INTERNAL APPLICATION OF VERATRIA, ETC. 25 
The action of the heart is strong, constant, and concentrated in a 
Space over the situation of the apex, and communicates a powerful 
impulse to any thing placed on it; the pulse is very full, throbbing, 
andj incompressible ; the carotid arteries beat violently, and the 
patient complains much of the noise in her ear, and of giddiness; 
she has also confusion of ideas, and a feeling of heat and fulness in 
the head. She has considerable anxiety, and her sleep is interrupted 
by palpitation. There is some pain in the region of the heart; and 
all these symptoms are materially augmented by exertion ; but this, 
from the sensation of lassitude which she almost constantly labours 
under, cannot be made to any great extent. 
The bowels are generally costive, and require the employment 
of active purgatives, which are the only medicines capable of re- 
moving the uneasy feelings of the patient, to any degree; the digestive 
functions are very active, and the appetite preternaturally great. 
She complains neither of difficulty of breathing, cough, nor pain in 
the arm. In the previous treatment of this case nothing had been 
found useful, and as it did not appear that any bad consequence 
could arise from the external application of the Veratria, it was 
ordered to be rubbed over the region of the heart, in the usual 
manner, after purgatives had been administered, for a few days, to 
regulate the bowels. : 
After the first or second friction with the ointment, all the 
symptoms were materially diminished in intensity ; the palpitation 
had greatly subsided ; the pulse had become much softer and weaker ; 
the anxiety, the pulsation in the head, the feeling of giddiness, the 
confusion of intellect, and the sensation of whizzing in the ear, had | 
all disappeared, and the general health and appearance of the patient 
were much improved ; but still some of the symptoms remained, not, 
however, to such a degree as to occasion inconvenience, and she is 
now in a comfortable state, and able to follow her household em- 
ployments; though exertion, to any great extent, cannot be used 
without aggravating her complaints. From the manifest benefit 
experienced from the Veratria ointment, she uses it herself when- 
ever, from any cause, an increase in the symptoms takes place, and 
with the effect of procuring immediate relief. 
4 
CASE VIII. 
A GENTLEMAN, aged about sixty, of a weak constitution, of seden- 
tary habits, and given to mental occupations, has laboured, for seven 
years, under slight palpitation, accompanied by feelings of anxiety - 
and general languor, coming on at intervals, and increased by exer- 
tion; his pulse is feeble, rapid, and intermitting; palpitation over 
the lower part of the left side, not excessive, but attended with a 
painful sensation in the region of the heart, which is so augmented | 
by walking, especially against the wind, as to compel him to stop 
and support himself on the nea object. Respiration generally 
