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general use, about eight years since, has not been over-rated, and it is said to possess some alterative powers." Dr. B. states that the use of this remedy in active inflammatory diseases has become very general; and closes his remarks by saying that he has seen the most marked benefit result from its exhibition. Dr. Ziegler remarks that in his hands, the veratrum viride has received a faithful and extended trial, and he was free to admit that, in the cases in which he had given it, it had proved beneficial beyond his most sanguine expectations. He gives the history of a case of typhoid fever, in which, after almost every conceivable remedy had been employed unavailingly, and the patient seemingly beyond the reach of medicine, Dr. Z. made use of Tilden's preparation of veratrum viride, and succeeded in restoring his patient to health. He has employed the veratrum in most of the diseases coming within the range of his practice, and that, too, with the most undoubted success. (Med. and Surg. Reporter.)

PUERPERAL FEVER.-Dr. Barker highly recommends the employment of veratrum viride in puerperal fever. He states that the article which controlled arterial action better than any other, and with less shock and irritation, was veratrum viride. Next in his opinion came aconite, digitalis, and tartar emetic. The latter, however, was seldom admissible. Veratrum viride had this advantage also over others that it was not incompatible with, nor antagonistic to, stimulation. He says we were often obliged to push the veratrum viride as far as possible, and at the same time to stimulate very freely. If we were to pursue the same method with aconite or digitalis, he thinks we should produce a great deal of distress. He very justly remarks that we must be very careful not to consider the patient out of danger too soon. The patient was not safe until the pulse had been brought down, and kept under 80 for some days by the article. Dr. S. W. Abbott, of Woburn, says that veratrum has been found of great value in puerperal peritonitis, in connection with opium and wine. He remarks: "In this disease my preceptor, Dr. Benj. Cutter, states that he has given the full dose of half a fluid drachm, and repeated the same in thirty minutes, with perfect safety and success. This was done for the purpose of producing emesis, and thus hastening the sedative effect, which is so clearly manifested whenever the medicine occasions nausea or vomiting. The system, suffering with

acute pain, tolerates the drug in much larger doses than would be safe in health, probably from the same reason that opium has been. safely given in enormous doses in the same disease." (Boston Med. and Surg. Jour.) Any amount of testimony could be adduced in favor of this agent in the treatment of this malady.

PUERPERAL MANIA.-A highly interesting instance of the sedative action of veratrum viride was given by Dr. John L. Atlee, Jr., at a session of the Lancaster (Pa.) Med. Society. In order to diminish the nervous excitement, and control the general circulation in a patient showing all the symptoms of puerperal mania, Dr. A. ordered the saturated tincture of veratrum veride, in doses of five drops every three hours, which, after three doses, produced subsidence of most of the symptoms, which disappeared completely when the medicine had been continued for four days, at intervals of four and lastly of six hours, followed by perfect re-convalescence.

NERVOUS AFFECTIONS.-Dr. J. S. Wilson, of Georgia, relates a case of epileptiform convulsions which was successfully treated principally with veratrum. The following is an extract of the case: "The subject of the convulsions was an anæmic boy of ten or twelve years of age; the spasms were frequent and extremely severe, every paroxysm apparently putting the life of the patient in imminent danger; the veratrum, to reduce the frequency of the pulse, and ether inhalations to quiet the spasms, were the remedies almost exclusively relied upon; and these indications were fulfilled in the happiest possible manter, snatching the little sufferer from the jaws of death." (Southern Med. and Surg. Jour.) Dr. G. M. Staples, of Dubuque, Iowa, says that this agent has proved highly serviceable in the eclampsia of childhood from teething or intestinal irritation, when the convulsions continue after the bowels have been deterged. Dr. Staples observes: "In hysteria* it has appeared beneficial in our hands after all approved modes of treatment had failed, in cases where the proximate cause of the paroxysms had disappeared, and still an hysterical disposition remained." Dr. Bishop relates the case of a little girl, aged four years, laboring under convulsions from congestions of the brain. Pulse 120. Applied cold to the head, and gave 14 drops of the tincture veratri viridis every hour. Three doses were given, when she broke out into a profuse,

* Medical and Surgical Reporter, May, 1861, p. 158.

cold perspiration, with all the symptoms of prostration. The friends becoming alarmed, summoned the doctor, who did not arrive until about two hours, or four and a half hours from the time she was first seen. Instead of finding her dead, she was lying upon the bed, playing with a doll, perfectly relieved, her pulse 72. Dr. Atkinson remarks: "From its action in our hands, we are prepared to anticipate the happiest results in infantile convulsions, than which there is scarcely any affection of childhood more alarming, or of which the treatment is less satifactory." (Med. and Surg. Reporter.) S. P. Hubbard says that he has saved many lives with the veratrum, and regards it as an excellent remedy when judiciously administered (Ibid.) In the treatment of hysteria, the patient should be brought as soon as possible under the influence of this agent, and counter irritation applied along the spine. The veratrum may be continued, after the paroxysms are subdued, for two or three days in small doses.

