*

heart is too much contracted; you would only over tax it and injure the patient. Again, I believe that digitalis is an invaluable remedy where we have extreme agitation of the heart, or extreme palpitation, from general debility of the whole system. * * My position is that it acts as a cardiac tonic, increases the muscular vitality and thereby rests the heart, and if you rest the heart you rest the whole patient, and diminish the great wear of the system, which is going on when the heart is acting so violently. I am aware a common notion exists to-day in the medical profession, that if a patient is debilitated over much, and is suffering from a chronic form of the disease, and has, as a consequence, palpitation of the heart, that digitalis is wrong. Right there I believe the remedy does good nearly all the time. I don't believe that digitalis is the proper remedy in the treatment of an acute form of disease as a rule. When we have an inflammatory condition, or where we have congestion, in most instances digitalis would do harm. Where we have a plethoric condition of the system, with more or less febrile excitement, our first duty is to relieve the patient of this plethora, and thus prepare the patient for digitalis, and then administer it. There is where it differs from veratrum. I believe it right to use veratrum in congestions and inflammations of different kinds, but I do not believe digitalis is adopted to that condition.

Dr. J. Thompson.-Concerning a great many of these remedies, I think on the one subject of sedatives, the remarks ought to be qualified. Quinine is sedative in large doses, and in certain diseases would do well; others I know act on the principle, that if they don't do any good they do no harm; but when we give veratrum as a sedative, and the patient vomits, we have to stand by the patient. Suppose it were given in the case of an infant, the antidote would be worse than the remedy.

We have antimony in inflammatory cases, which I

believe is superior to veratrum. So it can be said of many of these remedies, If they do no good they do no harm.

Dr. Harvey.-I want to be understood in what I said in considering the agents acting upon the heart, as acting through the nervous system. I fail to agree with the position taken by Dr. Todd. There is apparently certain elective effects produced by certain remedies. My idea would be better elucidated by taking up purgatives. We have aloes, sulphate of magnesia, and a host of other remedies that will act on the alimentary canal, hence we call them purgatives, cathartics, laxatives, etc. We know that these remedies act, some of them, on one portion and some on another, yet they all act on the alimentary canal, and are regarded as cathartics. It is the same way in regard to these remedies as acting primarily on the heart.

I do think that where we have a given condition, we can select a remedy which will suit that condition on account of its effect on the brain and nervous system. We have a continued fever or congestion of the brain, in which the patient will not be benefited by narcotic remedies, but you want to give aconite or some remedy to quiet the action of the heart. So you have chronic diseases, and you want a remedy that can be given for a length of time, and you have digitalis, which, undoubtedly, acts through that system, because it is known to quiet the nervous system. Certain oculists, when they are about to perform a delicate operation on the eye, take a little digitalis to quiet the nervous system; one grain of digitalis will so quiet the nerves, that they can perform the operation for cataract without the tremulousness, which frequently attacks all surgeons in performing operations of any kind. If it has this effect on the nervous system, it certainly acts through the nervous system in producing a sedative effect upon the heart.

Dr. L. D. Waterman.-With regard to aconite, to take up the argument at the point Dr. Harvey drops it, those articles that seem to steady the nerves, are often the articles that paralyze the nervous action. Preceding a surgical operation, men of a certain temperament become too much excited. It is upon that ground that I have seen good lawyers, in the court room, drop their papers from nervousness, until they would take something that would produce anesthesia. In spotted fever, aconite with bromide of potassium, is the remedy I relied upon. In a child's pulse, running from 125 to 130 in 40 or 60 minutes, watching it as carefully as a man can, the pulse would diminish and become calm, and the system would ameliorate just in proportion that they become 'calm. I am satisfied that a large part of this effect was produced by aconite.

There is another remedy that, in my judgment, demands more attention, and that is nicotine. I think that agent, acting through the sympathetic nerves and the system generally, if we could separate its good from its bad effects, would give us some good results. With persons that have never used it, it seems to act upon them sympathetically, and produces nausea; but I think we will be able to make it a valuable remedy yet.

Dr. Cook.-In such cases as those mentioned by Dr. Walker, some eight years ago I used it right along, of which I kept some record. It produces a peculiar emisis, but when taken in season is the greatest remedy known in that particular affection. I have used a little in malarious affections, but as far as I have used it in conjunction with quinine or the barks from which it is derived, I found recovery more rapid and apparently more complete.

As far as digitalis is concerned, I never had sufficient favorable opinion of it to justify its use in my own ex⚫perience.

In regard to arnica, I remember a circumstance that

happened in my practice some five years ago, where a woman, who always kept an arnica bottle on hand ready to apply to the children when bruised or hurt, had veratrum veride prescribed for her by a physician. At one time, she, by mistake, took the arnica instead, and being much frightened, supposing it to be poison, immediately sent for me. Having taken about the same quantity, no immediate results were discovered from that which might be expected from veratrum. The woman herself thought it of immense advantage afterwards, and proposed a change.

Dr. Hadley.-In closing the discussion on his paper, simply remarked: Last winter I had a case of bronchitis, and I know now what cured it since the doctor spoke. It was a case of a similar type and scarcely distinguishable from pneumonia; and one night the pulse became so rapid that veratrum veride was given to control it. About midnight the patient commenced vomiting. I was sent for about two o'clock, after the patient had vomited a good deal, and I immediately gave wine. The next morning my patient was better, and the morning of the second day discharged as cured.

Dr. Chas. N. Todd (in his seat).-I would like to protest against giving veratrum veride until vomiting is produced.

Dr. Harvey (by permission).-I want to express my opinion to the contrary exactly. If we would use veratrum where we ought to use it, we could arrest and break up disease much sooner; and the bad effects of veratrum veride can be relieved promptly by a preparation of opium. I never saw a case that did not improve after the effects of veratrum veride. I speak in regard to this matter, without a disposition to differ with any one, but as a matter of observation in ten or fifteen years' practice. I have never seen its evil effects. I think there is unnecessary fear with regard to veratrum veride. There is a copious secretion of mucus vomited up, which

is a reaction of the system, and the patient is relieved. I know of a patient who took a teaspoonful in the third week of typhoid fever, when he was very weak of course, but convalescent, and he died. Hours before, his pulse kept up to 160 a minute, showing that if poisonous at all, it was from the combined effects of the remedy and its antidotes.

Dr. J. Thompson (by permission of the Academy).-To use a quotation from an eminent Scottish writer, I might say: 'Tis "divine, rare, excellent, which goes far beyond all their panaceas, potable gold and philosopher's stones; a sovereign remedy for all diseases. A good vomit I confess; a virtuous herb, if it be well qualified, opportunely taken, and medicinally used; but as it is commonly used by most men, who take it as tinkers do ale, 'tis a plague, a mischief, a violent purge of goods, lands, health; hellish, devilish, damned, the ruin and overthrow of body and soul." [Laughter.]

Editorial.

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WE vote proof readers a necessary nuisance, and intend to "go" for them in a way they ought to "despise." In the last number, the "u" in Glaucoma is made to turn a summersault and come down to an “n,” while in the foot note, Indianapolis has lost its tail, and appeared as "Indiana," also, one gentleman is made to give 5 grs. morphia in a case of tetanus, when there was onlygr. given. For fear of a repetition we have made different arrangements, and hope hereafter that the