In scarlet fever the utility of digitalis is very great; it lowers the temperature and maintains the action of the kidneys, thus obviating the two principal sources of danger in that disease. Dr. Daniel Lewis, of New York, influenced by the author's opinions on this point, systematically used digitalis as the chief remedy in an epidemic of scarlet fever in New York, and presented the results in a paper submitted to the State Medical Society. While the mortality from this disease, for the city at large, is 23 per cent, for Dr. Lewis's cases it was less than 11 per cent. From a tea spoonful to a table spoonful (according to age) of the infusion every two, three, or four hours, is a suitable mode of administration. If uraemia occur, the infusion is the proper remedy, conjoined, of course, with other means. The author has seen most excellent results from a poultice of digitalis-leaves, applied to the abdomen and back, in cases of uraemic convulsions, the patient being unable to swallow, or the stomach so irritable as to reject all medicines.

Digitalis has been used with success in erysipelas, but it is by no means equal to belladonna in this affection.

In rheumatic fever the testimony in favor of the use of digitalis is certainly very strong. It lowers the temperature, and apparently materially shortens the duration of the disease. It may be given in powders—two grains every four hours—or a corresponding quantity of the infusion. In rheumatism, as in every other affection, very prompt effects do not follow the use of digitalis; a day or two must elapse before any marked reduction of temperature takes place, but a cessation of the joint-trouble may be looked for in seven to ten days. Digitalis is more particularly useful in the cardiac compliations of acute rheumatism, when irregular and feeble action of the heart, difficult breathing, cyanosis, and general aedema, are present. The following is a prescription of Oppolzer in this condition: Rx Inf. digitalis, oz ij; liq. potassii citrat., oz jss; acet. scillae, oz ss. M. Sig.: A table-spoonful every four hours.

Digitalis has recently been much employed in inflammatory affections, notably pneumonia. On examination of the reported cases the author finds that the defervescence, produced apparently by digitalis from the sixth to the tenth day, occurred at the time when the crisis in pneumonia is to be expected, and hence it is difficult, if not impossible, to estimate the precise share which the remedy had in the results. That digitalis has any power to prevent the deposition of fibrinous material, to prevent or check the migration of the white corpuscles, or to arrest the multiplication of the cellular elements of inflamed parts, seems to the author highly improbable. That it may be useful to combat some of the symptoms—high temperature, ischaemia of the arterial system from pulmonary obstruction, and low tension of the vessels— may be well admitted.

There is considerable evidence to show that digitalis is serviceable in chronic bronchitis with interstitial pneumonia (fibroid lung), when accompanied with difficult breathing, secondary dilatation of the right cavities, and general anasarca. It diminishes the cough and expectoration, tones up the weakened and laboring heart, and reduces the oedema. That digitalis has any curative power in pulmonary tuberculosis or caseous pneumonia, can hardly be credited, notwithstanding the claims which have been put forward. It may be used as an anti- pyretic when there is much hectic, but the derangement of the intestinal canal produced by it is a most serious bar to its employment in phthisis.

Some important results have been obtained by the use of digitalis in nervous diseases. The congestive form of hemicrania may not in-frequently be permanently relieved by the persistent use of digitaline-granules (one sixtieth of a grain bis die). Acute maniacal delirium, chronic mania, and delirium tremens, are disorders of the brain in which digitalis has proved very useful. The conclusions of Dr. Williams, of Hayward's Heath Asylum, are as follow:

"1. That digitalis is a valuable sedative in the treatment alike of recent and chronic mania, and when these forms of disease are complicated with general paresis and with epilepsy.

" 2. That the average dose of the tincture is from 3 ss to 3 j, and this quantity may be certainly given with impunity for several days, and subsequently—adjusted to the state of the pulse—may be advantageously used for several months.

" 3. That the indication by which the use of this drug is regulated is the state of the pulse, any marked intermittence requiring its immediate discontinuance.

" 4. That the weakness of the circulation is no indication against its employment; on the contrary, experience shows that the most enfeebled subjects bear its administration as well as the most robust."

In delirium tremens extraordinary doses of the tincture of digitalis have been used with success ( 3 ij— 3 iv), but these large doses are unnecessary. This treatment is most useful in the young and robust, with marked cerebral hyperaemia, according to some; but, according to others, in pale subjects with a tendency to cyanosis, the state of the brain being one of anaemia, with effusion and oedema. According to the author's observation, the latter indications are the more correct. The infusion is doubtless a better preparation than the tincture, and of this a table spoonful may be administered every four hours.

Some supposed cases of arachnitis have been reported cured by digitalis, but grave doubts must exist as to the accuracy of the diagnosis.

Cases of exophthalmic goitre in young subjects, purely functional in character, have been cured by digitalis, and the cardiac irregularities, and the dilatation of the cervical vessels, ameliorated in even incurable cases. Digitaline is the form in which to employ this remedy, or powdered digitalis may be given in pill, with iron and manganese to remove the anaemia.

Since the anaphrodisiac properties of digitalis were ascertained, it has been much used in spermatorrhoea. It is adapted to the same class of cases as those in which ergot has been shown to be so beneficial, viz., feeble erections, frequent emissions, and cold hands and feet. The author has seen better results from the combination of bromide of potassium and digitalis, in the spermatorrhoea of plethora, than from any other remedies: Rx Inf. digitalis, oz viij; potassii bromidi, oz j. M. Sig.: A table spoonful morning and night, and, after a week, at night only.

Digitalis is one of the most generally useful remedies in dropsy which we possess. It is, of course, specially indicated in the mechanical dropsy of valvular lesions. In renal dropsy from acute desquamative nephritis (tubal nephritis) "of all drugs, digitalis is of the greatest value," and the best form in which to administer it is the infusion. Several days usually elapse before very decisive results are achieved, but the flow of urine is, then, often enormous. The fact that, contrary to what has been heretofore believed, digitalis has a direct action on the glomerule of the kidney, is of great interest in this connection. The author has seen very favorable results from the use of digitalis in granular degeneration of the kidney when dropsy supervened, but its use in this disease requires caution in consequence of the fact that the elimination of urea and of the chlorides is retarded by this agent.