tiguous, and remote; do our best to free and cleanse the foul system of the perilous stuff that weighs upon the heart, and so prepare the way for gentle stimulation, for stereotyped prescription of ammonia, and the full effect of the next sweet oblivious antidote; endeavouring thus to turn the turmoil of the overlaboured heart into the even tenour of its way, relax the tension of the heaving chest, and give the grateful patient breath to say, I find relief, I die; but easily.

II.

Diseases of the Nervous System.

We are but imperfectly acquainted with the subject of nerve-waste, or rather loss of nervous power, which is highly interesting, whether as regards the form where the generation of nerve-power is deficient or its waste abnormally rapid. Recovery from exhaustion is quick in some persons and slow in others; the latter class comes most frequently under medical supervision. As the subject is somewhat intangible and difficult to trace, we are in some measure obliged to have recourse to indirect means of investigation. Our information is partly derived from the effects of remedies,-naturam morborum ostendit curatio: an imperfect source, for the prescrip

tion of these is too frequently empirical; we do not clearly know how the so-called tonics act, and we are still more uncertain as to the effects of narcotics, whether they act by supplying the deficient element, or by themselves affording food for waste; and although the question remains unsolved, it is for a time happily set at rest by the production of sleep. Next arises the vexed question of tobacco, as a useful sedative or a mere indulgence. With regard to the action of tea, especially of green tea, if its effect be to lower the heart's action and reduce the frequency of respiration, and so mechanically lessen the supply of blood to the brain, or if it be simply to stop waste, it is easy to see that it would be apt to act as an irritant, and keep awake those who are not the subject of that particular form of waste-for all active agents that do not repair go to oppress. This suggests inquiry into the lax condition which is ready to receive, and the irritable state which rejects medicaments, from the highest degree of toleration to utter repugnance to the smallest dose; and shows the importance of studying the opposite effects of ergotine and strychnine, of opium and belladonna on the nervous system, and of belladonna and digitalis on the heart.

Coffee is more effectual against the effects of cold than alcohol, because it not only stops waste, but according to Dr. Smith is a cardiac stimulant. Opinions as to not only the efficacy, but the actual effects of stimulants, are very different, and fiercely contested in proportion as their real action is imperfectly understood. If the opinion of Brodie be correct, that wines and alcohol do not give real power to the nervous system, but merely uphold strength while it is being expended, several of the phenomena of its use and abuse are explained. Without discussing the effects of its excessive use, it would appear that the impunity or otherwise with which it is indulged, depends to some extent upon the amount of exertion taken during its influence: to instance two extremes, the comparative impunity of post-prandial indulgence, and the contrast of the evil effects of the morning glass of sherry substituted for breakfast, with the day's work in prospect. The subject of delirium tremens escapes for a time, till the shock of an accident or some other circumstance proves to be an exciting cause; and according to the same hypothesis, the predisposition of the intemperate to heat apoplexy is still more obvious, because such persons live as it were on the brink of nervine bankruptcy, and all borrowing incurs a

larger debt to be repaid hereafter. Heat apoplexy is acknowledged to be a paralysis or paresis of the respiratory tract, giving rise to sanguineous congestion of lung from want of power to maintain circulation; cerebral congestion and extravasation ensue as a secondary result, the structure of the brain being free from appreciable lesion. Stimulants and the tonic cold are the appropriate remedies. This does not contradict what has been previously said of other forms of apoplexy, but opens the question as to the best means of promoting contraction of vessels-this must necessarily vary with different states. Here the illustration of Dr. Billing is readily brought to mind, whether to take bricks out of the cart, or to flog the tired horse up the hill-a practice which, if it does not issue in triumph, results in cruelty.

The effects of over-exertion, still more of dissipation, are more serious in the intemperate, because the structure generating nerve-force being reduced to a state of greater exhaustion, is thus rendered more liable to molecular change. As a correlative statement it may be remarked here, that whatever materially interferes with the generating power of nerve-vesicle, or the conducting power of nerve tubular fibre, constitutes paralysing lesion; and this definition includes all forms, whether of organic

change, functional derangement, or that condition in which abnormal expenditure is largely in excess of supply, viz., the state of paresis.

A certain expenditure of nerve-power predisposes to paralysis; a greater degree, especially when combined with depression from moral or emotional causes, tends to insanity: excessive use or expenditure of a natural function causes the first, the perverted use or abuse of the function leads to the latter. Some confusion of idea and consequent misapprehension appears to have arisen from losing sight of a simple verbal definition: we speak of a patient being depressed, and again of his having rallied, the idea thus conveyed to the mind is that of simple elasticity; but to examine the matter more closely, that which is spoken of as an impression or depression, is an actual loss of power or interruption of supply. The shock of an accident is an illustration of this; and it becomes an interesting question how far this is a mechanical effect, in the same way that the magnetism of a mass of iron is deranged by a severe blow. It should be borne in mind that in such cases we are not dealing with steel springs, but with a body in which waste and repair are continually going on: we are speaking, in fact,