PART III. TREATMENT 121 



the low diet and stay in bed. He suffered from shortness of breath 

 on exertion, and when he was discharged to a convalescent home 

 this became more marked and was accompanied by irregularity in 

 the action of the heart. The patient was kept at rest as much as 

 possible and in the course of three weeks the condition passed off, 

 when he returned to full duty. Another case which did not react 

 to twelve one-grain injections of emetin was then treated by twelve 

 one-grain injections with \ grain by the mouth. The patient was 

 kept in bed on a milk diet. Shortness of breath and irregularity of 

 the heart were noted when he got up after treatment. The condition 

 passed off in a couple of weeks. 



In none of the other cases treated was anything comparable 

 noted. It seems evident that certain individuals are more easily 

 affected by the drug than others, and it is probable that such have 

 an idiosyncrasy to the drug just as certain individuals have to 

 quinine. In the great majority of cases, however, emetin produces 

 no such symptoms, and case Healy, who had in all forty-six grains 

 of emetin together with a course of pulv. ipecac, during a period of 

 fifty-three days, was quite immune to the drug from this point of 

 view. 



In order, therefore, to be on the safe side it is better to keep the 

 patient in bed, especially when more than one grain of .emetic a 

 day is being administered and when the patient is being kept on 

 the low diet, for this in itself tends to reduce the resisting powers. 

 Furthermore, a patient in bed is under better control as regards 

 his diet, and it is easier to make observations "on the temperature 

 and pulse under these conditions. The collection of samples of the 

 stool for examination is also facilitated. 



Temperature. In none of the cases treated did the emetin 

 appear to have any effect on the temperature. In those in which 

 some irregularity was noted during the course of emetin some 

 other factor was present. In one case peculiar unexplained 

 elevations of temperature were found to be due to appendicitis, 

 and in another case to malaria. 



0) When does the Infection disappear under Emetin Treat- 

 ment ? In Tables X, XI and XII (Columns C) are inserted showing 

 the number of days before infections disappeared after emetin was 

 commenced. In the cases in which there was no reaction (NK) 

 to the emetin treatment there was no disappearance of infection, 

 accordingly a blank is left. In other cases where a ? is inserted 

 the exact day of disappearance of infection is doubtful, either 

 because the infection was temporarily absent at the commencement 



