STRYCHNIA IN SPINAL MENINGITIS 
429 
minute, and so weak as scarcely to be detected at the jaw. The 
respirations were accelerated to twenty; the mucous membranes 
slightly injected ; the hind extremities cold, and the temperature 
at 104§° F. The urine which he was seen to pass during the 
morning, looked normal, but constipation was quite marked. Be¬ 
lieving from the rapid development of symptoms, especially the 
loss of power behind, that he would live but a short time and 
could not long remain standing, he was placed in a box stall, and 
received seven drams of aloes, one dram of ginger, and half a 
dram of calomel in a ball. This was followed by ounce doses of 
tr. belladonna every two hours, a strong mustard poultice to the 
lumbar region, and soft food, with plenty of water, ordered. Early 
next morning he was purging freely, the fseces being very soft 
and of unpleasant odor; the pulse stronger ; the temperature at 
104°; the respiration sixteen, but no appetite nor improvement 
of locomotion. He now received half grain doses of strychnia 
every two hours, in conjunction with the tr. belladonna every two 
hours between. On the 23d there was no improvement noticed, 
and the purging still continued. The dose of strychnia was in¬ 
creased to one grain every two hours. On the 24th the temper¬ 
ature was down to 1031° ; the pulse at seventy-eight; the respira¬ 
tion at sixteen; the purging remained free as on the 22d, and 
very fluid; no appetite, but some slight improvement in the gait. 
To arrest the purging and stimulate the appetite, the strychnia was 
now given, in one and a half grain doses, in solution in ounce doses 
of tr. capsicum. The belladonna was continued, and another 
poultice of mustard applied to the loins. The purging stopped 
within six hours, the appetite returned, and marked symptoms of 
improvement were present at the time of next visit. The dose 
of strychnia was gradually increased and the belladonna diminished, 
until the patient took four grains of strychnia every three hours, and 
yet no signs of poisoning from the drug could be detected. With¬ 
in two weeks’ time he was taking exercise, and resumed work 
after three weeks of sickness and convalescence. The conclusion 
I have come to regarding the use of strychnia in these diseases is, 
that they demand large and oft-repeated doses of the drug, and 
that when the appetite fails, or excessive purgation results from 
