Effect of Chlorides upon Distribution Ratio of Bromides in Blood and Cerebrospinal Fluid

Abstract

It was found 1 that the quantitative determination of bromides by the Walter method was influenced by the variations in the chloride concentration. In the presence of chlorides the bromides cannot be completely recovered by this test, and the loss is directly proportional to the degree of concentration of chlorides. It was pointed out that the use of distilled water in diluting the blood serum to be examined for bromides, introduced an error in that the loss of bromides in the blood was proportionally less than the loss in the cerebrospinal fluid. For this reason it was suggested that the blood should be diluted with a NaCl solution which will raise the concentration of chlorides in the serum to the degree found in the cerebrospinal fluid. Seeing that most of the reports on the distribution of bromides were made on the basis of investigations in which the blood was diluted with distilled water, we here report a series of cases in which this error was corrected.

In Fig. 1 we have arranged the findings in 173 cases representing different forms of mental and nervous diseases on the basis of the distribution ratio of the bromides. The first thing that becomes apparent is that these ratios fall distinctly below those that have been reported previously. 2 The highest quotient in this chart is 354, whereas the low ones reach the level of 158. With this we also find that diseases such as psychopathic personalities, senile psychoses, etc., which have previously been shown to have a normal ratio varying between 280 to 320 in the present chart have fallen to a level predominantly ranging between 240 and 285. In other words, the absolute figures in determinations, where the error introduced by the distilled water is corrected, fall distinctly below the figures where this was not taken into consideration. Analysis of the chart shows, however, that the relative proportions of these figures and their relationships to different types of diseases remain practically the same as in previous publications.