MISCELLANEA. 
113 
fomentations. On the fourth day the pain shifted to the joints of 
the thumb, the scratch being perfectly healed : the pain thus con- 
tinued to shift about to different parts of the thumb up to the day 
he applied for advice. The thumb now presented a swollen ap- 
pearance ; was very hot and painful ; and on the first joint was a 
circumscribed swelling about the size of a shilling, red, quite hard, 
and tender on being touched, gradually rising to a small obtuse 
cone, the top of which was indented, and marked by a yellow spot. 
The pain, heat, and swelling, did not extend beyond the thumb, and 
there was no swelling in the axilla. The man’s countenance was 
dejected, and he complained of restlessness and debility : his nights 
were sleepless, owing to the increase of pain at that time ; tongue 
clean, and rather dry ; pulse 90, and firm ; bowels regular ; is 
thirsty, .and is annoyed by a constant unpleasant taste in the mouth. 
A linseed poultice was applied ; and two grains of opium, along 
with twelve grains of compound extract of colocynth, ordered, to 
be divided into four pills, two of which were to be taken each night 
at bedtime ; a draught of the compound senna mixture the morn- 
ings following. 
2 6th. — Medicine has acted well ; has passed two restless and 
disturbed nights, from the incessant pain and intolerable heat in 
the thumb. The pain has affected the tips of all the fingers, and on 
the fourth finger of the left hand is the appearance of a circum- 
scribed swelling, resembling in every respect that on the thumb. 
The swelling of the thumb has diminished a little, but it still con- 
tinues hot and red — pulse 92, soft — tongue clean, and still rather 
dry — eyes dry-looking — urine natural — appetite capricious. Com- 
pound ipecacuanha powder, ten grains, was ordered each night, 
with a draught of compound decoction of cinchona, Jvss., and com- 
pound tincture of cinchona, Jss., a sixth part to be taken every six 
hours : — linseed poultice continued. 
28 th. — During the last two nights has slept at intervals, but 
was frequently awoke by wandering unpleasant dreams : dur ng the 
day he is tolerably easy, but towards night the pain increases. The 
thumb and finger are less swelled, the heat and redness the same 
— tongue clean, less dry — pulse 88, soft — bowels not open — Teels 
low-spirited and languid, and is unable to set about any thing — 
appetite improved. Ordered to continue the poultice and the bark, 
and to take two colocynth pills at bedtime. 
30/^. — The pain in the fingers was better till last night, when 
the fourth finger became hotter and more painful : his nights are 
still restless, and he is watchful — complains of headache and diz- 
ziness this morning, and of a little oppression in the chest. For 
several hours, yesterday evening, he suffered from considerable 
