the ammonia procured for me, having found that it was not a very strong preparation. He disapproves of throwing the injection merely under the skin, and believes that after the injection has been made, there is no necessity for resorting to the use of stimulants (Ibid. pp. 122 and 124).

Taking the hint from his suggestion to inject liquor ammoniæ into the veins in opium poisoning, etc., I injected this fluid with the most satisfactory results in the following case, the ammonia having been, however, injected subcutaneously, and not into the vein as recommended by him :

On Thursday evening, November 12, 1869, I received an urgent message to visit Miss B., aged 25 years, who, while suffering from severe facial neuralgia, swallowed through mistake, instead of a tonic mixture, two tablespoonfuls of an aconite mouth lotion.

The mixture and the lotion being upon the dressing table, Miss B., in the hurry to get out for some shopping, swallowed, just after breakfast, two tablespoonfuls of the lotion, instead of an equivalent dose of the mixture, her mouth being at the time benumbed by a previous use of the lotion as such.

The mistake was made at 11 o'clock a.m. A cup of tea was next taken by her, and she left home in a few minutes. Several shops were visited on her way to the house where she intended to make most of her purchases, so that the latter was not reached until half-past twelve o'clock p.m. She had barely entered it when she became "alarmingly ill, staggered on attempting to walk, and was seized with a fearful benumbed tingling in the lower half of the back, then in the face and head, while at the same time the tingling in the mouth became more developed. The head felt as if it were distorted by the pressure of a vice, and sensation of tightness across the nose and eyes was most distressing. In a few minutes more, the legs became so weak, and such tremor came over her, that she could not stand without assistance. She was conveyed immediately to the house of an acquaintance in the neighbourhood, her friends being under the impression that she was too prostrate for the drive home a much longer distance. She was placed upon a sofa. The debility had become so great that she fainted on three or four occasions in attempting to sit up. Benumbed tingling of both the upper and lower extremities commenced at half-past one o'clock p.m., and vision became very imperfect, a blackness, as she described it, having come over the sight. A little time afterwards, vomiting of an olive-yellow-coloured fluid commenced, and was almost incessant up to seven o'clock p.m. Towards evening she was greatly collapsed, and having fainted when in this state, her friends fancied that she had expired."

Before I saw her brandy had been given repeatedly, as well as

acidulated drinks; but they were vomited as soon as they reached the stomach. Warm jars, also, were applied to the feet, and additional warm clothing was placed over her. There was no indication of mental aberration, and the bowels were undisturbed. I arrived at fifteen minutes to seven o'clock p.m., and found her in a most perilous state. The face was pallid, the pupils were largely dilated, and the extremities of icy coldness. Vomiting was almost constant, and loud eructations were frequent. She had, as she expressed herself, "a dreadful benumbed tingling in the legs, arms, head, face, and in the mouth, the head feeling as if it were compressed by a vice." The pulse was felt with difficulty at the wrists, and the heart's action was weak and irregular. I gave her immediately some warm brandy punch, and, in a few minutes afterwards, a mixture composed of aromatic spirit of ammonia, sulphuric ether, tincture of ginger, and camphor mixture. A sinapism was placed over the heart, and one upon the calf of each leg. The punch and the mixture were not retained upon the stomach.

She was pulseless at ten minutes to seven o'clock, and the extremities were cold as death. The pupils were much dilated, The intellect continued unimpaired.

It being obvious to my mind that death at the heart had commenced, I resolved to inject hypodermically twenty-five drops of liq. ammoniæ ; but as the time that would be required to procure my own syringe might be a fatal loss to the patient, I sent to a neighbouring cutler, who was kind enough to send me one in a few minutes.

Seven o'clock p. m.: I injected half a drachm liq. ammoniæ under the skin, corresponding to the insertion of the right deltoid muscle.

Ten minutes past seven o'clock: Vomiting not so frequent; but the stomach will not tolerate the stimulants. She continues collapsed and very cold; forehead covered with sweat, eyes glassy, and pupils much dilated; tongue pale and contracted; no trace of pulse at the wrists; intellect unimpaired. Injected half a drachm of liq. ammoniæ under the skin of the outside of the right arm, about midway between the elbow and seat of the first injection.

Twenty minutes past seven o'clock; Vomiting at longer intervals; still pulseless at the wrists, and no sign of return of warmth in the extremities; complains constantly of the compresed and distorted feeling of the head; pupils have continued of the same size. Injected half a drachm of liq. ammoniæ under the skin of left infra-scapular region.

Twenty-five minutes past seven o'clock: Pulseless, Injected half a drachm of liq. ammoniæ under the skin a little below the middle of the outer part of the left arm.

Half-past seven o'clock: While my fingers were applied over the course of the radial artery, at the wrist, searching for a pulsation, I fancied I felt a weak, irregular, thready beating of the vessel. In a few minutes, this became no longer doubtful, but gradually stronger and stronger.

Eight o'clock: Pulse fully established, but a little irregular; vomiting had almost ceased; extremities warming; tingling of the skin and compressed sensation of the head and face no longer felt. The tingling, however, of the extremities, although not so decided, did not cease until half-past twelve o'clock next morning; and that of the lower lip continued until November 28.

