(6) The only _drugs_ likely to be of any avail are atropine and strychnine, the former being used with the idea of paralysing the terminations of the vagus in the heart muscle, the latter as a cardiac tonic and a stimulant to the respiratory centre. Some authorities have recommended the injection of atropine by a long needle passed into the heart muscle, but most are content to give either or both drugs hypodermically. Really to paralyse the vagus, a very large dose of atropine is required--about ¹⁄₃₀ gr. Strychnine should be given in a dose of ¹⁄₄₀–¹⁄₃₀ gr. [Illustration: FIG. 48B.--Artificial respiration by Sylvester’s method. Inspiration.] (7) In cases where the right heart has certainly been over-distended, the expedient of venesection has been tried. Some six ounces may be withdrawn from the external jugular or one of the veins of the arm. (8) As a last resort, _the heart may be massaged_. The only practicable route is to open the abdomen (if not already done) pass one hand under the left side of the vault of the diaphragm, placing the other hand over the precordial region. Between the two hands, the heart can first be thoroughly compressed to empty its presumably flaccid and over-distended cavities, and then lightly massaged. Several cases of recovery from this measure are on record. Status Lymphaticus. Before leaving the subject of accidents it may be well to allude to this condition, which is also known as status thymicus, and as lymphatism. It is met with mostly in the young, the commonest ages probably being five to fifteen years. Certain pathological conditions have been found in fatal cases, of which the most important are an enlargement of the thymus gland, of various lymph glands, and of the tonsils, including the naso-pharyngeal tonsil (adenoids). The heart muscle is frequently degenerated. Of the cause of these abnormalities we are as yet in doubt. There is some reason to believe that the condition tends to disappear with advancing years, if the subject survive. The most outstanding clinical fact in connection with the disease is its tendency to cause sudden death on very little provocation. A fright, a sudden exertion, and above all an anæsthetic may cause sudden and fatal syncope. DIAGNOSIS. Suspicion that the disease is present may be aroused in several ways. The presence of enlarged tonsils and adenoids, combined with general enlargement of lymph glands from no obvious cause, and a tendency to faint, make a very suggestive picture. “Night-crowing” (a sudden attack of laryngeal spasm, occurring at night, and often repeated at intervals) also raises grave doubt. The diagnosis can only be established with certainty by an X-ray photograph, when the great enlargement of the thymus may be seen in the upper part of the chest. ANÆSTHETICS IN STATUS LYMPHATICUS.