590 THE TREATMENT OP DISEASES. 



perhaps be attempted before resorting to this serious measure in the way of assisting 

 the patient by getting him to use good soft pens, and large cork pen-holders that 

 may be grasped by the whole hand. We may mention incidentally that thick cork 

 holders are a great convenience in writing even in health. 



Electricity undoubtedly does good in some cases, but the exact form in which it 

 should be employed if at all is a point that can be determined only by a medical 

 consultation. Gymnastics, shampooing, tonics, and cold-water bathing may do good, 

 In Vienna the following mode of treating dancers' cramp is adopted by the ballet- 

 master : he either ties a handkerchief tightly above the ankle, or has the sufferer 

 placed on a wooden cylinder, which she rolls backwards and forwards, whilst the 

 whole weight of her body is supported on it. In this way the pain is relieved so 

 that dancing can be resumed, but its return is not prevented. 



A case is recorded of writers' cramp being , cured by extract of physostigma. 

 The patient was a clerk, aged thirty, intelligent and well educated. He had been 

 ill three months, and was rapidly growing worse. Both hands were affected the 

 right most, though the left was first attacked. After writing a short time the 

 fingers would be drawn up and cramped so that he could not use them, and his 

 hand would start so that the pen would sometimes fly out of his fingers. His 

 writing, which was formerly very good, had become so altered that his friends 

 scarcely recognised it. The fingers of both hands trembled a great deal, just as they 

 would in shaking palsy. He complained of severe numb and shooting pain in 

 both hands, which he compared to neuralgia; it was most severe in the index-finger, 

 and often kept him awake at night. The tip of the index-finger was very tender, 

 and the pressure of the pen caused great pain. The hands perspired most profusely. 

 He was ordered a thirtieth of a grain of extract of physostigma, to be taken every i 

 two hours in the form of a pill. He quickly improved. At the end of a fortnight 

 his most distressing symptoms were relieved. The tenderness at the tips of the 

 fingers was less, and he wrote better, for the effort caused less cramp and starting 

 of the hand. In a few weeks the tremulousness, with the cramps and startings of 

 his fingers and hands, left him, so that his writing gradually improved till it became 

 as good as ever. In a little over two months he was cured. Till he took the phy- 

 sostigma he was daily growing worse, and from the time of beginning it he steadily 

 and continuously improved. 



Phosphorus (Prs. 53, 54) or hypophosphite of lime (Pr. 55) has been recom- 

 mended in this complaint. Fellows' Compound Syrup of Hypophosphites a tea- 

 spoonful three times a day in a little water is most useful in many affections of 

 the nervous system. 



YELLOW FEVER. (See article on TYPHOID, TYPHUS, AND OTHER FEVERS, p. 529.) 



