That a different action may be obtained from a different dose of the same medicine is an elementary therapeutical axiom in constant application, and it is, I believe, a clinical fact that phosphorus can relieve the symptoms which are usually associated with fatty degeneration, not only of the brain, but of other organs. I have notes of more than thirty cases in which fatty degeneration of the heart might fairly be diagnosed: the cardiac sounds were feeble, the impulse weak, the pulse slow, sometimes excited, irregular, soft, and compressible; with dyspnoea on exertion, and a sense of anxiety and tendency to syncope to a greater or less degree; arcus senilis sometimes present. After taking phosphorus for a few months, most of the patients were much relieved, and were able to move about without fear, and with comparative comfort. No doubt somewhat similar cardiac symptoms may be caused by nerve-exhaustion or gout; the absolute diagnosis of fatty degeneration cannot always be insisted on, and I do not wish to maintain that phosphorus reconstructs degenerate cells, but its acknowledged power over nutrition makes it reasonable to suppose that it can hinder or stop commencing degeneration, and especially improve the condition of the nervous system.

It is highly important to carefully proportion the dose to the necessities of each individual case, as some will take with advantage more than others. Where the heart-action has been very irregular, or the dyspnoea and syncopal feelings more than ordinarily troublesome, I have given fa to 1/20 gr. occasionally; but these doses should not be given frequently, for fear of aggravating the symptoms. I prefer to give 1/200 to 1/100 or 1/50 gr.

twice or thrice daily. Not only in heart disease of the kind described, but in fatty degeneration of other organs, and in the form which threatens during typhus and some other acute diseases, phosphorus is worthy of attention.

For many years I have been accustomed to use it in such cases, and the improvement traceable to it is often remarkable. The smaller doses mentioned are to be preferred, in order to avoid irritant effects, and to get the system slowly, but more fully under the influence of the remedy; when this is done, the effect is more thorough and lasting.