SCARLATINA.-Dr. E. Hoyt thinks he has derived much benefit from the use of veratrum in scarlatina; he learned while at the South that the physicians there were using it with good results in the same disease. He states, that where arterial excitement needs reducing, it is decidedly, better than digitalis. He says he likes it in measles, pertussis, and parotidea. (Amer. Med. Monthly.) Dr. Coe testifies: "In the treatment of every form of febrile exanthema, and particularly of scarlatina the veratrin is unequalled, as these types of disease are accompanied with great arterial excitement, a high degree of plasticity of the blood, and a strong tendency to the production of effusion and exudations, for the prevention or removal of which the veratrin is of such remarkable utility. Were veratrin of no further service than in the treatment of scarlatina, we should deem it invaluable and indispensable. So far as our observations have gone, and they extend over a period of five years experimental use of the veratrin, both in our own practice and in that of others, we have never yet seen a case treated with it that did not result in a perfect cure, unattended with effusion, exudation, or malignant sequelae of any kind. In scarlatina, as we find it in this region, we premise our treatment in the early stages, with pododophyllin, and afterwards rely upon veratrin and asclepin, in combination. Seldom is further medication unless it be to meet special symptoms. To prepare the

necessary,

veratrin for use in scarlatina, it should be thoroughly triturated with asclepin and made into solution with hot water. It may then be administered in such doses and with such frequency of repetition as may be necessary to control the disease. Our experience is in favor of administering it at intervals of two hours. When the inflammatory action is violent, it may be administered every hour in the commencement until the violence of the symptoms is subdued, and then repeated at intervals of two or three hours as may be necessary to maintain its proper influence. As soon as an intermission, full and complete occurs, the cerasein may be given in suitable doses, the veratrin and asclepin being continued at intervals of four or six hours until all danger of a return of the febrile symptoms is past. Veratrin seems appropriate in all stages of scarlet fever. We have known cases of the worst form, and in the latter stages, where the patient was in convulsions, and the medical attendant had abandoned all hope, in which the exhibition of this remedy has promptly arrested the disease, breaking up the convulsions and saving the patient. The absence of effusion, exudations, and other of the usual distressing sequents of scarlatina, when treated with veratrin, we attribute to the remarkable resolvent, alterative and tonic power of this remedy, whereby the depurative action of the entire economy is promoted, and these retentions, accumulations, and consequent congestions are prevented. It stimulates the functions of the absorbent, venous and lymphatic vessels in a peculiar manner, and, by resolving the viscid and plastic condition of the blood and secretions, enables them to discharge their various functions fully and effectually. It is our firm conviction that the three remedies above enumerated, namely: podo. phyllin, veratrin, and asclepin, will, when judiciously employed, cure a larger per centage of the cases of scarlatina than any other plan of treatment yet devised." As confidently as Dr. Coe speaks of this agent in the treatment of scarlatina, many of our medical journals advocate its virtues equally as much so. Those, who use it most freely, applaud most cheerfully its merits. Dr. G. W. Borstler, Lancaster, Ohio, (Western Lancet) in speaking of veratrum in general, says: "The veratrum has never disappointed me, and that without one unfavorable symptom resulting from its use. In no instance, however, have I brought down the heart's action to a normal state, without my patient complaining of some

degree of nausea.

As a curb to the inordinate action of the heart

it is truly invaluable."

DYSMENORRHEA.-"So far as my experience goes," says Dr. Miller, "I have found the veratrum very good in dysmenorrhoea of plethoric patients, but uniformly hurtful to those who are anæmic. He has frequently added a little morphia to it with benefit. It will often be found beneficial in the treatment of this malady, to give veratrum and small doses of sanguinaria in combination; sometimes stramonium in conjunction will be advantageous." Dr. Coe says: "Veratrin exercises a specific influence over the uterus, and has been beneficially employed in amenorrhoea, atonic chlorosis, uterine leucorrhoea, and other affections dependent upon vascular debility.'

DYSENTERY.-Dr. Pattee informs us that he has used this agent in dysentery, as recommended by Dr. Tully, with effect, and can confidently recommend it in connection with morphine, as one of the most efficient remedies in the treatment of simple dysentery, that we have. It may be alternated with various astringents, if needed. Due discrimination must be exercised with this agent, as with all others, as regards time, quantity, repetition and continu

ance.

NERVOUS ASTHMA.-Veratrum has been recommended in nervous asthma, and the analogy of the effects of nauseants and nervous sedatives in this affection, says Dr. Stillé, would lead us to suppose that it might be beneficial, and not only in cases which are free from organic complication, but in some also in which emphysema and organic diseases of the heart co-exist, as well as in those of nervous palpitation of this organ. Dr. S. observes: "The benefit experienced in several instances of both forms of cardiac disorder has been very decided, and tends to prove that the medicine did not produce such marked relief by any debilitating influence. The cases reported include examples of nervous excitability with muscular atony of the heart, and others of great embarrassment of the circulation from valvular disease; but in all the relief was marked when the rate of the pulse diminished although none of the toxical effects of the drug were developed.' Veratrum is reported to have been used with advantage for many diseases not mentioned in this paper for want of room. It has been employed successfully in various cutaneous affections. Dr.

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