Shortt,|| and was subsequently employed with success by Dr. Middlemore.¶ It, however, entirely failed in the hands of Mr. Tyrrell** and Dr. Mackenzie; and Dr. Taylor states that he is unable to recall a single instance in which it proved permanently beneficial, although temporary improvement of vision, to a remarkable degree, was sometimes produced. Dr. Middle-more limits its use to those cases in which the retina is in a state of atony, from some cause acting on its texture, either directly or through the medium of the system; and he considers that it should not be used when there is much vascular fulness of the system or of the retina, or a tendency to inflammation. To the surface, previously denuded by the application of a blister, he applied gr. 1/4 of Strychnine; this is to be gradually increased to gr. ij.; and if, at the end of a fortnight, the sight be not improved, the remedy may be discontinued. It is only to be applied once daily; and if it create much irritation, it may be combined with a little Opium. Its effects should be carefully watched. In Night Blindness, its internal use in small doses gradually increased, may prove of service. It deserves a fair trial in this affection.
* Lectures, vol. i. p. 546.
Hospital Facts and Observations.
§ Med.-Chir. Trans., No. lxi. p. 217.
|| Edinburgh Med. and Surg. Journ., No. xxxiv.
¶ Diseases of the Eye, vol. ii. p. 282.
Ibid., p. 916.
Lib. of Med., vol. ii. p. 336.
Dr. Hogan relates some cases cured by its use; and M. Trousseau* states that, of thirteen cases submitted to its influence, ten were completely cured. He prefers the sulphate, on account of its superior purity and uniformity of action. He dissolves gr. j. in Syrup fiiiss.; and of this, administers f3iiss. daily, divided into three doses, and gradually increases the dose, until itching of the scalp and slight stiffness of the masseter muscle are observable. It requires to be exhibited with great caution, and should not be employed until less dangerous rome-dies have had a fair trial. It has also been advised in Epilepsy.
2629. In all cases of nervous exhaustion, whether the result of mental harass or sexual excess, and also in the threatenings of Epilepsy, and of some forms of Apoplexy, Dr. Marshall Hall states that the Acetate of Strychnine is a remedy of great promise, and that he has seen benefit from its use. He advises the following formula: - Strych. Acet. gr. j., Acid. Acet. xx., Alcohol f3ij., Aq. f3vj., M. sumat. gutt. x. pro dos. This should be combined with a rigid system of mental discipline, of diet, &c.
Dr. Homelle relates three cases which were entirely removed under the use of Strychnine: - Strych. gr. 2/5, Magnes. Calcin. 3j., Sacchar. Alb. j., M. ft. pulv. xx. One of these is to be given every hour until copious evacuations follow, which is generally after the twelfth or fourteenth dose. The medicine is supposed to act by increasing strongly the peristaltic contractions of the intestines, and giving them the power of overcoming the obstruction, whether caused by fAeces or a paralysed condition of the muscular coat. In Colica Pictonum, a combination of Strychnine and Morphia is recommended by Dr. Bally. § In Lead Colic, Strychnine, in doses of gr. 1/16 thrice daily, has been successfully used by Dr. Swett.||
Bardsley ¶ speaks of Strychnine as being an effectual remedy; and this is further supported by the experience of Dr. Copland,** who found that the preparations of Nux Vomica, particularly the extract, were most useful, in combination with Aloes, in stimulating the uterine organs, and strengthening the system. Its use requires caution.
* Rev. Med. Chir., Jan. 1850. On the Threatenings of Apoplexy. &c., p. 63. Union Medicale, 1848.
§ Brit. For. Med. Rev., No. i.p.225.
|| Rankiug's Abstract, xix. p. 89. ¶ Hospital Reports, p. 51. ** Dict. of Pract. Med., vol. ii. p. 839.