EXTERNAL APPLICATION OF VERATRIA, ETC. 21 
ing. She dates the commencement of her disease from a severe 
inflammatory affection of the chest, occasioned by cold caught 
during her confinement. To relieve the chest symptoms, bleeding 
and other antiphlogistic measures were had recourse to; but the 
palpitation continued to such a degree, as to render her incapable 
of taking any exercise without materially aggravating her symptoms. 
She has had many exacerbations arising from slight causes, and yet 
so severe as to render venesection necessary to alleviate the violent 
throbbing in the left side of the thorax. Her eyes are suffused, her 
memory impaired, and she has a considerable degree of nervous 
Irritability. Her breathing is difficult, accompanied by slight 
cough and a sense of partial suffocation, along with pain across the 
region of the heart and down the left arm, and these feelings are 
materially increased by walking or any other exertion. Her pulse 
is irregular and quick; bowels costive; feet generally cold ; and her 
sleep interrupted by the palpitation. 
While labouring under these symptoms she was put under the 
influence of small doses of tartrate of antimony and blue pill; and 
at the same time an embrocation of croton oil was ordered to be 
rubbed over the chest and down the affected arm, until a free erup- 
tion was produced. So long as the patient continued this plan of 
treatment, and remained quiet, she experienced great relief; but the 
palpitation returned nearly as violent as ever, upon slight exertion, 
and she now began to complain of a degree of debility which she 
had not before been subject to. Under these circumstances, she 
_ was ordered to have an ointment prepared with twenty grains of 
Veratria to an ounce of lard, rubbed in the usual quantity over the 
region of the heart for five minutes night and morning; and owing 
to the severity of the pain in the arm, frictions with the croton oil 
were ordered to be made along it, until a raw surface was obtained, 
and over this the Veratria ointment was applied. 
On the night after the first application the symptoms were very 
much diminished in intensity, but the Veratria had occasioned a 
degree of heat and tingling in the arm, so great as to prevent her 
sleeping; the pain, however, never afterwards returned. In three 
or four days she began to take exercise without inconvenience ; 
from this time she gradually improved, and at the end of three 
weeks left town, and returned home quite well. : 
CASE IV. 
Mr. J.,a clergyman, fifty years of age, has been affected with 
severe palpitation for the last seven years, accompanied by quickness 
and irregularity of the pulse, difficulty of breathing, loss of voice, 
cough, expectoration, and a distressing sense of anxiety ; has some- 
times been seized in the pulpit with giddiness, succeeded by throb- 
bing in the neck and confusion of intellect, and these symptoms 
have occasionally gone on to such an extent as to oblige him to de- 
January, 1838.—C 3 
