Amidst great doubts which still remain as to some possible actions of aconite in disease, there are certain main facts which can easily be verified by those who are willing to try the remedy perseveringly and with strict attention to the proper mode of administration. In the first place, by the employment of aconite, so much of the evil of inflammatory and febrile states as depends directly upon too rapid action of the heart and excessive temperature, may in a large number of cases be rapidly and effectually diminished or put an end to. Secondly, pain and spasm of various kinds not dependent on inflammation may be relieved either by the internal use of this drug,or more frequently by its external application.

In regard to its applicability to inflammatory and febrile affections, the conclusion seems justified that aconite is especially adapted to produce the kind of effects which were formerly aimed at by the now little used practice of bleeding (this is the opinion also of Dr. Ringer,1 who has very extensively employed the drug in the same manner as is recommended in these pages), and that it is probably in the class of cases in which the latter remedy did good when its benefits were not outweighed by counterbalancing evils peculiar to itself that the employment of aconite proves valuable. A quick pulse with a certain strength of heart action as measured by the resisting quality of the pulse, and a certain attendant dry heat of the skin, seem the leading external characteristics of the typical condition which serves as our therapeutic indication. As regards the action of aconite in reducing temperature, we can but conjecturally suppose, but with much probability, that it effects this, firstly, by lowering the action of the heart, and secondly, in a minor degree, by restoring skin-transpiration.

Inflammatory Fevers. - In my experience I find aconite always indicated in the early stage of simple inflammatory fevers, where as yet little organic change has taken place; also in the early stage of pneumonia, and in most acute congestions. It should be given in all inflammations of serous membranes, before the exudation has passed the plastic stage, especially in pleurisy, pericarditis, etc. When administered soon after the first invasion of the disease, it quickly diminishes the action of the heart, calming and subduing it; and at the time moistens and often bathes the skin with profuse perspiration. Subsequently it allays the fever, and prevents the spread of any congestion which may already have taken place.

1 Handbook of Therapeutics.

Aconite does not necessarily remove the exudations, but it checks and prevents the further development of the evil.

When aconite is given in the early stages of inflammatory fever, it not only abates the frequency of the heart's action, but reduces the tempera-true to its normal standard (which, indeed, is the powerful good to be gained by it), and, having accomplished this, it ceases to be of much further use.

Pneumonia. - I have now before me nine recorded cases of pneumonia in the first stage, several of them implicating the pleura more or less. The subjects of these were of ages ranging from twenty to sixty-two. The pulse varied from 110 to 140, and the temperature from 102° to 1052/5°. In every one of these nine cases the attack was ushered in by rigors followed by preternatural heat of the body; short, quick breathing; dry, hot skin; flushed face, headache, thirst, exhaustion, and short, dry cough, with more or less pain or uneasiness in the affected lung. The usual examination showed dulness over the congested part, with fine crepitation. Now, we are all aware that in some of the most favorable cases of pneumonia treated without medicine the fever subsides upon the third or fourth day, but that it far more frequently lasts from six to ten days, even though the ordinary remedies be administered. In these nine cases, however (which it is proper to remark are not selected, but have been taken consecutively as they occurred to me in practice), the fever in no instance lasted longer than six days, reckoning from the commencement of the rigors. In every one of these cases, moreover, in from three to six days after the temperature had fallen to 99°, or below, the lungs became almost natural. In none of them did the pulse fall to the normal standard without the temperature likewise falling to at least 99°. but in several instances the pulse remained high, and the temperature sank to below 99°, making it very probable that the aconite had done its required work. Eleven other cases of pneumonia, all of which, before I saw them, had passed into the second or consolidated stage, I also treated with aconite, but in none could I perceive that it had any effect in removing the consolidation. At the circumference of the consolidated lung there is generally a tendency to spreading of the congestion. Aconite will control and remove this tendency, but in comparison with certain other medicines it has no power over the actually consolidated portion.

Tonsillitis. - Aconite is valuable in tonsillitis, and in ordinary sore-throat. It relieves those irritable tickling throat-coughs so often met with in throat and lung affections; and is likewise useful to plethoric persons when suffering from asthma, accompanied by short, dry cough, an anxious look, a sense of great oppression, often amounting almost to suffocation, and a full strong pulse. I have often employed it also, with the best results, in croup, haemoptysis, and epistaxis, and likewise in coryza, and in acute catarrh.

Rheumatic Fever. - In rheumatic fever, if aconite be used from the commencement, the heart is, in my experience, seldom affected, and the patient suffers much less from pain and swelling in the joints, while the duration of the fever is considerably lessened. It is rare indeed to meet with permanent organic disease as a result of rheumatic fever when the disorder is treated with aconite from its commencement.