The same remark is applicable to their use in scrofulous affections. it is in the earlier stages of these complaints, before exhausting suppuration has occurred, while the attendant local inflammation is still somewhat active, and some degree of febrile excitement is present, constantly or at times, that the remedy is indicated; and, in this condition, it occasionally seems to be useful in lessening the frequency of pulse and heat of skin, and perhaps in moderating the inflammation. Scrofulous affections of the absorbent glands, the joints, the skin, etc. sometimes offer these indications; and the same may be said of the earlier stage of phthisis, when there is often occasion to moderate the excessive frequency of pulse, the intercurrent inflammation of the lungs, bronchia, or pleura, and hemorrhagic excitement; but the medicine is seldom appropriate after the occurrence of hectic, and care should be taken to avoid irritation of the stomach and bowels. Hence it is necessary to use the remedy in very small doses, except under circumstances of temporary excitement, when it may be used more freely for a time. A good method of administering it, when intended for permanent effect, is to dissolve it in the ordinary drinking water, in such proportion as to be quite imperceptible to the taste, and to allow the patient to use it thus habitually with his common drink. For this purpose one-quarter or one-half of a grain may be dissolved in a quart of pure cold water; the whole of which may be taken in twenty-four hours, if required by the thirst of the patient; though care should be taken not to swallow much of it at one time. The same method of administration may be used in other forms of scrofulous disease, and in the chronic cutaneous eruptions.

5. Nervous irritation. in nervous diseases there are now and then paroxysms of high excitement, in which tartar emetic proves very useful, by the sedative and relaxing effects which attend its nauseating operation. There is, perhaps, no more efficient method of overcoming the paroxysmal excitement of mania; the medicine being given in doses just insufficient to vomit, and repeated at intervals of half an hour or an hour, so as to sustain a degree of nausea, greater or less according to the demands of the case. Usually one-quarter or one-half of a grain will be sufficient for the effect desired; but sometimes it may be necessary to increase the dose. it should be omitted when the immediate occasion ceases, or if it cause vomiting or purging. in the same mode of administration, I have used it very happily in controlling the violent paroxysms of hysteria, especially when in the form of frequently recurring-convulsions. it has also been recommended, in connection with opium, in the violent cerebral excitement not unfrequently occurring in delirium tremens. it is, indeed, among the most efficient remedies in those cases of the disease, in which active meningeal or cerebral congestion, or even inflammation has been excited, under the intense stimulus of a debauch in drinking, and the affection has afterwards become complicated with delirium tremens by a suspension of the stimulant.

6. in obstetrical practice, tartar emetic has been highly recommended by Dr. James Young, of Scotland, to produce relaxation of the rigid os uteri, especially in the first confinement. He administered it by the rectum, injecting one grain dissolved in six fluidounces of lukewarm water. (Ed. Med. Journ., i. 645.) Dr. H. R. Storer, of Boston, has also used the medicine with advantage in the same way. (Boston Med. and Surg. Journ., lvi. 122.)

T. A patient with pneumonia, who was treated with large doses of tartar emetic, passed a tape-worm; and, as no anthelmintic medicines had been given, the result was ascribed, and with apparent justice, to the antimonial: so that tartar emetic may rank among the anthelmintics calculated to expel the taenia. (M. Passot, Gaz. Med. de Lyon, quoted by the Lancet, March 31, 1860, p. 325.)

Of the local use of tartar emetic as an irritant we shall have occasion to treat, when on the subject of the rubefacients.

5. Administration

Tartar emetic is almost always best given in solution; and the best solvent, on the whole, is pure water. When suspected of inflaming the mouth and throat in its passage, it may be administered in pill. The dose varies greatly, according to the effects desired. As an alterative, from the thirty-second to the twelfth of a grain may be given, and so repeated as to amount to one-quarter or one-half of a grain in twenty-four hours. For its moderate sedative effects, and as an expectorant and diaphoretic, without the complication of nausea, from one-twelfth to one-quarter of a grain should be repeated every hour, two, or three hours. With a view to the production of nausea, from one-quarter to half a grain may be administered at intervals of half an hour or an hour. Two or three grains will usually act as an emetic, and sometimes a much smaller quantity, even so low as one-quarter or one-eighth of a grain; but in this case, upon a repetition of the dose, the emetic effect will often cease after a time. When the object is to produce a profound sedative impression, I have already stated that the commencing dose may be half a grain or a grain, to be repeated every two hours, and gradually increased, if required, to two grains, or even two and a half. The sedative effects sometimes continue several days after the suspension of the medicine.

Particular caution and watchfulness are necessary in the use of tartar emetic in infantile cases; and the physician should never direct its continuous use in a child, without warning the nurse of its possible effects on the stomach and bowels, and directing its discontinuance should these effects come on.

The only officinal preparations of tartar emetic, for internal use, are the following.