I venture to offer my experience of the use of the above drug for the purpose of comparison with that of other observers. I am anxious not to appear as an advocate of this or any other medicine, having a rather limited faith in the efficacy of drugs in the treatment of disease. It is so difficult to be sure that the results observed are fairly due to the ascribed cause that it is but seldom that any drug can be credited with a direct curative effect. The effects of most medicines are so uncertain and indefinite that it is well-nigh impossible to attribute any positive results to their administration in the face of so many disturbing causes. In dealing with potent drugs the case is different. When the toxic effects of an agent are produced it only remains to ascertain whether these are beneficial or not. For this reason it is easier to pass a judgment on the value of such a drug as hyoscyamine than of morphia or chloral, &c., because its affect is obvious and ascertainable. I will not now discuss whether it is good to give a sedative or not, but only relate my experiences. The preparation I have used has always been “Merck's extractive alkaloid,” dissolved in spirit, for convenience, of the strength of one grain to a drachm of spirit. I have never given more than 1¼ grain, and I usually give either one or two-thirds of a grain as a dose. If one-third does not bring sleep, I double the dose. The usual effect is to send the patient into a heavy sleep in half-an-hour, or even less time, and this may last for six hours, or even more. I have very seldom found it produce sickness, and not, as a rule, interfere with the appetite. I fancy, from what one or two patients have said, that it produces a sensation of fulness and throbbing and headache, and I have seen the face congested and the prolabium purplish. The pupils are widely dilated. I have used this preparation for two years past, and have found it very useful in many cases. I have given it in cases of acute mania, of general paralysis, of chronic excitement, and may safely say it has been of greater use than any other narcotic I have employed. In acute cases, where it is difficult to get medicine down at all, it is a point to be able to give one small dose of fluid and be sure of quieting a patient for several hours. This cannot be ensured by chloral or opium, as the consequences of a dose of Batley, &c., &c., can never be reckoned on, and sickness leaves the prescriber in ignorance of how much has been absorbed by the system.
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