APPLICATION OF VERATRIA IN GOUT. 43 
the affection appears to be more general in its nature, much benefit 
will be found to arise from its exhibition in this manner, as well as 
from the ointment. During the height of an acute attack, the 
friction should not at once be resorted to; for in this disease, as in 
rheumatism, the local remedy will be found most advantageous after 
the violence of the constitutional symptoms has been removed, by 
other treatment: in some instances, however, it has been of much 
service when made use of at the time an attack was threatened, by 
warding it off, or making the subsequent stages less severe. 
The general directions for applying the Veratria ointment in 
gout, are nearly the same as those already given for its use in rheu- 
matism. Fifteen or twenty grains of Veratria to one ounce of lard, 
will be sufficient to begin with, and the friction should be continued 
until the tingling sensation be freely produced : indeed, the quantity 
of ointment used, and the duration of the friction, are of little 
moment without attention to this circumstance. 
In a late work, Sir Charles Scudamore has made some very 
judicious remarks on the effects of Veratria ointment, and on its 
manner of application in gout. His experience, in most essential 
particulars, confirms what I have myself observed, and as illustrations 
of the utility of the remedy, I shall avail myself of three of the 
eases he has given, and shall here insert them.” 
CASE I. 
“A apy, aged forty-four, subject to severe attacks of regular 
gout, in an unusually severe paroxysm, derived great benefit from 
the internal medicines which I prescribed; but she remained 
entirely lame, from the tender, swollen, and rather painful state of 
the ankle-joint and foot. I directed the Veratria ointment, in the 
strength of ten grains to the ounce; and the good effects of the ap- 
plication were very quickly shown. She described that she was in 
considerable pain at the commencement of the friction, but that it 
abated at the end of twenty minutes, and was exchanged for strong 
prickings like those from electric sparks, and a remarkable warmth, 
rather agreeable than the contrary. These sensations lasted about 
an hour. On the following morning the swelling of the ankle and 
foot was much reduced, and allowed of standing. A further per- 
severance with the remedy proved very beneficial ; and this lady, 
by means of it, and further general treatment, recovered in the most 
favourable manner.’’ 
CASE ILI. 
“ A GENTLEMAN, aged sixty, one of the greatest martyrs to gout 
that I ever saw, was seized with sciatica and lumbago, at the same — 
* Principles and Treatment of Gout, 1835. 
