Belladonna has important application in the treatment of certain disorders of the nervous system. Sick-headache, due to or accompanied by spasm of the arterioles—a condition manifested by pallor of the face, vertigo, and tinnitus aurium—is relieved by belladonna. At first the distress may be even increased, but great relief presently follows. This remedy is injurious in the congestive form of sick-headache. The following is a serviceable combination in the cases of sick-headache due to vaso-motor spasm: Rx Atropinae sulph., gr. ss; chinoidin, 3 j. M. Ft. pil. no. lx. Sig.: One pill twice or thrice a day.

Although belladonna in the physiological state induces wakefulness and busy delirium, in certain morbid states of the brain it is hypnotic. The indications for its use are as follows: prostration, low state of the arterial tension, languid intra-cranial circulation, a contracted pupil, and insomnia, due to the condition of the brain manifested by these objective signs. In various kinds of mental disorder, in which the foregoing symptoms are present, much good may be expected from the use of belladonna in moderate doses; but harm only will be produced by it when there is much vascular excitement.

Belladonna, according to Trousseau and Pidoux, is a more efficient remedy in the treatment of epilepsy than the salts of silver, copper, or zinc. They insist that the capital condition of success is perseverance on the part of the physician and patient, that belladonna should be given steadily for a year in gradually-increasing doses, and that if amendment is then produced it should be continued through two, three, or even four years. Belladonna is not equal to bromide of potassium in cases of diurnal epilepsy, in epilepsy accompanied by cerebral hyperaemia, and in epileptiform convulsions due to coarse organic lesion of the brain. The best results are obtained from it in nocturnal epilepsy, in petit mal, and in pale, delicate, and anaemic subjects, with cold hands and feet, blue skin, and weak heart.

In neuralgia belladonna affords relief, although not equal to some other agents. Given hypodermatically (see post), it is often very effective. In any case, its use must be persisted in; full doses are necessary, and physiological effects must be produced and maintained for some time. A solution of atropine is the best form for the stomach administration. Dysmenorrhoea, when neuralgic in character, and ovarian neuralgia, may be permanently removed by belladonna. It is useful in these cases to combine it with synergistic remedies. Rx Ext. belladonnae, grs. iv; ext. stramonii, grs. v; ext. hyoscyami, grs. v; quininae sulphat., Э ij. M. Ft.pil.no. xx. Sig.: One pill two or three times a day. When anaemia exists, iron may be added to this formula.

No single agent has been as uniformly successful in the treatment of nocturnal incontinence of urine as belladonna. This morbid state is due to several conditions, and belladonna is not equally successful in all: nocturnal incontinence may be due to an excess in the acidity of the urine, which renders it unduly stimulating; to relaxation of the sphincter vesicae; to an irritability of the mucous membrane, in consequence of which erroneous impressions are communicated to the brain. Belladonna gives relief in the two last-named conditions. The atropine dissolved in the urine acts locally on the nerves of the mucous membrane, diminishing their irritability; the sphincter is put into a state of tonic contraction by reason of the systemic effect, which includes, of course, the sympathetic system. The error is often committed of giving too little of the remedy; systemic effects must be produced, and children, compared with adults, are insusceptible to the action of belladonna. The best form for administration, because less disagreeable and more constant in effect, is a solution of atropine.

Nocturnal seminal losses, as respects mechanism of production, making allowance, of course, for difference of seat, have a strong analogy with nocturnal incontinence of urine. This trouble may be considered a morbid state, only, when the losses are frequent and affect the health. Bromide of potassium best relieves spermatorrhoea, so called, when it is largely physiological and due to a normal plethora; belladonna is most serviceable when the genitalia are relaxed, the emissions flowing without force, and without a distinct dream and orgasm.

Atropine is a remedy of the greatest importance in the practice of ophthalmology. As it dilates the pupil, diminishes the intraocular pressure, contracts the arterioles, and acts topically on the sentient nerves, it is obvious that its field of utility is wide, and its therapeutic power great.

In phlyctenular keratitis atropine renders the greatest service; it diminishes the photophobia and blepharospasm, and lessens the blood-supply by contracting the vessels. It has a still more beneficial action in iritis; it prevents adhesions, anterior and posterior, and by dilatation of the pupil so compresses the vessels as to jugulate the inflammatory process. When the cornea is perforated, herniary protrusion and adhesion of the iris are prevented by dilating the pupil. For these purposes a four-grain solution of atropine is the proper strength for instillation into the eye. When it is desirable to suspend the power of accommodation, in cases of hypermetropia to determine the refraction of the eye, and in astigmatism to ascertain the difference in the meridians, atropine is used. A weak solution only is employed, to dilate the pupil for a brief period, in order to facilitate the examination of the fundus of the eye. Dilatation of the pupil with atropine is also necessary in the examination of cataract, especially in the early stages of its formation. It should be remembered that strong solutions of atropine instilled into the eyes may, by subsequent absorption, produce atropinism, and to such an extent as to occasion solicitude.

In certain affections of the skin belladonna is useful—viz., in the cutaneous neuroses, prurigo, herpes zoster, erythema, and eczema, etc. Cases of these affections which resist ordinary treatment, yield to belladonna. The tincture, or the alkaloid, in suitable doses, may be given in quantity sufficient to maintain a slight physiological action. Hyperidrosis (colliquative sweating), unilateral sweating, and other forms of profuse transpiration through the skin, are arrested by the internal and, in some cases, by the local application of the belladonna preparations, as Ringer has shown.

No remedy is so generally effective in relieving the sweats of phthisis as atropine. The one sixtieth of a grain at bedtime usually suffices. The author was the first to indicate this use of atropine in his "Prize Essay." Not only is atropine antagonistic in action to that condition of the sudoriparous glands resulting in the sweats of disease, but it equally antagonizes the hyperidrosis produced by such drugs as jaborandi.

In the treatment of that form of phthisis known as caseous pneumonia, atropine has an important place, quite irrespective of its power to arrest the sweats. As Dr. Fothergill, of London, and myself, nearly simultaneously ascertained, it has an influence on the progress of these cases, and a curative effect that is often very remarkable. The author has observed with regret that some of those who have found this remedy useless, were entirely mistaken as to the character of the cases in which atropine has proved beneficial. As a remedy for the caseous inflammation, without regard to sweating, the period when the degree of benefit above referred to may be expected from it, is the stage of deposit immediately succeeding the stage of catarrhal inflammation, and before softening and extrusion, and not in tuberculosis.