Another noteworthy case was that of a robust man of thirty years, who was attacked with acute gastro intestinal catarrh. The patient had as many as one hundred watery evacuations in forty-eight hours, with fainting fits, violent cramps in the calves of the legs, two attacks of general convulsions--in short, he presented the picture of a person attacked with cholera. Opium, champagne, hypodermic injections of sulphuric ether, counter-irritation, etc., proved useless. The doctor was on the point of injecting dilute liquor ammonii into the veins, but, none being obtainable, it occurred to him to try nitrite of amyl as a last resort. A considerable amount was poured on a handkerchief and held before the patient's mouth and nose, while the legs were also rubbed energetically with the same agent. Respiration soon became deeper and more regular, while the pulse gradually returned at the wrist. These procedures were repeated again and again, without regard to the quantity of the drug used, as soon as the radial pulse became weaker, and kept up until the patient complained of a sense of fullness in the head, and requested the discontinuance of the drug. The evacuations became less frequent, and in a week the patient was able to be up. Resuming then, Kurz concludes that nitrite of amyl is indicated in cardiac affections when the capillary circulation is obstructed and the cardiac muscle is threatened with paralysis from overwork; further, in cases of impeded circulation occasioned by cholera or severe diarrhea, particularly in the so-called hydrocephaloid (false hydrocephalus) of children. It is worthy of trial in tetanic and eclamptic seizures, and in tonic angiospasms such as occur during the chill of malarial fevers, although in the last-mentioned condition pilocarpine is perhaps more suitable, provided the energy of the heart be unimpaired.
As regards the dose, Kurz's experience demonstrates that we need not restrict ourselves to a few drops. The quantity may be increased, if necessary, until symptoms of cerebral congestion show themselves, when the drug should be momentarily or permanently discontinued. Usually from three to five or ten drops are sufficient, sometimes even less. Kurz has met with no unpleasant consequences, much less serious complications, from the application of nitrite of amyl. But the drug is contraindicated in cases associated with cerebral hyperaemia, in atheromatous conditions of the arteries, and in the so-called plethoric state--_Beta's Memoabilien, March 24, 1881_.