I cannot think that, under any circumstances, whether in children or adults, admitting the use of the lancet and local bleeding, the plan of excessive antimonialization should be substituted; and, in cases in which the condition of system will not permit depletion, the mercurial treatment, in connection with opium and ipecacuanha, and blistering, is probably quite as effectual, and certainly much less hazardous; aided, as it may very properly be, by the use of antimonials in safe doses.

Chronic inflammations are often benefited by tartar emetic, though less decisively than the acute. it may be appropriately employed, whenever the state of the system is sthenic, and the action of the heart and arteries above the healthy standard.

In the anemic disorder following exanthematous fevers, which is often probably nothing more than the result of desquamative inflammation of the secretory ducts of the kidneys, tartar emetic has been found eminently useful by Dr. Lange, of Konigsberg. One-eighth of a grain may be given every fifteen or thirty minutes, and suspended when found to irritate the stomach or bowels. (Ann. de Thérap., 1866, p. 114.)

2. Local Vascular irritation. in any disease of which this condition constitutes the main feature, tartar emetic may be used, unless some one of the contraindications before enumerated exist. But the special affections which most frequently require it are the hemorrhages, dependent on local irritation or active congestion in the part affected, and attended with an excited state of the circulation. These conditions are frequently presented by hemorrhage of the lungs, whether parenchymatous, or in the form of haemoptysis, in which tartar emetic is often used with a view to repress arterial excitement, and is an admirable adjuvant of the lancet, or substitute for it when forbidden. Under similar circumstances, it may be used in uterine hemorrhage and haematuria, and even in the hemorrhoidal flux when febrile in its character; but it is forbidden in hemorrhage from the stomach and small intestines, in consequence of its local irritant properties; and in active cerebral congestion, or apoplexy, though indicated for its sedative effects, it is somewhat hazardous from its liability to cause vomiting, and thereby occasion pressure on the brain. in all these hemorrhages, it has no direct hemostatic power, but operates solely by diminishing the congestion upon which the bleeding depends.

3. Fevers. in all the idiopathic fevers, with a sthenic state of the system, and no gastric or intestinal irritation, or peculiar tendency to it, tartar emetic is very useful by diminishing the febrile excitement, and promoting the secretions, especially that of the skin. it forms in these affections an excellent addition to the neutral mixture or effervescing draught, increasing very greatly the sedative influence of that remedy, while receiving from it a more decided direction to the surface of the body. in the paroxysms or exacerbations of the miasmatic fevers, whether intermittent or remittent, it is often thus associated, with great advantage, whenever the stomach is not irritable. it is less useful in yellow fever, in consequence of the very frequent presence of gastric irritation or inflammation, and, upon the whole, is better avoided in that complaint. To enteric or typhoid fever, moreover, it is inapplicable from the characteristic intestinal lesion of that disease, which either provokes diarrhoea, or gives a strong tendency to it, and through which the antimonial might occasion exhausting discharges, while aggravating the local affection. it might be supposed that tartar emetic would be contra-indicated also in typhus fever, in which the state of system is anything but sthenic, and there might be danger from impairing the quality of the blood. Nor have I been in the habit of using it in that complaint, influenced by the views which I entertain of its essentially depressing character, and greatly preferring citrate of potassa as a diaphoretic. Nevertheless, one of the preparations of antimony, either the empirical James's powder, or the officinal substitute for it, which, so far as it acts at all, resembles tartar emetic in its influence, has been much used by British practitioners in their indigenous fever, which is usually typhus; and Dr. Graves, of Dublin, specially recommends the conjoint use of tartar emetic and opium in the intense cerebral excitement, sometimes occurring in the advanced stage of that disease. Of the exanthematous fevers, measles offer the strongest indication for the use of this remedy, both from the bronchial inflammation, and the sthenic condition of system, which attend and usually characterize the complaint. The eruptive fever in smallpox is often accompanied with vomiting, and the secondary fever with debility, both of which contraindicate tartar emetic; but, under other circumstances, the medicine may be advantageously used in the disease, whenever called for by the frequency of pulse, and increased heat of skin. Scarlatina is too often essentially asthenic to justify the use of the antimonials; and the same is also frequently the case with erysipelas; though instances of the latter affection of an opposite tendency sometimes occur, in which the medicine may prove beneficial, pushed even to nausea or vomiting.

4. Cutaneous and Scrofulous Diseases. in all the cutaneous eruptions with a febrile and sthenic state of system, the antimonials are indicated for their sedative effects, when no gastro-intestinal irritation complicates the disease. But they are also much used in cases not attended with fever, whether acute or chronic, under the impression that they exercise an alterative influence favourable to the disease. They may be employed in all cases, when the stomach and bowels are not irritable, the blood is in good condition, and no general debility exists. There is no doubt, I think, that they do good in these affections; but it is questionable whether they do so by any other influence than a slight degree of that which renders them so useful in acute inflammations, operating insensibly, through a long period of time.