As would be expected from what I have said, it has proved itself a medicine of singular value, not only in connection with childbirth, but in puerperal hypochondriasis. A remarkable instance of this is reported by the late Sir James Y. Simpson, Bart. A lady, he tells us, the mother of several children, was twice the subject of the most painful mental despondency, commencing about a month after her confinement. Upon one of these occasions her delivery had taken place in London, where she had the advice of several eminent physicians; but her complaint took a very long and tiresome course, seeming to defy all remedies, and terminated only very gradually and slowly. It was arranged, upon a subsequent occasion, that the confinement should take place in Edinburgh, in order that the patient should be placed in the care of Sir J. Y. Simpson. Her child was born, and some weeks subsequently she returned to England, apparently in perfect health. At this point begins the very interesting aspect of the case in question. In the course of another month the lady again went to Edinburgh, but now in the lowest possible state of depression, a perfect embodiment of mental misery and unhappiness. "I tried many plans," says the eminent authority from whom I derive this account, "to raise her out of this dark and gloomy state; - all failed. At last, fancying from some of her symptoms and complainings that there might be a rheumatic element in the affection, I ordered her fifty drops of the tincture of cimi-cifuga daily. After taking one dose, she refused to continue the medicine, the drug having a taste similar to that of laudanum, and all opiates having a tendency to make her worse. On being assured that there was no opium in the medicine, she recommenced it, without any expectation, however, of good resulting to her, having lost faith in every species of medicine. When I next saw her, some eight or ten days afterward, she was changed in a marvellous degree, but all for the better. On the third or fourth day after resuming the drug, so she informed me, the cloud of misery which had been darkening her existence suddenly began to dissolve and disappear, and in a day or two more she felt perfectly herself again, in gayety, energy, and spirits. So pleased was she with the effects of the drug, that nothing could induce her to cease from the use of it for a further period of six or eight weeks; and the last time she passed through Edinburgh she told me she had prescribed her new-found and priceless remedy to more than one melancholic subject, with success nearly as great as she had experienced in her own person."

Returning to my own experience of the utility of cimicifuga, I have to add that I have prescribed it with success in suppression of the menses, brought on by cold, and attended by rheumatic pains in the thorax, the lumbar region, and the limbs, and especially when the subject has been one of a nervous habit. In this respect cimicifuga resembles pulsatilla, which itself, as we have seen, is an excellent remedy in the treatment of suppression of the lochia or of the catamenia.

Spermatorrhoea, etc. - I have prescribed cimicifuga for patients suffering from spermatorrhoea and nocturnal emissions, and who experienced the very usual accompaniments of melancholic hypochondriasis, and in most cases the effect of the medicine was highly beneficial. I am persuaded that it is an excellent tonic for the nervous system, and that its operation is good in delirium tremens, for which I have several times prescribed it. It has been used for these disorders in America, and with results of the most satisfactory nature. One recommendation, when com pared with digitalis, is that it does not interfere with the digestive system in the way that foxglove does, but, on the contrary, rather increases and strengthens the appetite. The tremors and vertigo it certainly removes in a short space of time. While under the influence of cimicifuga, the patient often sleeps calmly, and awakes refreshed.

Hysterical Chorea. - In conclusion, I may mention that I have seen the effects of this medicine excellently illustrated in cases of long-standing hysterical chorea. In several instances the disease yielded to it rapidly. Such cases, as a rule, are attended by menstrual irregularity, and the patient often suffers from intercostal, or mammary, or uterine pains, of a rheumatic type. I recently attended a young lady of eighteen, who suffered from chorea ensuing upon an attack of rheumatic fever, with cardiac complication, which rapidly gave way before tincture of cimicifuga - a case the more important to be cited at the present moment, since the form of chorea with which I then had to deal is very often obstinate, and yields only with much difficulty to medical treatment, baffling, in many instances, all known agencies. Sympathetic pains and neuralgias, which arise from the so-called "irritable uterus," no matter what their precise character, are quickly relieved by tincture of cimicifuga - again proving this medicine, though hitherto so little regarded, to be one of the most valuable that we have at command.

Preparations And Dose. - The only officinal preparation is the extraactum cimicifugae fluidum, 3 ss.- 3 j. (2. - 4.). Dr Phillips recommends a tincture (four ounces of dried root to pint of spirit), dose ten to fifty minims. Commercially there is a tincture (one part fresh root to two parts of alcohol) and also a mixture of the active principles obtained from the dried root, and sold under the names of cimicifugin or macrotin, the usual dose of which is gr. j.-ij. (.06-.12).