554 THE PATHOLOGY OF NIGHT-SWEATING IN PHTHISIS. 



was increased to twenty drops, and after this there was no 

 sweating. 



But it is evident that if strychnia increases the excitability 

 of the respiratory centre to stimuli applied directly to it, such 

 as the carbonic acid present in the blood, it is likely also to inr 

 crease its susceptibility to reflex irritation, such as that caused 

 by tubercle in the lungs, and thus it might be that it would 

 tend to increase the cough in case of phthisis. This, indeed, it 

 appears, in some instances, to do. I have tried here to remedy 

 this by a combination of strychnia with opium, and this appears 

 partially to succeed. Where, however, strychnia does not appear 

 to suit, atropia may answer perfectly. Now, atropia, no doubt, 

 acts upon peripheral terminations of the secretory nerves in the 

 sweat glands, and thus it will altogetlier prevent sweating. But 

 this is not the whole actioai of atro[)ia. It has been noticed by 

 Emger that the beneficial action of atropia continues for a very 

 considerable time after its administration. It seems difficult to 

 believe that tliis is merely due to its action upon the sweat 

 nerves, for it is probable that the greater part of the airopia 

 has been excreted from the body before the beneficial action 

 which it produced has come to an end. 



It seems not improbable, therefore, that the benefit derived 

 from the employment of this drug in the night-sweating of 

 phthisis is not due merely to its action upon the peripheral 

 terminations of the sweat nerves, for, as has been shown by Yon 

 Bezold, it has a marked action in stimulating the respiratory 

 centre. At the same time it lessens the irritability of the sen- 

 sory nerves in the lung, and is thus likely to diminish the 

 exhaustion of the respiratory centre, which the reflex irritation 

 produced by the tubercle would otherwise occasion. It is to 

 this stimulation of the respiratory centre, as much as to the 

 paralysing action on the respiratory nerves, that I should be 

 inclined to attribute the benefit to be derived from atropia or 

 from hyoscyamus, which acts almost in the same way as atropia, 

 and is so frequently given, along with oxide of zinc, in sweating 

 of this sort. In Dover's powder w^e have a combination ]mvint> 

 an action somewhat resembling that of atropia in certain 

 respects, though differing from it very markedly in others. Id 



