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142 CASIiJS ILLUSTRATING THE TREATMENT.
transmitted to the intiamed piles when I made the vibrations. I
subjected one side at a time to manipulation. I treated the
patient twice a day up to the 24th, the duration of the treatment
decreasing with each sitting. I also gave frictions over the sensory
nerves on the sacrum, and over those on the "luteal reo-ion
After that I made shakings and tapotement of the liver; nerve
frictions in the back opposite the lower angle of the scapula on
the right side ;
and lastly, general petrissage of the abdomen. I
supplied the patient with some corrosive sublimate solution and
lint for the journey, in order to keep the ulcers clean.
XIX. STIFF Kl^EE FORCIBLY BEOKEN DOWK
The following case dates as far back as the summer of 1884,
when I was in charge of my brother’s institution in London.
Dr. Thomas Easton, of Stranraer, was also there studying
the treatment. He has been kind enough to send me the
notes which he took of the case at the time. They are as
follows :
Paul W., Holly Bank, Sheffield, engineer, suffered from rheu-
matism for many years. It was first contracted at a colHery
work, where he was often exposed to damp and cold. At first
the rheumatism was mostly confined to his right shoulder. In
February 1883 he felt the pain in his right knee, but after
applying cold water to it for a day or two it disappeared. He had
then a period of six months during which his health was \Qxy
good. In N"ovember of the same year the rheumatism returned,
and his right shoulder was severely affected. At this time he had
a fall, bruising the right knee. The rheumatism spread more
over the body, attacking the left hand, and finally seemed to
settle permanently in the right knee. The patient was then
confined to bed for ten weeks, during which his knee was kept
at rest.
Hot fomentations and blistering were tx’ied, and subsequently
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