REPORT OF SOME CASES OF ARTICULAR DISEASE 377 



moment than what he had experienced from caustic issues, and immediately 

 afterwards he told us that he did not feel the pain of the burn at all. Next day 

 he found less pain in moving the head, and in two or three da^'S his countenance 

 assumed a cheerful aspect. A steady daily improvement has since taken place 

 in his symptoms, and at the present time (the 15th of July) he has no pain what- 

 ever when he sits at rest, and can also use strong and active exertion without 

 uneasiness, and no longer requires to support his head in lying down or rising ; 

 he can turn his head round pretty freely and look up to the ceiling, and it is 

 only in sudden movements of the neck that he feels any pain at all. The swelling 

 of the neck has greatly subsided, and he can open his jaws wide, and swallow 

 with comparative facility. The sore on the neck is almost healed, and he talks 

 of leaving the hospital in a few days as cured. 



Remarks. — The above cases speak for themselves ; and I might add several 

 others, that exemplify in an equally striking manner the beneficial effects of 

 the actual cautery in certain forms of articular disease. It will be observed 

 that it is by no means so painful a remedy as is generally supposed, and also 

 that its good effects are more than can be attributed to the mere discharge of pus 

 from the sore which it produces, seeing that a great improvement commonly 

 occurs within a few hours of its application, and long before suppuration is 

 established. 



It is now many years since the use of this means of counter-irritation was 

 introduced into Great Britain by Mr. Syme ; but although a constant series of 

 successful cases have since continued to demonstrate its value to those who have 

 witnessed his practice, yet I am satisfied that it has not hitherto been sufficiently 

 generally appreciated. Case IV is an example of its efficacy against a most 

 formidable disease, where caustic issues had been long tried in vain. I believe 

 many limbs and lives have been sacrificed that might have been saved by the 

 actual cautery, and by it alone ; and having been myself very strongly impressed 

 with the importance of the subject, I should be truly glad if any surgeon who 

 may have hitherto overlooked it, should be induced by the above report to 

 inquire more closely into its merits. 



LISTER II C C 



