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September 23, 1939


JAMA. 1939;113(13):1243. doi:10.1001/jama.1939.02800380061024

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To the Editor:—  In an otherwise excellent article on bromide intoxication (The Journal, August 5, p. 466) Dr. Gundry fails to mention an important point in treatment. He suggests sodium chloride by mouth or parenterally to replace the bromide in the system but no note is made of gastric aspiration.Ordinarily the bromides are eliminated by the kidneys, but Otto E. Toenhart (Wisconsin M. J.12:901 [Dec.] 1935) points out that hydrobromic acid is secreted by the stomach in approximately the same ratio to hydrochloric acid as that of the salts in the blood. By using continuous gastric lavage he prevents reabsorption and materially hastens elimination of the bromides from the body.During the past two years Dr. E. D. Hoedemaker and I have had occasion to use continuous gastric aspiration in at least twelve cases of bromide psychosis, with gratifying results. The use of sodium chloride alone necessitates

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