In cases in which death is to all appearance impending, I should not like to lose time in trying to limit the injection to the vein, as suggested by Professor Halford, and would rather take the chance of a sufficient quantity of the ammonia being absorbed from the areolar tissue before its local action takes place, the chief objection to this procedure. Of the four injections made under the skin in Miss B.'s case, but one caused subsequent annoyance, the cutaneous eschar that resulted from it being about the size of one of our new halfpennies. There being no doubt that the symptoms were caused by tincture of aconite, the important matter to ascertain was the quantity that had been taken. I therefore made the necessary inquiries on the point, and learned that the lotion, if made according to the directions for compounding it, should have contained one drachm and a half of the tincture in every fluid ounce. Of this lotion Miss B. took two tablespoonfuls, as already mentioned.

Whether or not the late appearance of the symptoms was owing to the tincture being a weak preparation, or to the fact that it had been taken immediately after breakfast, or even to some peculiar idiosyncrasy, are matters for conjecture. At all events, when they were established, they were of the most alarming nature, and portended approaching death.

Although I am fully sensible of the wonderful assistance Nature renders to our art, nevertheless I believe that if she had not been herself assisted in this case, she would have failed in maintaining life sufficiently long to allow the influence of the aconite to pass away.

When we consider that none of of the stimulants given by the mouth were retained upon the stomach-that Miss B. was almost pulseless at a quarter to seven o'clock, and pulseless at ten minutes to seven o'clock, and continued to be so until about half-past seven o'clock-and that during these forty-five minutes she became weaker and weaker, colder and colder the saving of her life may, I think, be fairly attributed to the ammonia subcutaneous injections, and for the following reasons:1. The vomiting, which had been almost incessant up to the moment of

the first injection, commenced to lessen in frequency immediately after it, and nearly ceased after the fourth; 2. The disappearance of the pulse from the wrists at ten minutes to seven o'clock, and its reappearance after the fourth injection; 3. And because none of the stimulants that had been given by the mouth were retained upon the stomach, any influence they may have exerted when descending to this viscus, and for the few moments they were in it, not being sufficient to prevent the progressive failure of the circulation.

In addition to the varieties of poisoning for which professor Halford has recommended liq. ammoniæ injections, it appears to me well worthy of trial in poisoning by chloroform and in hydrophobia. Possibly, if life could be prolonged beyond the time that death usually occurs in cases of hydrophobia the latter might be averted. Whatever doubt may exist as to the necessity of venous injections in a case like the one I have just narrated, there can be little as to the advisability of injecting the veins in hydrophobia; for, as the injections would probably have to be frequently repeated, such a multiplication of the cutaneous eschars it would be better to avoid.-Medical Times and Gazette.

Materia Medica and Chemistry.

ERGOT OF RYE AS A THERAPEUTIC AGENT.

By Dr. J. WARING-CURRAN, Dublin.

Although the chief uses of ergot of rye are, for the most part, confined to those affections of the uterus over which it seems to exercise a specific action, I have been induced to give extensive trial of the drug in other complaints; and as I have found most satisfactory results from its administration, the following paper has been written in the hope that ergot of rye may be more frequently exhibited as a medicine, and that the practitioner may be reminded that in it he has a most potent therapeutic agent of reliable efficacy in other diseases, apart from those affecting the uterus.

In Parturition.-The physiological action of ergot of rye upon the parturient uterus in exciting contractions of the unstriped muscular fibre is familiar to all, and the constant pains which it induces so characteristically differing from genuine labour pains. This action is entirely produced through the ganglionic nervous system by affecting the muscular coats of the blood-vessels, and thus diminishing their calibre. We are told by Dr. Brown-Séquard, as the result of a series of experiments made by himself, that the blood-vessels of the pia-mater of a dog under its

influence became smaller, and that the reflex action of the spinal cord was diminished to a great extent.

In three-fourths of the labours attended by myself, I have exhibited ergot with most salutary results. I have never observed any ill effects from it, when judiciously given, to either mother or child. I never attempt it unless the os is dilated and dilatable; and primapara cases, if the pelvic development be natural, and the os be not rigid, never prevent my giving it. The cases we read of, (and lectures have told us about its destructive effects upon the mother, and its poisonous properties to the child,) experience teaches me must have been cases where ergot was improperly given.

I have used extensively the liquid extract prepared by the action of ether and spirit upon powdered ergot, and the tincture too; but on neither have I the least reliance. Some time ago I was sent to assist a medical gentleman; upon my arrival I found the child's head in the vagina, and complete inertia; the gentleman in attendance told me he had given the liquid extract in large and repeated doses without any appreciable therapeutic action. I immediately prepared a fresh infusion-the preparation I invariably employ, and added to it some borax; in twenty minutes its action commenced, and within an hour the child was born. I do not say that in such a case the short forceps would not have done equally well; but people, as a rule, have, in private practice, so great a hatred to instrumental deliveries, and are so apt to attribute every little trivial subsequent complaint to their use, that I have not used the forceps as frequently as formerly.

When studying midwifery, some years ago, at the Rotunda Lying-in Hospital, Dublin, I painfully noticed-and the observation has made no little impression upon me--that the students and embryonic midwives were compelled to allow poor women to continue in labour, hour after hour until nearly exhausted, because the rules of the institution forbade their interference, unless an over-fed and morose female superintendent was awaked and consulted. The educated student, revolting at such consultations, allowed the case to linger in preference. As I now reflect, I have not a particle of hesitation in saying that many of those confinements might have been safely and expeditiously concluded hours previously, had the best informed and senior student been permitted to prescribe a dose of ergot. To keep a woman in labour five minutes longer than she might be is unnecessary and a great cruelty. The freshly prepared infusion, with borax, will demonstrate its action in twenty to twenty-five minutes, or earlier if the anterior os be gently irritated with the forefinger. So far as ergot is related to the accoucheur I should feel disappointed