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 
in 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 observed 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. 
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