An important incidental advantage, in these cases, is frequently its effect in removing the dropsical effusion, whether in the pericardium, the other serous cavities, or the general areolar tissue, which so frequently complicates them.

Functional palpitation of the heart, either from plethora, anaemia, or mere nervous disorder, is often more or less benefited by digitalis; but the remedy is applicable only to the cases in which the affection has a certain degree of permanency, and not at all to those occasional and fugitive attacks which occur under passing excitements, and are so common in hysterical women, and nervous persons in general. For these it is not sufficiently quick in its action, and is much inferior to the nervous stimulants, which operate by equalizing excitement. Whenever digitalis is exhibited, in the more enduring cases of palpitation, it should be associated with measures calculated to remove the cause; as otherwise it will be of little comparative service, merely repressing the cardiac excitement, without correcting the conditions of system of which that excitement is intended to be an index, and sometimes even a remedy. in plethoric cases, therefore, it should be accompanied with measures for diminishing the quantity and lowering the quality of the blood, and, in the anemic, with others of an exactly opposite character.

In aneurisms generally, and particularly in aneurism of the aorta, digitalis sometimes proves serviceable by lessening the distending effect of the heart's contraction, when the circulation is too vigorous or too much excited. it acts, however, only as a palliative.

Nervous Diseases. Sufficient has already been said of the use of digitalis in palpitations of nervous origin. it has been recommended in some spasmodic affections, as epilepsy and spasmodic asthma; and may have occasionally proved serviceable in these diseases; but it is inferior to many other remedies more commonly employed; and is peculiarly indicated only when the spasmodic disease is attended with a prevalent abnormal frequency of pulse. in delirium tremens, it has recently obtained great reputation; and the statements made in its favour are so numerous and authoritative that, notwithstanding my previous prepossessions against it, I cannot avoid acknowledging that it is an efficacious remedy. it requires, however, to be given in large doses, of which the system in this affection appears to be peculiarly tolerant. More than a fluidounce of the tincture has been given with impunity; and the ordinary method of exhibition is to give from half a fluidrachm to half a fluid-ounce, repeated, in reduced doses, every two, four, or six hours, until sleep is induced. This tolerance of digitalis in large doses is like that of opium in the same disease, of which much larger doses are required than in most other complaints. But, notwithstanding the favourable reports of the action of digitalis in delirium tremens, and the large doses which are given with ordinary impunity, I cannot but think that the practice is somewhat hazardous, and I should much prefer treating delirium tremens in safer methods.* Though unfavourable results are not apt to be recorded, yet there is reason to believe that they now and then occur. Dr. Geo. Johnson, of London, states that he has heard of several instances of sudden death from large doses of digitalis (see Am. Journ. of Med. Sci., Oct. 1866, p. 537); and I have myself known an instance in which the exhibition of two fluidrachms of the tincture, repeated at the usual intervals, was followed, after a very few doses, by fatal prostration. Acute mania, when attended with cerebral and cardiac excitement, and especially when depletory measures may be deemed inappropriate, and the cerebral stimulants are not admissible, may sometimes be advantageously treated with digitalis. it is said also to have proved very useful in the active delirium of low fevers. (R. B. Motery, Am. J. of Med. Sci., April, 1865, p. 371.) in nervous headache it is said to have been usefully employed in association with sulphate of quinia; and great efficiency has been ascribed to it by Mr. Hardwicke, of Rotherham, England, in obstinate neuralgia. (Association Med. Journ., June, 1855, p. 512.)

Allusion has been before made to the antaphrodisiac property, said to be possessed in an extraordinary degree by this medicine. in April, 1853, the attention of the profession was called, by M. L. Corvisart, in a communication contained in the Union Medicale, to several cases of spermatorrhoea, which had been either cured or benefited by this remedy, given in the ordinary doses through the day. (Ann. de Thérap., 1854, p. 50.) This favourable report of it was afterwards confirmed by Dr. Brughmans, in the Journal de Medecine of Brussels (Nov. 1853), who found it extremely useful, not only in the affection mentioned, but also generally in erethism of the genital organs, such as attends gonorrhoea and chancre; and, from his account, it may be inferred to be equally applicable to the irritation and inflammation of these parts from other causes. (Journ. de Pharm. et de Chim., Fev. 1854, p. 152.) Still later (Oct. 1854), a case of severe spermatorrhoea is related by M. Laroche, in the Gazette Medicale, which was cured by the remedy in three weeks. (Lond. Med. Times and Gaz., Nov. 1854, p. 473.) Should it be found to fulfil the in cases admitting of delay, one grain of the powdered leaves may be given, in the form of pill, twice or three times a day, and increased every other day by one-quarter or one-half of the dose, until its effects are experienced, or until from two scruples to a drachm shall have been taken, when, should it have produced no sensible effect, it ought to be suspended for a few days, for fear of a cumulative operation, and afterwards resumed. When it begins to operate, the dose for a like reason should be diminished, so as simply to maintain its influence; and, if nausea and vomiting, or great prostration are produced, it should be suspended; to be resumed, in a smaller dose, when these effects have subsided. Should deficiency of the urinary secretion, and a confined state of the bowels come on during its administration, particular caution should be used not to press the remedy too vigorously. if these rules are observed, I believe that it may always be given with safety.