EXTERNAL APPLICATION OF VERATRIA, ETC. 17 
they are intended to serve: in some affections, however, in which 
the symptoms are more severe, or which are seated in parts only 
thinly covered by integuments, the attempt has been made to apply 
it directly to a part denuded of the cuticle, but although the effects 
upon the disease were much greater than when the surface remained | 
unbroken, yet the extreme irritation which followed the practice 
rendered its repetition impossible. 
External Application of Veratria in Affections of the Heart. 
When any of the preparations of Sabadilla or Veratria are adminis- 
tered in repeated small doses by the mouth ; besides exerting their 
peculiar effects upon the nerves of sensation already mentioned, they 
‘act also upon the circulating system. In many instances the force 
and frequency of the pulse are remarkably diminished by them, and 
the circulation is rendered more regular; whilst in others, a contrary 
effect is produced. This appears to be the result of the influence 
exerted by the medicine on the nervous system, for it takes place 
chiefly in those whose nerves are easily excitable ; in some cases, 
also, in which organic disease of the heart has been present, the 
internal exhibition of one or other of the preparations has afforded 
the patient considerable relief, but apparently, not so much by acting 
upon the nervous system, as upon the kidneys, and thus removing 
some effusion existing in the chest, and which was the immediate 
cause of the aggravated syrnptoms. 
Precisely the same effects are produced, when Veratria ointment, 
or the tincture of Sabadilla, are rubbed over the region of the heart, 
though perhaps not in so great a degree. This latter method, 
however, of employing Veratria, is upon the whole the preferable 
one, as in many cases the stomach might be incommoded by the 
internal use of it, and in addition to its action on the heart, there 1s 
also another exerted, when it is applied to the skin, namely, the 
tingling, which of itself appears to have a beneficial effect, especially 
in nervous cases, probably by acting as a counterstimulant, whilst 
the quantity absorbed during the friction is sufficient to produce its 
other effects on the system. | | 
From the observations which I have made on the action of 
Veratria in affections of the heart, I have been led to conclude, that 
there are some cases in which the symptoms may be removed by 
its use, though of a class that might have been considered as indiea- 
ting confirmed organic disease; amongst the following, will be 
found instances of this kind, and others could have been given; 
these have occurred in patients in whom a gouty or rheumatic 
diathesis has been present, and this fact may perhaps afford some 
explanation of the effects of the remedy. 
There are, then, three states of disease, in which the oimtment 
may be tried: namely, simple nervous palpitation ; in the same 
affection occurring in gouty subjects; and as a diuretic in eases of 
organic disease, though of course in instances of this kind any 
