. 
H., Chicago, set. 22. Never taken ether ; 
occupied twenty minutes in administering 
it. Prof. S. then incised an occluded hy- 
men, for the purpose of making a vaginal 
examination, the patient having been un- 
successfully treated by general measures at 
the hands of other physicians. The ether 
was taken away at the expiration of thirty 
minutes. Free emesis at once. Assoonasshe 
was able to swallow readily, forty grains of 
the bromide was given in an ounce of water, 14 
and immediately thrown from the stomach. 
In half an hour, forty-five grains were given 
in about two ounces of water, and rejected 
at once. In an hour, sixty grains were 
given in two ounces of water; this the sto- 
mach retained about fifteen minutes, and 
then threw up. The bromide was then 
discontinued, and the various ordinary 
remedies resorted to. Carbolic acid in 
two-drop doses (sat. sol.), pieces of ice by 
the mouth, ether by mouth in drachm doses, 
ice at the epigastrium and sacrum, and all 
without avail, the extreme nausea continuing 
till the next forenoon. A double rocker 
pessary (Ilodge) was introduced for retro- 
version, and the patient, who had not left 
her room before for four months, with but 
two exceptions, walked with ease a half 
mile and back, passing three flights of ho- 
tel stairs, on the tenth day after the ope- 
ration. 
Case IX.—Friday, Nov. 8th. Mrs. E. 
B., of North Adams, eet. 26. Had taken 
ether several times, with invariable emesis. 
Gave the ether at about 11 o’clock, A.M., 
occupying' some fifteen minutes. Prof. Sto- 
rer operated for vaginismus (Sims’ opera- 
tion) by a Y-shaped incision on the floor of 
the vagina. A large glass dilator was in- 
troduced, to prevent the severed nerves 
from re-uniting. On regaining sensibility, 
she vomited once. Gave thirty grains 
in half a tumbler of water, which was also 15 
rejected. Gave thirty grains in a table- 
spoonful of water, with two drops of crea- 
sote ; this the stomach retained one hour 
and then rejected. I repeated the same in 
half an hour and the stomach retained it, 
though the patient slept but little through 
the night, and complained much of nausea. 
Case X.—Saturday, Nov. 9th. The same. 
The removal of the dilator and its attempt- 
ed replacement were attended with so much 
acute pain, that at the patient’s earnest re- 
quest I administered ether for the accom- 
plishment of the latter. As soon as she 
could swallow easily, I gave sixty grains 
of the bromide, followed in an hour by 
thirty grains. No vomiting, but slight 
nausea. 
Case XI.—Sunday, Nov. 10th. Same. 
For replacement of the glass. Still very 
nervous. I occupied some thirty minutes 
in giving the ether. Gave ninety grains of 
bromide of potassium in divided doses, in 
three hours. Some nausea at first; no 
vomiting. The drug seemed to relieve the 
nausea quickly, and she ate a hearty din- 
ner four hours afterwards. 
Case XII.—Monday, Nov. 11th. Same. 
The patient took voluntarily, without ad- 
vice, one powder of thirty grains, some 
thirty minutes before taking the ether. 
Gave her thirty grains soon after removing 
the nther. No nausea. 16 
Case XIII.—Same. Had eaten a hearty 
.meat dinner. I gave the ether some two 
hours after the meal. Gave ninety grains 
of the potassium, with narceine gr. i., in 
divided doses, in one hour and a half, and 
followed with narceine gr. ij. in ch. no. viij., 
one every half hour in a teaspoonful of 
water. No nausea, save very slightly at 
first. 
Case XIV.—Saturday, Nov. 16th. Same. 
Gave ninety grains of the bromide in three 
hours, with relief of the nausea; no vom- 
iting. 
Case XV.—Thursday, Nov. 21st. Mrs. 
P., of Milford, set. 30. Had taken ether 
before. Gave it in about ten minutes. Prof. 
S. opened and discharged a labial cyst of 
some twelve years standing, dissecting out 
the cyst wall and applying the actual cau- 
tery. Kept her under the ether half an 
hour. Vomited once, freely, during the 
operation. Gave thirty grains of the po- 
tassium in about two ounces of water. 
Repeated three times, at intervals of an 
hour. No more vomiting, and but slight 
nausea. 
Case XVI.—Monday, Nov. 25th. Mr. 
