s with as minute care as would be
given to a surgical operation. By these precautions the danger of
abscess, always considerable if hypodermics are carelessly given, is
minimized. As the dose is large, a site must be selected for the
injection where the tissue is loose, otherwise the pain will interfere
with the desired frequency of use. The buttocks serve best, or the outer
masses of the pectoral muscles, or the abdominal muscles. If the
administration causes pain (due in part to the large quantity used and
in part to the local effect of glycerin), a fraction of a grain of
cocaine may be added to the solution when measured out for use.

It may at once be said, emphatically, that in some cases remarkable
results have followed the use of this material, while in others no good
has been done; but the same may be said of most plans of treatment in
this disorder. As to possible danger from it, no harm has been done to
any patient known to me, except that abcesses have occurred sometimes,
though very rarely, for in many hundreds of injections it has been my
good fortune to see abscesses form only three or four times, two of
these instances, by curious ill luck, being in physicians. Patients
describe a stimulating effect not unlike that of strong coffee,
following a few hours after use and lasting for a day. The sexual
appetite, if present, is increased; if absent, it is often renewed,
sometimes in elderly men to an inconvenient extent. In one tabetic
subject who had lost desire and ability for more than three years both
returned in sufficient force to allow him to beget a child. This
patient, like most of the others, was ignorant of what drug was being
used and of what effects might be expected, so suggestion played no
part. Apart from this special effect, the solution acts only as a highly
stimulating tonic.

The full dose of forty minims or thereabouts is maintained for a
fortnight or less, and then gradually diminished in the same way that it
was increased. Sometimes, when the effect has been good, a second
"course" may be given after two or three weeks' interval.

During the treatment by hypodermic the masseur should be told to avoid
rubbing where the injections have been given. A few trials with the
fluid internally have produced so little result of any kind that I am
inclined to think the gastric juices must alter it so as to lessen or
wholly destroy its power.

As to other drugs, experience has not given me much co