\ 
APPLICATION OF VERATRIA IN DROPSY, ETC. 45 
effusion may depend, otherwise the anticipated effects may not be 
roduced. 2 : euks | 
_ If, after a careful examination, nothing wrong, of importance, can 
be detected, the ointment may then be had recourse to ; but if the 
contrary be the case, the diseased state, whatever that may be, 
should, if possible, be first removed, and then the treatment may be 
proceeded with. : : | . 
The same rule before laid down, as to the relation which the 
strength of the ointment ought to bear to the extent of surface 
over which it has to be rubbed, and to the state of the patient, must 
here be kept in mind. But as the frictions should, if possible, be 
made over the whole surface under which the effusion exists, and 
as this must vary with the situation and extent which it occupies, 
‘it is evident that no prescription applicable in every instance can 
be given, except that the quantity of the ointment rubbed in each 
time, should not, in adults, contain less than two, nor more than 
four or five grains of Veratria; and the friction should be continued 
for about twenty minutes, and repeated once or twice a-day. If 
the plan of treatment is to be of service, the diuretic effect will 
probably show itself in a few hours, and the repetition of the friction 
must be regulated by the effect produced. _ | 
As an illustration, the following case may be introduced, leaving 
it for others to judge whether the rapid disappearance of the watery 
effusion was the result of the large quantity of diuretic medicine 
the patient had previously taken, or whether it arose from the action 
of the Veratria. : | 2 : 
J. Burnell, Esq., of Theresa Lodge, Pocklington, near York, aged 
thirty, came under treatment in the summer of 1830. About a year 
previously, he was attacked with ascites, which proved so very 
obstinate that, although he was put under almost every plan of treat- 
ment which could be devised by his medical attendants, during nearly 
the whole time, the disease suffered no abatement, but on the contrary 
appeared to be increasing rapidly. At the time he presented him- 
self, the dropsy had become general ; his lower extremities and 
scrotum were swollen to an enormous size ; the abdomen was com- 
pletely distended with fluid; and the organs within the chest were 
much impeded in their functions. There was great difficulty of 
breathing, attended with cough and slight watery expectoration ; 
the pulse was small and intermittent, and the patient was unable to 
remain inthe horizontal posture for one minute, without experiencing 
the most distressing sense of suffocation ; the distension of the legs 
increased to such a degree that serous fluid oozed from them; and 
altogether, the case was one of the most severe ever witnessed. 
The previous treatment of this case had been as active as possible ; 
diuretics and drastic purgatives of almost every kind had been em- 
ployed, without producing any other effect than weakening the 
patient ; and a course of mercury, continued during some time, had 
been equally unsuccessful. ‘The flow of urine was less than an Ein- 
January, 1838.—£ ye 