J., of Boston, set. 18. Had never taken 
ether. Had eaten heartily about an hour 
and a half before coming to the office. I 
gave the ether in about twenty minutes, 17 
and then operated for phymosis, cutting 
with my "blind knife ” the constricted 
bands of the prepuce, dividing through the 
mucous surface only, and leaving the in- 
tegument entire. lie vomited severely 
during the operation. Gave about fifty 
grains of the bromide, with arrest of the 
vomiting, and, within an hour, of the 
nausea. 
Case XVII.—Thursday, Nov. 28th. Mr. 
F. W. S., of Boston, get. II. Never taken 
ether. Ate no breakfast. Gave ether in 
seventeen minutes. Cut down over the 
first metacarpal bone, and continued my 
incision subcutaneously over the surface of 
the trapezium, evacuating about half an 
ounce of laudable pus. Vomited freely 
during the operation. Gave thirty grains 
of the potassium, and repeated in half an 
hour. No more vomiting. Ate a hearty 
supper. 
Case XYIII.—Friday, Dec. 6th. (Case 
II.) Mrs. G., of Cambridge, Gave ether 
at 10.50, A.M., occupying about twenty 
minutes. Prof. Storer commenced the ope- 
ration for artificial perinseum at 11.50, per- 
forming it in a new manner, using no su- 
perficial stitches, but bringing the extremi- 
ties of the wire trusses, to which his deep 
metallic sutures were applied, together in 
such a way as to closely approximate the 
lips of the wound. Vomited freely dur- 18 
ing the operation. Gave bromide in forty- 
grain doses half hourly, for three doses, 
and then hourly till six o’clock. Com- 
plained some of nausea, but no more vomit- 
ing. 
Case XIX.—Tuesday, Dec. 3d. Miss S., 
Boston, set. 42. Had taken ether twice 
before, with great nausea attendant. Spu- 
rious anchylosis of right shoulder, depend- 
ent upon uterine disease. Occupied about 
twenty minutes in the etherization, and 
maintained its influence for half an hour. 
The shoulder was found to move very free- 
ly. As I removed the ether, there was free 
emesis. Had eaten a hearty breakfast. 
Gave forty grains in an ounce of water 
without relief; a second dose had the desir- 
ed effect, and she rode home from the office 
in an hour and a half. 
Case XX.—Thursday, Dec. 12th. Miss 
, of Montpelier, Yt., set. 20. Had 
taken ether two or three times previously, 
with invariable emesis. She yielded to its 
influence in about fifteen minutes, and Prof. 
S. incised freely an occluded hymen. I 
maintained its influence about twenty min- 
utes. Soon after reaction was established, 
I gave thirty grains, and repeated six times 
at intervals of half an hour. At first there 
was great nausea, no vomiting. The for- 
mer yielded in about an hour and a half, 
and at 5 o’clock the patient ate a hearty 19 
dinner, retaining the same on the stomach 
without nausea. Took, voluntarily, thirty 
grains at 9 o’clock, and had a quiet night. 
Case XXI.—Thursday, Dec. 26th. Mrs. 
M., of New York. Gave the ether in ten 
minutes. Prof. S. removed some haemor- 
rhoids, leaving one in the hope that the 
contraction following the operation might 
render its removal unnecessary. Removed 
the anaesthetic in ten minutes. Prescribed 
potass, bromide, §ij. in ch. no. iij., one 
every half hour. Some nausea, no vom- 
iting. 
Case XXII.—Friday, Dec. 20th. (Case 
XIX.) Miss S., of Boston. Gave the ether 
again, having Dr. Francis C. Ropes and 
Prof. J. G. Pinkham in consultation, with 
reference to the condition of the shoulder.. 
Vomited while in profound anaesthesia; 
during the reaction, I gave ninety grains, 
in divided doses, within an hour and a half. 
No more emesis. Was able to ride home 
from office with comfort. 
Case XXIII.—Thursday, Dec. 26th. Mrs. 
F., of Taunton, set. 56. Never taken ether. 
Had eaten a hearty dinner. Occupied 
twenty minutes in producing anaesthesia. 
Opened a whitlow on the last phalanx of 
the first digit. Gave thirty-grain doses 
every hour (150 grs.). Some slight nausea, 
no vomiting. 20 
Case XXIV.—Monday, Dec. 30th. Mrs. 
D., of New Bedford, aet. 45. Never taken 
ether. Was etherized in ten minutes. 
Prof. Storer removed some haemorrhoids, 
rupturing the sphincter ani, and applied 
ferri perchl. Ordered pot. br. gi. in ch. 
no. xij. One powder every half hour till 
the stomach became quiet. Called again 
in the evening, and found that she had 
taken two of the powders, but disliking 
their taste had discontinued them. No 
vomiting, though some nausea. 
