Where the attacks are frequent, and especially where the patient is constantly conscious of some premonition of a seizure, the writer's plan of keeping the high tension in check by the administration of small and oft-repeated doses of Nitroglycerin is most beneficial. This may be carried out by dividing each B.P. tablet into 6 or 8 fragments, and carrying them in the vest pocket, one being slipped into the mouth every half-hour, so that the full daily dose be so divided as to produce no symptoms of flushing of the face, throbbing of the vessels, or headache. By this method of using the drug attacks may often be entirely prevented for long periods, especially if a larger dose be given at bed hour, with a full dose of alcohol after lying down for the night.
Cardiac Tonics are often indicated, as symptoms of failing compensation may be present, but Digitalis should be avoided as a rule. It is a mistake to count upon the combination of a vaso-dilator with the digitalis as sufficient to counteract the peripheral resistance, since the action of the former is rapid and comparatively evanescent, whilst the digitalis is slow and continuous in its effect. Strophanthus is therefore preferable as a routine in such cases, and it may he combined with Strychnine and Trini trin, as in the following: It . Tinct. Strophanthi
Tinct. Nucis V om. 3iij. Liquor. Trinitrini xvj.
Arjtc Camphorre ad 5viij. Misce.
• Fiat mistura. Cpl. 'ass. cuater in die ex paubulo a:lice.
During the day the above dose would fall due about every 4 hours, and when the patient is confined tb the house it is a good rule to encourage him to pour out his dose into the medicine measure and take the half of it every 2 hours, by which plan a more continuous action of the vaso dilator is procured and headache is avoided. Theohromine or its salts are of value even when there is no diminution in the amount of urine passed. Mercury in the form of Blue Pill or short courses of not longer than a week of a daily I-gr. dose of Calomel are decidedly beneficial.
Sanatogen as an adjuvant to the diet may be advantageously employed where Phosphorus is indicated, as in many cases arising from prolonged brain exhaustion.
High-frequency currents have been employed with advantage when arteriosclerosis has been a prominent feature, but their use should be left in the hands of the electric specialist. Baths of Sun Light, Arc Light and CO, have been advocated, as also graduated gymnastic exer cises and hydrotherapy.