General Diseases. 321 



persons are concerned, were I to hint at the care required 

 in the administration of this drug. I will merely observe, 

 for the benefit of non-professional persons, that cases have 

 fallen under my notice in which death had resulted from 

 irregularity in the time of giving such medicine, and more 

 particularly where the dose had been for some time 

 gradually increased until it had reached more than treble 

 the primary quantity. Forgotten for some hours, or it may 

 be a day, and then given perhaps fasting, a fatal issue is 

 pretty nearly certain to follow. 



When there is any difficulty in administering the medicine 

 m the form of pills, the liquor strychnia may be conveniently 

 substituted. 



Local remedies in chorea and paralysis are often very 

 beneficial. I have found setons exceedingly valuable. If 

 the convulsive movements of the former, or the numbness 

 ■ of the latter, are confined to the hind parts, the seton re- 

 quires inserting across the loins ; if general, at the back of 

 the head and across the loins. Counter-irritation along 

 the spine is also serviceable, and galvanism is occasionally 

 useful. 



Though, in principle, the hot bath, from its relaxing pro- 

 perties, may appear wrong, it is nevertheless, in chorea, 

 sometimes attended with good results. It certainly affords 

 relief when the convulsive twitchings are excessive,, and so 

 far I have bbserved no after-evil from its use. I should not 

 advise its adoption when distemper also existed. Quietude, 

 except when the patient is necessarily disturbed, is very 

 essential ; and attention to the bed being dry, and the 

 excretions regular, are also matters of importance in chorea 

 and paralytic affections. 



When abatement of the twitchings, with returning 

 strength, is observed, a favourable issue may be expected ; 

 but it is advisable not to discontinue the medicine so long 

 as any nervous complication remains ; afterwards it should 

 be gradually^ not suddenly, suspended. 