Case XXV.—Monday, Dec. 30th. (Case 
XXIII.) Mrs. F., of Taunton. Gave ether 
in about fifteen minutes, and removed a 
small portion of the last phalanx of thumb, 
which was slightly carious, and with a te- 
notomy knife extended my former incision 
subcutaneously to the palmar fascia. Alsc 
incised by the side of the nail, hoping 
thereby to save its matrix. She came out 
of the ether with considerable hysteria, 
and at first refused to take the medicine. 
In the course of half an hour, I had per- 
suaded her to take forty grains dissolved in 
half a cup of water, and repeated in half 
an hour. Ilere the bromide acted as a very 
powerful sedative, the patient falling asleep 
immediately after the last dose, and sleep- 
ing quietly for more than four hours, wak- 
ing up as though from a natural sleep, with 
none of the disagreeable effects of the 
ether, save its taste, which remained in the 21 
mouth. I gave, with a lemon, two drops 
of a saturated solution of carbolic acid, with 
the effect of relieving the taste. Took a 
light supper of tea and toast, and one more 
powder (40 grs.) on retiring. Slept quietly. 
In the night, awoke with a feeling of weight 
at the epigastrium and nausea. Volunta- 
rily took one powder, and at 10 ate a light 
breakfast (in bed). At 2, P.M., ate quite 
a hearty dinner. 
Case XXVI.—Sunday, Jan. 12th, 1868. 
Mrs. S. P. A., of Brookline, set. 29. Never 
taken ether. Ate a good breakfast, not 
expecting the operation. Occupied about 
fifteen minutes in giving the ether. Prof. 
Storer then removed a small fibroid tumor 
from the anterior wall of the cervix, and 
applied both ferri perchl. and the actual 
cautery. I then packed the vagina, and 
ordered potassii bromidi §i. in ch. no. x. 
Three powders to be taken in an hour and a 
half, and one every half hour afterward, if re- 
quired. Before the administration of the 
drug, there was much nausea and vomiting, 
which the first powder seemed to allay. 
Ate a light supper, and slept quietly. 
Case XXVII.—Thursday, January 16th. 
(Case XXI.) Mrs. M., of New York. Very 
hysterical. Occupied some fifteen minutes 
in giving the ether. Prof. Storer removed 
a hsemorrhoid which he had allowed to re- 
main at a former operation, but which was 22 
now occasioning discomfort. She vomited 
during the operation. I gave her forty-five 
grains of the bromide in a sherry-glass of 
water, and in a few minutes, to use her 
own expression, she “felt much easier.” 
Case XXVIII.—Saturday, January 25th. 
Mrs. C. F. W., set. —. Had taken ether 
several times. Was very nervous and hy- 
sterical. Occupied some fifteen minutes in 
etherizing her. Dr. Storer removed some 
outgrowths around the urethra and vulva, 
and several haemorrhoids, and ruptured the 
sphincter ani. She came out of the ether 
very slowly, with great nausea and vomit- 
ing. Took ninety grains in an hour, with 
decided relief. 
Case XXIX.—Thursday, January 30th. 
Mrs. Anna W., of Roxbury. Had taken 
ether several times. Gave it in about fif- 
teen minutes. I)r. Storer then removed 
some metallic wires which were purposely 
left after an operation a year since, for rup- 
tured perinmum, to act as splints. On 
sufficient reaction, she took forty grains 
of the bromide, with a cessation of the 
nausea. By accident, she was overlooked, 
and in about two hours the nausea return- 
ed so severely that she vomited twice. A 
second dose of forty grains quieted the 
stomach, and a third dose brought a quiet 
sleep. 23 
Case XXX.—Sunday, Feb. 2d. Miss 
Kate W., of Chelsea. Ilad taken ether and 
chloroform, equal parts, once. Gave the 
ether in twenty minutes, and without occa- 
sioning hysteria. Prof. Storerremoved some 
irritable fringes from the vulva. Removed 
the ether in twenty minutes. Some vomiting 
while in profound aneesthesia. Bromide of 
potassium, thirty grains, seemed to quiet 
the nausea without a repetition of the dose. 
The drug which we have been consider- 
ing is of such universal interest, that I 
believe there are many who would like to 
review such articles as have been written 
upon it. I here append a list of those ar- 
ticles and notices that I have found most 
valuable, viz.:—London Lancet, Jan. 23, 
1860, May 28, 1864 ; Le Mouvement Medi- 
cale, Paris, Aout, 1861; Journal de Med. 
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