i879-] 
A merican Nervousness. 
607 
at the beginning of an attack, and during the attack, and as 
a permanent cure, provided its action is maintained for 
weeks and months. Its quick and permanent influence over 
the symptoms of headache suggests its great value in other 
conditions allied to sick headache, or from which sick head- 
ache springs. 
Another remedy, not very widely known, but one the value 
of which is easily proved, is citrate of caffeine , and allied to 
caffeine is coca , belonging, indeed, to the same family ; 
indeed, it is the active principle of common coffee, tea, 
guarana, and chocolate. It relieves the pain and uneasiness 
that follow over-exertion, and the peculiar distress that comes 
from sleepless nights, for which purpose, I may say, caffeine 
may also be used. 
Th ezine preparations, particularly the bromide, valerianate, 
and oxide are sedatives of very great value in various neu- 
rasthenias, and I use them with great freedom. I gave once 
the zinc combination, including the bromide, the valerianate, 
the phosphide, and the oxide, to a physician who consulted 
me about a year ago for neurasthenia, resulting from over 
work in his profession. In a few weeks he reported himself 
to me to express his gratitude and to testify to the great 
value of the remedy as a hypnotic as well as a sedative. 
Duboisia, the new remedy from Australia, is likely to take 
a minor if not a major place among the resources of the 
neurologist. Its effeCt is somewhat like that of atropine, but 
yet not entirely like it ; and, for the symptom of hyperdrosis, 
seems to be more effective according to experiments that I 
have made with it. 
Cimicifugin is a remedy the value of which in choreic 
condition is undeniable, and I am persuaded that its use 
need not be restricted to those conditions. 
Strychnia is one of our older remedies, and I use it some- 
times alone, but very frequently in combination with other 
remedies ; yet it cannot be used in all cases, for sometimes 
it has a depressing effeCt. 
Opium , in small doses, is excellent for many phases of 
neurasthenia; and were it not for the danger of forming the 
opium habit, I should use it more frequently than I do. 
Alcohol also, in the form of wine, particularly claret and 
burgundy, is to be advised in some cases of this kind, but 
not recklessly, or without reference to the age, character, and 
temperament of the patient. Alcohol is one of the best of 
our hypnotics in cases where the bromides fail to produce 
sleep. Where chloral causes severe headache next morning, 
claret wine, freely used, may produce satisfactory effects 
VOL. ix. (n.s.) 2 Q 
