The reason a dead space is often left in closure of lacerated sphincter is that the operator does not denude far enough beyond the fistula. As the surfaces to he sutured represent two arcs of a circle, it is necessary to suture so that they radi ate like the sticks of a fan. No matter how the sutures are inserted, if the bowels are not moved daily by a saline cathartic, a certain percentage neces. sadly fail. T. A. Emmet (Amer. Jour. of Obstet., Aug., '99).
VALERIAN.—Valerian is the rhizome and rootlet of [aleriana o/ficinalis (nat. ord., Valerianacea): a native of Europe, but cultivated in America. The prin LI cipal constituent of valerian is a volatile t I• oil which, by oxidation, yields valerianic acid. Valerianic acid may be made arti ficially by the oxidation of amylic alco hol, and it is from this acid that the offi cial valerianates of ammonia, iron, qui nine, and zinc are found; but it does not quite correspond with the natural acid in its physiological effects. The ammo niated tincture is a valuable preparation, owing to the stimulating and carminative effects of the ammonia. The valerian ates are seldom used except in the com bination known as the "three valerian ates" of iron, quinine, and zinc. An elixir of valerianate of ammonia is an excellent preparation when well made; it should contain 2 grains of the salt to the fluidrachm and may be given in quantities up to a tablespoonful.
Preparations and Doses. — Valeriana (U. S. P.), 10 to 30 grains.
Extractum valeriande fluidum (U. S. P.), 4 to S drachms.
Tinctura valeriande, U. S. P. (20 per cent.), 1 to 2 drachms.
Tinctura valeriainu ainmoniata, U. S. P. (powdered root, 20 parts; aromatic spirit of ammonia, sufficient to make 100 parts), 1 to 2 drachms.
Physiological Action. — Valerian is a very feeble depressant to the nervous system, tending to produce rest. It re duces irritability and reflex contractions, and is a sedative to the spinal cord. In large doses it produces a feeling of warmth in the stomach, and sometimes nausea, vomiting, and colicky pains. The pulse is generally slightly quickened, and a sense of exhilaration is induced, accompanied, however, by formieation in the hands and feet (H. C. Wood). Very large doses cause a feeling of heaviness, and even of pain, in the head.
Therapeutics. is valuable for the relief of the milder forms of functional disturbance arising from a weak and overexeitable or an exhausted nervous system. It is, therefore, given with advantage in nervousness and hys teria, but is less useful in mania a polo and in the delirium of adynamic fevers, in which latter cases it is generally con joined with the bromides or with more powerful remedies.