362 MATER i A MEDIC A AND THERAPEUTICS. 



and finally collapse, preceded and accompanied by a slow feeble 

 or irregular pulse, feeble respiration, cold sweats, fall of tem- 

 perature, occasional muscular twitching and creeping, and itch- 

 ing sensations on the skin. It has now been proved that these 

 phenomena are not referable to the cerebrum, which remains un- 

 affected, with perfect consciousness, nor to the motor centres 

 of the cord or motor nerves, all of which are but slightly depressed. 

 The muscles are the organs attacked by veratria, which 

 produces a highly remarkable lengthening of the contraction, 

 the descending portion of the muscle curve (phase of relaxa- 

 tion) being fifty times its ordinary length. Therewith the 

 force of the contraction is increased. These two effects on the 

 muscle contraction are so marked that the muscle appears to 

 be in a state of tetanus, but the curve is really a single contrac- 

 tion, and not compound or a fusion of closely repeated simple 

 spasms. Larger doses cause weakness of the muscles and finally 

 paralysis. 



The heart, after primary acceleration, is affected just like 

 the voluntary muscles, its contractions becoming greatly 

 lengthened, and thus its frequency reduced (even by 20 to 60 

 beats per minute in fever), long pauses occurring at the end 

 of systole. Irregularity, acceleration with feebleness, and 

 finally paralysis are the result of larger doses. The blood 

 pressure rises " at first, falls during the stage of infrequency, 

 and is then dangerously lowered. The primary stimulation of 

 the heart and vessels, and part of the succeeding depression, 

 occur through the centres in the medulla. 



Respiration is first accelerated, then slowed, and finally 

 arrested through the centre, the muscles, and the pulmonary 

 vagus ; the movements exhibiting expiratory pauses and irre- 

 gularity. 



The fall of temperature, which may amount to several 

 degrees in fever, appears to be referable to the circulatory 



4. SPECIFIC 



The specific uses of veratria depend on its depressing 

 action on the heart, vessels, and body temperature ; that is, it 

 is a powerful antipyretic. It has been recommended for the same 

 conditions as aconite, namely, acute febrile processes in strong 

 subjects, such as sthenic pneumonia and acute rheumatism. If 

 it b*e considered safe and desirable to treat such cases with 

 powerfully depressant measures, veratria may be used ; but in 

 England, at least, the opposite line of treatment is generally 

 followed, and every lowering influence on the heart carefully 

 avoided. In aneurism and in haemorrhage, where the blood 



