721 which would depress a healthy circulation, give much relief to veins highly distended with water-laden blood. The following case is to the point :-T. P-, aged seventy-three, came to me at the West London Hospital as an out-patient in August last. He was a spare little man, with a dilated heart, in which there was little hypertrophy, with ascites, oedema up to the knees, and an irregular pulse. He was passing very little water. By the kindness of my senior, Dr. Thorowgood, he was admitted

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... o the hospital, to be under my care. While giving him digitalis and iron, it seemed very desirable to relieve the circulation. This might be effected by either diaphoresis or catharsis. I preferred the latter, and gave two scruples of compound jalap powder every alternate morning. The relief afforded by this plan was very pronounced : the secretion of urine was much increased, the respiration was easier, and the pulse less irregular and better sustained. After eight different purgings he was so much better, and the ascites and oedema so much relieved, that the purging was abandoned, and the digitalis and iron continued. In a short time he became an out-patient, and walks backwards and forwards from Barnes to Hammersmith weekly, without discomfort ; in fact, he is proud to say in how short a time he can accomplish his walk without any shortness of breath or sense of fatigue. This case shows better than any amount of comment the effects of well-directed catharsis in the venous congestion of heart disease. I may add that in repeated cases experience has taught me the value of catharsis in the treatment of cardiac dropsy.