_ NEURALGIA IN THE FINGER. 65 
pared as already directed, for twenty minutes, along the back of the 
hand and fingers. The friction at first gave him extreme pain, but 
towards the end of the time he could bear it better, and it gave rise - 
to a sensation of heat in the affected finger, which was attended bya 
marked diminution of the pain. He was ordered to repeat the fric- 
tion for ten minutes, twice a day, and to take six drops of tincture 
of Aconite, prepared for internal use,* every four hours, in water. 
The immediate effect of this treatment was, to enable the patient to 
do without his daily dose of twelve grains of acetate of morphia, 
which he had been in the habit of taking for many months before. 
The friction excited sensations of heat and numbness in the hand, 
and could be borne with greater ease at each successive application, 
and he could sleep three or four hours ata time without interruption. 
The dose of the tincture was gradually augmented in the course of 
this week, to ten drops every four hours, and the frietion was ordered 
to be used till heat and tingling were produced, whenever the pain 
came on. 
The pain was removed every time the tincture was applied, and 
the quantity taken internally occasioned tingling and numbness in 
the extremities, and acted as a diuretic. The patient slept six or 
seven hours at a time: he had intervals of perfect freedom from pain, 
with distinct paroxysms, varying in intensity: and on the seventh 
day, from the commencement of the treatment, he was so far reco- 
vered, that he could bear to have his nails cut, which had not been 
the case for nine months previously. 
Second Week. During the next seven days the same treatment 
was continued. He took the tincture internally, in nearly the same 
dose, and rubbed it on the affected joints, whenever the pain came on. 
Under these means, the accessions of pain gradually diminished in 
intensity, and the intervals of complete relief became longer, so 
that at the end of this week he had little pain except on motion. 
Third Week. This week he was directed to continue the same 
treatment, to use the affected joints as much as he could : this, how- 
ever, brought on attacks of pain, but these were at once removed by 
frictions, continued until tingling was produced. 
Fourth Week. On the first day of this week he was directed to 
substitute for the tincture the following ointment :— 
R. Aconitine. gr. ii. 
Adipis, 4 1. ut fiat unguent. 
and to rub with it whenever he had pain. 
The tingling caused by this ointment was very considerable, and 
generally lasted three or four hours afterwards. He had occasion to 
use it three times a-day, and one grain of Aconitine was added to the 
second prescription, as the first began to lose its effect. In a day 
or two he discontinued the tincture internally, and was directed to 
use the ointment of the ammoniated extract of Aconite, made ac- 
* Vide page 55. 
