blood in the venous system, through the loss
of the normal activity of the peripheral heart, gradually raises
the resistance by increasing the amount of blood which has to be
pushed along in the venous system. This loss of the action of
the peripheral heart more than counterbalances the temporary
relief secured by the paralysis of the vasoconstrictors.

"Thermic applications, general and local, may safely be affirmed
to be the true physiological heart tonic. In the employment of
the cold pericardial compress as a heart tonic, the application
should generally be continued not more than half an hour at a
time, and its use may be alternated with general cold
applications to the surface. A cold towel rub, or the cold trunk
pack is the best form for application if the patient is very
feeble.

"The cold towel rub is applied thus: wring a towel as dry as
possible out of very cold water, and spread it quickly and
evenly over the surface; rub vigorously outside until the skin
begins to feel warm; then remove, dry the moistened surface, rub
until it glows, and make the same application to another part;
and so on until the whole surface of the body has been gone
over. The procedure should be rapid and vigorous.

"If the cold trunk pack is employed, a sheet of not more than
one thickness should be wrung as dry as possible out of very
cold water, and wrapped quickly about the body, after first
dipping the hands in water, and rubbing the trunk vigorously. In
cases of extreme cardiac weakness, very cold and very hot
applications may be alternately applied over the region of the
heart. The duration of the hot and cold applications should be
about fifteen seconds each.

"Any one who has ever witnessed the marvelous effects of
applications of this sort in reviving a flagging heart will
never doubt their efficacy, and will have no occasion to resort
to alcohol, or any other intoxicant, to stimulate a flagging
heart. The writer has employed these measures for stimulating
the heart for more than twenty years, and might cite hundreds of
instances in which their efficiency has been demonstrated. They
are applicable not only to the cardiac depression encountered in
the adynamic stage of typhoid and other fevers, but in cases of
heart failure from hemorrhage, of surgical shock, collapse und