Tolerance to Nitroglycerin.

In a recent issue ofThe Journal,1there appeared a note concerning the administration of nitroglycerin in which the correspondent (Dr. Maddox) referred to a case under treatment at my service in the Jefferson Medical College in 1888. This patient was an interesting example of rapidly-acquired tolerance to the drug, as he was taking, as remarked by Dr. Maddox, when seen by him in the clinic of Dr. Da Costa, 20 grains of pure nitroglycerin daily. It may be of interest to state that this and similar cases in which marked tolerance to nitroglycerin was easily acquired, I made the subject of several papers some years ago. I reported this particular case in thePhiladelphia Polyclinicin August and in December, 1888, under the caption of "Remarkable Tolerance to Nitroglycerin." Later, in a paper entitled "Tolerance to Nitroglycerin Easily Acquired: Limitations of Use of the Drug in Chronic Nephritis,"2