32. Mode Of Administration

As an Anodyne, Anti-Neuralgic, and Calmative, Dr. Fleming directs ev. of his Tincture, to be given at first, thrice daily; the quantity to be increased daily, to the extent of one minim each dose, until the physiological effects, described under the second degree of operation, have been produced. As an Antiphlogistic, he recommends that ev. of his Tincture should be given at first, and repeated in four hours; by which means, the second degree of operation, will, in all likelihood, have been induced. In order to sustain the sedative action thus developed, eiiss. of his Tincture should be given every three or four hours, or less frequently, according to the effect produced. When this mode of administration is adopted, it is absolutely necessary that the patient should be seen and the pulse examined, before the exhibition of each dose. When this cannot be done, the remedy may be given in the manner pointed out for its use as an anodyne and anti-neuralgic.

Dr. Fleming found the best method of administering the remedy in diseases of the heart is to give it in smaller doses than those recommended for its use as an anodyne, but more frequently repeated, as eiij. or eiv. of his Tincture five times daily. Sickness may be avoided by administering an effervescing draught.

Dr. Fleming prefers the Tincture for internal administration. from its uniformity of action, and also because the high price of the alkaloid causes it to be extensively adulterated. The great strength of Fleming's Tincture, however, renders it a dangerous preparation, and there are few physicians who would prescribe it in the doses he recommends.

As an externalapplicatimi, from 3j. to 3ij. of Fleming's Tincture may be rubbed over the affected part, thrice daily; the friction being continued each time for a quarter of an hour, or, indeed, until the physiological effects are fully developed. It should on no account be applied if there exists any abrasion of the skin. The Aconite Liniment of the British Pharmacopoeia (see Offic Prep.) is stronger than Fleming's Tincture.

33. Therapeutic Uses

In Neuralgia, Aconite was first recommended by Murray; * and is doubtless a remedy of the highest value. Dr. Fleming cites forty cases, thirty of his own, and ten of other writers, in all the latter of which permanent cures were effected. Of the thirty under Dr. F.'s care, seventeen were permanently cured, and in thirteen, the relief was only temporary. Some of these were treated by external, and others by internal applications. The selection of the mode of cure must be guided, in a great measure, by the nature and cause of the affection. Should it appear, observes Dr. Fleming, to be caused by inflammation, either in the painful part, or in the nerve further up in its course, or should it be traceable to sympathetic irritation, the internal use of the remedy is more likely to be beneficial; but if, on the other hand, it seems to arise from some local irritation applied to the nerve, or is merely functional, its topical application will probaby be sufficient. In every case where one method of treatment fails, the other should be had recourse to. Pereira, Copland, Watson, Skey, and others, recommend the external application; whilst Hufeland, Busse, and Tealier advise its internal administration. In all cases, it is advisable to commence its use externally; should this fail, it may, subsequently, be given internally. The state of the secretions should, at the same time, be carefully attended to.

* Apparat. Medic. vol. in. p. 17.