pericarditis, with one or two points of fatty degeneration of the heart's substance, and sound kidneys were found. The reporter of the case inclines to the opinion that the acid produced sudden collapse and cardiac failure, while Bristowe referred them to the rheumatic poison itself. I have not been able to refer to Hoppe Seyler's paper,[173] in which he relates that having given 5 grammes of salicylic acid to a child of seven and a half years affected with articular rheumatism, shortly afterward there occurred deafness, agitation, profuse sweating, dyspnoea, and finally fatal collapse. The condition of the heart and kidneys before and after death is not given. Weber {58} published[174] an instance in which 15-gr. doses of salicin given to a woman of twenty-seven produced in thirty-four hours a rapid fall of temperature from 103° to 96° F., accompanied by delirium and serious but not fatal collapse. It is well to remember that a similar failure of cardiac power is occasionally observed in other fevers when rapid defervescence occurs, although the salicyl compounds have not been taken; and it is certainly necessary to give these remedies cautiously, and often to administer alcohol with them, when the heart's action is at all enfeebled by protracted pyrexia and pain, or by disease (inflammatory or degenerative) of its substance or envelope. Indeed, if severe cardiac inflammation obtain in rheumatism, the remedies are powerless and perhaps unsafe. The sudden reduction of the temperature when much exhaustion obtains, even in the hyperpyrexia of rheumatic and other fevers, whether by salicylic acid or quinia or the cold bath, may be attended with fatal collapse of the heart. [Footnote 165: _Lancet_, i., 1882, 135.] [Footnote 166: Quoted by Wood in his _Therapeutics and Mat. Med._, 1880, from _Centralb. für Chir._, 1877, 809.] [Footnote 167: See DaCosta's observations in _Am. Med. Journal_, vol. lxix., and Ackland's in _B. Med. Journal_, i., 1881, 337.] [Footnote 168: _Boston Med. and Surg. Journal_.] [Footnote 169: _N.Y. Med. Record_, April 29, 1882, 456.] [Footnote 170: Köhler, _Centralb. f. Med. Wissensch._, 1876, and Dunowsky, _Arbeiter Pharm. Labor._, Moskau, i. p. 190, quoted by H. C. Wood, _Therapeutics, Mat. Med., etc._, 3d ed., p. 639.] [Footnote 171: _Clin. Soc. Trans._, xiii. p. 266, c. iii.] [Footnote 172: _Ibid._, p. 123.] [Footnote 173: Quoted by D. Seille, Thèse, _De la Méd. Salicylée dans le Rheumatism_, Paris, 1879, p. 54.] [Footnote 174: _Clin. Soc. Trans._, x. p. 70, 1877.] Instead of the frequent weak pulse above mentioned, I have many times found salicylate of sodium render the pulse very slow, labored, and compressible in typhoid fever, and generally at the same time the temperature has been considerably reduced below what it had been.