Obstruction and Constipation. - Under this heading may be included the very remarkable action of belladonna in removing constipation or even positive obstruction of the bowels, which depends upon want of tone (mingled sometimes with partial irritative spasm) of the muscular coats of the intestine. The practice was introduced by Trousseau, who gave doses of 1/4 to 3/4 grain, repeated every few hours; and since that time it has been recommended by many authors. Fanciful attempts have been made to explain this action by the supposition that the belladonna suppresses the mucous secretions, and allows the faeces to come into direct contact with the mucous membrane, and thus to stimulate the bowel to act. There can be little doubt, however, that the drug acts directly upon the bowel as a stimulant and a co-ordinator of muscular action; and thus (secondarily) as a controller of any irregular (spasmodic) action that may be present.

Inflammation. - Besides its power to relieve functional affections, belladonna exerts a powerful influence over certain actual tissue diseases. Many forms of inflammation are amenable to its power, and among these may be mentioned certain diffuse inflammatory affections of the skin.

In cases of erysipelas, when the skin has been of a deep red hue, with accompanying heat, pain, and swelling, and when the constitutional disturbance has been considerable, I have administered this medicine with results that were perfectly satisfactory. Erysipelas exhibits itself under a diversity of forms, and is not amenable to any uniform mode of treatment. It becomes important, accordingly, that we should carefully note which of the forms give opportunity for the wise employment of belladonna - since I by no means wish it to be supposed that I am recommending belladonna for erysipelas without reservation. The forms in which belladonna may be employed with advantage are such as are marked by superficial inflammation - inflammation, that is to say, which does not much affect the subcutaneous areolar tissue, and in which the surface is free from vesicles. When these are the conditions, belladonna will rapidly quell the disorder. So when erysipelas attacks the brain. The power which this drug exerts in abating the delirium, and in promoting the quick subsidence of the disease, is manifested so energetically, and in so short a space of time, as to be quite astonishing. In erysipelas of a phlegmonous character, before suppuration or sloughing takes place, belladonna is likewise of considerable service; here, however, the operation of the drug cannot be relied upon with the absolute certainty that pertains to its use in the superficial and non-vesicular kind, and therefore I do not wish to say more than that in such cases we may at all events place faith in it. For erysipelas, five drops of the tincture should be administered in a little cold water every hour, to the extent of five or six doses; afterward every two or three hours, as may be deemed necessary, and at the same time the extract may be painted over the surface twice a day, if needful. (Mr. Lis-ton called attention to this use of belladonna forty years ago (Lancet, April 16, 1836). He employed it alone, or in conjunction with aconite.)

Let me now speak of belladonna in connection with sore-throat. In all those forms of inflammatory sore-throat which have a prelude of more or less fever, with pain, redness, and swelling of the tonsils, and which are attended by difficulty of deglutition, belladonna operates with surprising efficacy. Five drops of the tincture, taken every one or three hours in half an ounce of cold water, will quickly remove the inflammation, and the other symptoms will soon disappear. In all ordinary cases of inflammation of the throat, whether accompanied or not by ulceration, this treatment will likewise prove successful, though altogether useless in sore-throats of the aphthous, diphtheric, and syphilitic kinds.

Catarrh of the bladder is another complaint which is very successfully treated with belladonna, the good effects being remarkable and permanent. The cases have been recent ones, and, where the medicine has shown itself to be most efficient, they have been such as have resulted from a chill, and have been attended by more or less pain of an undefined character in the hypogastric and perineal regions, and by frequent and painful micturition. Notwithstanding the severity of the symptoms ordinarily attendant upon this malady, belladonna overcomes them. The dose should be ten drops every one to three hours, in a little cold water, according to the condition of the patient; but as soon as relief has been obtained, the ouan-tity should be reduced, and the intervals between the doses be ex.ended. The perinaeum may be smeared, night and morning, with a small quantity of the extract, the external effect well supplementing the internal one.

Belladonna will also relieve the violent contractions of the muscular coat of the bladder which so frequently accompany diseases of this organ. When the bladder is simply in a state of great irritability, and micturition is both frequent and painful, but where no organic change has taken place, belladonna, if given in five to twenty drop doses, every three or four hours, will soon bring relief.

In the early stages of encephalitis, and during the whole period of excitement, belladonna again shows its powers to advantage; the severe headache is relieved, the suffusion of the eyes is diminished, the delirium abates, and the nausea and vomiting are often rapidly subdued. Light and sound at the same time become less distressing to the patient, and the general result of the employment of the medicine is that the attack does not lead, as otherwise it probably would, to a state of great prostration, accompanied by unmistakable typhous symptoms. Usually, also, there is a complete absence of certain symptoms which ordinarily characterize the later stage of the disease, and some of which are occasionally manifested in the early one; namely, muttering delirium, strabismus, tremors, twitchings of the muscles, and incontinence of urine. In spinal meningitis, as a matter of course (the membranes being continuous with those of the brain), corresponding results may be confidently anticipated.