"BROMIDISM"

To the Editor:— InThe Journal, June 19, page 496, Nielsen reports a case of bromidism from prostigmine bromide. The data given, however, are inadequate for such a conclusion. The patient could not have taken the drug for more than two hundred days, and the larger doses much less time. She had raised the dose until she took 240 mg. per day. Had she taken 240 mg. for two hundred days it would equal 48 Gm. Since the bromine content of prostigmine bromide is approximately 26 per cent, 48 Gm. would be equivalent to 15 Gm. of sodium bromide or 18 Gm. of potassium bromide. At death the patient's blood contained 225 mg. of bromide per hundred cubic centimeters. If the total blood volume was 4,000 cc. the total bromide in the blood would be equivalent to 9 Gm. of sodium bromide. With this volume of blood a person should