374 REPORT OF SOME CASES OF ARTICULAR DISEASE 



Mr. Syme cauterized thoroughly the skin over the anterior and posterior aspects 

 of the joint, rubbing a red-hot cautery iron freely backwards and forwards four 

 or five times over each part. It had the effect of raising and rubbing off the 

 cuticle, but did not char the skin. An hour afterwards the patient was suffering 

 but little pain. 



Nov. 4. — Said, with a smiling countenance, that she slept well last night, 

 the first time for four months, and feels now no pain save that of the burns. 



Nov. 5. — A poultice was applied yesterday ; the pain of the burn is now 

 gone, and she feels no pain at all. Says that she has not only lost all pain, but 

 also that the feeling of numbness is gone from the limb, and that she seems 

 to have more power in it. The burned parts present a white sloughy appearance. 



The poultice was continued till the sloughs separated, when simple cerate 

 was substituted for it, with the view of retarding, rather than promoting 

 cicatrization. 



Nov. 12. — To-day she has been trying to lift the arm, and felt none of the 

 old pain in the attempt. 



Jan. 31, 1854. — She has to-day left the infirmary. She has for some time 

 past been gradually acquiring more and more power in the limb ; she can move 

 the arm backwards and forwards for a considerable extent, and even raise it 

 slightly. The movements of the forearm are free ; there is no tenderness what- 

 ever about the shoulder. The return of the use of the limb has been accompanied 

 with a restoration of the fullness of the muscles, so that there is now no difference 

 between the contour of the two shoulders. She continues quite free from 

 spontaneous pain. 



I saw her again towards the end of May. She was still quite free from pain, 

 and there remained only some stiffness about the joint that prevented her from 

 raising the arm to the full extent. 



Case II. — Disease of Shoulder-joint ; Actual Cautery ; Cure. 



Lily Kay, aet. 50, admitted the 23rd of March, 1854. Has generally enjoyed 

 good health, except that for the last twelve years she has suffered inconvenience 

 from what she supposed to be rheumatism in the right shoulder, characterized 

 by shooting pain, occurring more especially when she attempted to lift anything. 

 In January last the limb became completely disabled from increase of the pain, 

 which now assumed a gnawing as well as a shooting character, and also began 

 to be felt in the elbow-joint, and in the arm, forearm, and hand. At this time 

 she first observed the existence of swelling about the shoulder-joint. 



The pain continued to increase till the time of her admission into the infir- 

 mary, when it was exceedingly severe ; not constant, but frequently keeping 



