Mettauer on the Crusta Genu Equince in Epilepsy. 197 
and jalap, has generally been found most suitable; of each 
from two to five grains. Calomel with tart, antim. may be 
added, should the biliary secretion prove very defective, in 
proportions of two to four grains of the former, and one-fifth 
to one-third of a grain of the latter. These are to be repeated 
daily, or once in two days, until the circulation is balanced, 
the encephalic congestions in a measure dislodged, and the 
sympathies restored. These preparatory steps having been 
premised, the crust may be commenced with. 
The form or preparation is to be determined by the pecu- 
liarities of constitutions, or the complications which modify 
the disease. Should the case occur in a constitution display- 
ing a highly wrought sanguineous developement, the crust in 
simple powder will be most applicable, and should be pre- 
ferred. 
It will be safest to begin with the remedy at night, and as 
soon after the disturbances of the preceding paroxysms have 
subsided as possible. When given at night for the first time, 
it is more certainly retained by the stomach, and patients too, 
are less averse at this period of the day to the taking of an 
offensive remedy, very probably because the gastric organ is 
rendered less fastidious by the action of food and drinks upon 
it during the day. 
With young subjects from six to eight years of age, two 
grains will, in a majority of cases, constitute the commencing 
dose. We have never used it with patients younger than six 
years, or older than thirty. Older patients, say from eight to 
twelve, or fifteen years of age, will bear four or five grains, 
or even larger doses in the commencement, and with such it 
may be more suddenly increased to the maximum doses, 
without gastric disturbances. The remedy rarely offends the 
stomach when the foregoing precautions are properly attended 
to; on the contrary, it seems rather to compose and tran- 
quillize this organ. Three doses, in a majority of cases, are 
as many as will be required in the twenty-four hours. Should 
cases occur marked by convulsions of unusual violence, with 
frequent paroxysms, it may be given oftener. From many 
trials with this article, it has not been perceived that there is 
