38 TURNBULL ON RANUNCULACE. 
chest, or in other parts, the symptoms may be relieved almost im- 
mediately by the first friction ; and in more obstinate cases, a few 
more will, in general, have the desired effect. 
CASE I. 
Mr. G., a gentleman about forty-eight years of age, had been for 
some time subject to occasional severe attacks of acute rheumatism, 
affecting chiefly the joints of the extremities, and attended with a 
considerable degree of general fever. For several days before he 
came under treatment he had been labouring under very acute 
symptoms of the disease; he had had a good deal of fever, a quick 
throbbing pulse, much heat of skin, and the joints of the elbows, 
wrists, knees, and ankles were swollen red, and so very painful as 
1o render motion to any extent impossible. ‘ 
In this case the most active measures had already been put into 
practice. Venesection had been freely employed, he had used 
large and repeated doses of purgatives, of various diaphoretic medi- 
cines, and colchicum ; and along with these means the antiphlogistic 
regimen had been carefully pursued since the commencement of the 
attack, but no abatement in its violence had taken place. | 
As everything likely to effect a cure in the usual way appeared 
to have been resorted to, the previous internal treatment was ordered 
to be persevered in, and at the same time an ointment, consisting of 
ten grains of Veratria and an ounce of lard, was directed to be 
rubbed upon the affected joints, for ten minutes at night, and again 
the following morning. When the patient was visited next day, his 
rheumatism was nearly gone. The ointment had occasioned a con- 
siderable increase in the heat of the parts, but the inflammation and 
swelling were greatly diminished, and the pain almost removed ; 
he could now use the affected joints with perfect ease, and there 
was no return of the symptoms for some days. He then experienced 
a slight renewal of the complaint in one of the ankles ; and at the 
very first appearance rubbed the ointment, of his own accord, over 
the inflamed surface for the usual time, but although it produced 
sensations of heat and tingling as usual, yet no amelioration of the 
pain took place : the friction was therefore ordered not to be repeated 
till twelve hours had elapsed, and at the end of that period one ap- 
plication entirely removed it. 
CASE II. 
A. Boy, twelve years of age, and of a delicate habit of body, had 
been labouring for three or four days under an attack of acute rheu- 
matism, attended by a good deal of febrile excitement ; the pulse 
was quick, the skin hot, and the tongue dry, and slightly furred ; 
both his ankles and knees were swollen to a considerable degree, 
