The drug, which, more than all others, is entitled to be classed as a specific, is quinine. In neuralgia dependent upon malarial poison, quinine administered in doses sufficiently large, effects an early and complete cure. If employed judiciously after a paroxysm, it can generally be relied upon to prevent the occurrence of any indication of the succeeding paroxysm. It thus breaks up the regularity of the attacks. It does not, however, ensure against a subsequent recurrence of the trouble unless the remedy is continued. Smaller doses are sufficient to prevent a return of the malady than were necessary to stop the regular recurrence of the paroxysms.

Moreover, in cases in which there is no evidence whatever of the presence of any malarial poison, quinine will frequently effect a speedy cure. How it does this it is not easy to satisfactorily explain, but it is well recognized that quinine exerts a distinct and powerful influence upon the nervous system. Thus it is seen that quinine has a double claim to the title of specific in neuralgia, for it not only antagonizes one of the common causes of the disease, but it also exerts a curative action in many cases in the absence of this exciting cause. In cases of rheumatic origin, as well as in some cases in which this relation cannot be clearly established, salicylic acid or salicylate of sodium, and the iodide of potassium are useful remedies. The former is especially adapted to acute, and the latter to chronic cases. The good effects of both have been especially demonstrated in cases of sciatica.

When there is reason to suspect that the disease is dependent upon syphilitic infection, iodide of potassium should be prescribed; or, if the

Among the tonics which are useful in the treatment of neuralgia, may be mentioned iron, arsenic, codliver oil, phosphorus, strychnine, small doses of quinine, the various. vegetable bitters, and the laxatives which act as stimulants to the normal secretions of the alimentary canal.

As already intimated malaria, syphilis and rheumatism are often associated with anæmia. In these cases therefore very frequently, and in more purely anæmic cases always, iron is of very great value. Its beneficial action is not so prompt as that of many other drugs, but the benefit secured is more permanent. In cases in which it is indicated, its use-in proper doses-can be continued for a long period without unpleasant results. So slow and gradual is the action of iron, that only in subacute cases, in which the pain is not very severe, is it possible to rely entirely upon this drug. Other remedies which act more directly in relieving pain must usually be prescribed in connection with it.

In certain forms of visceral neuralgia, and in particular in neuralgia of the stomach-gastralgia-arsenic is a valuable remedy. By some it is regarded as almost a specific in this disease. But while admitting that it has positive therapeutic value, it will generally be found that its use will be attended with more satisfactory results if some distinctly neurotic drug is prescribed in connection with it.

Of iron and arsenic it might, perhaps with some justice, be said that they deserve to be included among the specifics on account of their special action in curing anæmia. But it seems to me more proper in the present state of our knowledge, to include them among the tonics.