In cases of inflammation of the spinal cord and its membranes, when brought on by external violence, I am again disposed to rely strongly upon the efficacy of belladonna. Quite recently I have seen two patients suffering from this disorder, and the agony resulting from the violence of the pain in the lumbar region, whence it extended to the hips, the thighs, and round the abdomen, was simply indescribable. The pain was aggravated by pressure upon the lumbar vertebras, and the pulse was quick and full: temperature 104°. Opium was administered in various ways, but the relief given by it was only temporary, and not until belladonna was tried had either patient any permanent alleviation from his sufferings. I ordered the tincture to be taken in five-minim doses in an ounce of water every half-hour or hour until relief should be experienced, and that, while the medicine was in course of operation internally, a belladonna plaster should be applied to the injured portion of the spine. The result of this treatment was that the pains were in a short time entirely subdued, and that the continuance of the medicine was rendered needless.

Pneumonia, Nephritis, and Iritis. - In the early stage of pneumonia, and in acute nephritis, belladonna has frequently proved useful. I have likewise successfully employed it in iritis. Taken internally in iritis, in five-minim doses, every three hours, and used as a lotion three or four times a day, in the proportion of one drachm of the extract to four ounces of water, belladonna not only dilates the pupil and breaks down the adhesion, but subdues the inflammation; helping in a two-fold manner to correct the mischief.

Belladonna is not merely useful in ordinary inflammations, but has a remarkable influence over ulcerative processes of various kinds. The extract, locally applied, will heal irritable ulcers of the rectum and fissures of the anus; or, if it fail to accomplish this end completely, it will, at all events, greatly mitigate the pain and trouble which arise from them. In fissure, the purpose may be accomplished in an easy and very satisfactory manner by passing a small portion up the back part of the rectum, the operation being repeated night and morning. For the removal of the ulcer the tincture should be administered internally, and the extract be smeared in small quantity upon the affected surface.

Belladonna is also an excellent agent for the mitigation, and even for the complete removal, of the acute and burning pain which so constantly follows defecation, when there is ulceration of the nature just described; it likewise prevents the recurrence of the distressing spasms of the sphincter ani to which the patient is subject. If it fails, when used alone, to heal the fissure, or to remove the ulcer, the extract of belladonna should be combined with mercurial ointment in equal proportions. The mercurial ointment, employed alone, does not exert the same salutary effects, nor is relief obtained so readily as when combined with belladonna. Both these last observations will apply also to chronic ulcerations of the rectum, arising from secondary syphilis; that is to say, while for such ulcerations mercurial ointment, employed alone, is of only limited utility, the mixture with it of an equal quantity of belladonna generally gives excellent results.

In recent induration and inflammation of the breasts, very remarkable effects are produced by belladonna, in consequence of its action in arresting secretion.

Among the most practically useful of these is its influence in arresting the suppurative inflammation which is so common in women who have been obliged suddenly to give up suckling. The local application of the ointment, or the fresh extract, together with the internal use of five to ten minims of the tincture, three or four times a day, very quickly relieves the distention and congestion, if the treatment be adopted sufficiently early. Another example of useful arrest of secretion is occasionally seen in the arrest of salivation by the use of belladonna. This has even been known to take place in mercurial salivation, and more decidedly in that which is occasionally produced by iodide of potassium.

In Fevers. - Not only in inflammations, but in certain kinds of fevers, belladonna is of great service.

Typhus fever gives occasion for the useful employment of belladonna. In the early stages of this formidable disorder, with its accompanying delirium, sleeplessness, painful sensitiveness to light and sound, and liability to convulsions, belladonna will reduce the severity of the symptoms. No medicine that I am acquainted with can be so thoroughly relied upon for averting the disastrous consequences which usually follow these head complications. One of the very special phenomena attending the exhibition of belladonna in typhus is seen in the altered condition of the tongue, a point to which John Harley (loc. cit., p. 251) directs attention. From being red and glazed, or dry, brown, and cracked, sometimes destitute of the least trace of moisture, the tongue of the patient suffering from typhus becomes, under the influence of belladonna, moist around the edges, if no farther, and, under favorable circumstances, absolutely wet in every portion. My own experience many years ago perfectly prepared me for Dr. Harley's statement.

Finally, I may allude briefly to several other disorders in which I have proved the efficacy of belladonna, but respecting which there is no need for extended remark.

One of these is delirium tremens accompanied by congestion of the brain.

Another is gout of the stomach, for which complaint I have administered the tincture in five-minim doses every one or two hours.

Asthma. - Dr. Hyde Salter has made some very important remarks upon the therapeutic action of belladonna in asthma. His observations-have been verified by Dr. Sydney Ringer and others, and are well worth careful perusal.1