which, from their situation, it is not in the power of man to coerce, Ambrose Paré, in introducing the tying of arteries in amputation, is not the author of the most important improvement ever made in the operative branch of the healing art; or, because we meet with ulcers so vitiated as to admit of being cured by no mode of treatment, that the use of bandages, as introduced by Mr. Baynton for the cure of old ulcers, is not the most valuable improvement that medical surgery has received in modern times. Cinchona does not always cure intermittent fever, nor mercury syphilis. But would any man be so mad as to reject these remedies as not generally to be depended on, for the cure of these diseases?

On the 16th January,

residing at Cramond,

came to consult me about a rheumatic affection, of many years' standing, in his left haunch. His knees and thighs had also been affected, and are still feeble, but free from rigidity and pain. Walks with a timorous irresolute step, the one foot often involuntarily kicking the other. I applied a bandage to both knees, beginning a little below, and carrying it a little above the joints. This gave him a command of his limbs, he said, to which he had been a stranger for many years. His principal complaint, however, was situated immediately under the crest of the left ilium. As soon as I ascertained this, I was sure of being able to afford him relief; for the smooth surface of the bone I knew would present an equable resistance to pressure from without. I began, therefore, with desiring the patient to perform the various motions of which the trunk of the body is capable in its sound state. But this was a task to which he was altogether unequal. His body, indeed, had been confined to a prone posture for a great length of time. He could tie the shoe of his right foot with ease, but could not reach farther than the middle of the left leg. I put him, therefore, in this position; desiring him to point, at the same time, to the spot that checked his stooping farther. This done, I pressed my hand against the part affected, and desired him to put his hand down to his foot. This he did at once, and with facility, to his own astonishment, and to that of his son-in-law, who looked on. Having several times practised this, and other motions of which he was formerly incapable, I applied a compress and bandage,

formed of such materials as were at hand, and sent him away rejoicing.

On the 9th January, I was called to Mr. B. a gentleman traveller, lodged in the Black-bull inn, who informed me he had been arrested on his journey, for four weeks before, by acute rheumatism, and that he had been attended by His father, who had come from Whitehaven to see and carry home his son, having heard, in the town, of the successful application of bandages in the cure of rheumatism, mentioned, on his return to the inn, the circumstance to the patient, who took no rest till his father brought me to him. I stated the impropriety of my interfering with the patients of another practitioner in his absence. But the young gentleman told me, "he had not seen his doctors for some time; that he conceived they did not intend to visit him any more, he having been out; and, at any rate, he was not to be deprived, on account of any trifling piece of etiquette, of the benefit of the bandages, if benefit was to be obtained from them."

This gentleman I found convalescent, but complaining grievously of pain in his left hand, which was also much swelled; of pain and stiffness of the left elbow; of pain and weakness about the left shoulder; of pain and rigidity of the muscles of the back of the neck; of weakness and pain upon motion, all along the spine; and of pain and stiffness of the left knee, the outside of which he could scarcely suffer to be touched.

I began with desiring the patient to show me how he could walk. He moved and threw his weight upon the left leg, slowly and timorously, as if afraid to trust himself upon it. But no sooner was a bandage applied, than he planted his foot firmly, and walked with great freedom, declaring that, in respect of his knee, he felt quite a different man. I next proceeded to examine the state of his left arm, and found the range of motion it possessed very circumscribed indeed. He could not even put his hand to his mouth. Upon application, however, of a bandage, from the points of the fingers to the elbowjoint inclusive, he could do it freely. On account of the patient being very much fatigued, I did nothing at this call to the shoulder, farther than grasping it with one of my hands, in VOL. VI. No. 21.

C

order to show him what could be done. Upon this, he moved his arm with great facility in every direction.

January 10th.-Passed a good night, having slept from eleven to five without interruption. Pain of the left hand and knee greatly abated; in other respects as before. Removed the bandages and ordered the diligent use of the flesh-brush, for a considerable time, to the parts affected, which was extremely grateful to the patient. Applied the bandages as before, and also to the left shoulder, making a turn under the right, by which two breadths of the roller were made to press upon the back of the neck, a circumstance that also gave much pleasure and satisfaction.

January 11th.-Pain of the left knee, wrist, and elbow almost gone. Muscles of the neck also much relieved. Swelling of the left hand greatly abated. Motion of the left arm entire, and much more vigorous. Omit the bandages.

January 12th.-Has slight pain and stiffness to-day, in both ankles. In other respects improving. Swelling of the left hand entirely gone. Applied bandages to both ankles.

January 13th.-Was out yesterday; but says the pain and stiffness of his ankles were such, that he could not have walked at all without the bandages. Is resolved to have a set of them to carry along with him. This, I think, sufficiently indicates the opinion he entertains of their utility. It is, indeed, in such cases as this, that the pre-eminence of bandages in the cure of rheumatism is most conspicuous. Let us suppose that bandages had not been applied to this gentleman's ankles,—he must of course have remained at home; let us suppose that I had confided to rubefacients and flannel, for the removal of his pains, when would the desired effect have been produced? in a day? a week? a month? No man can answer these questions. One thing only is certain,-that the longer a patient in such circumstances is confined to the house, the longer is his general health of being restored. But no sooner were the bandages applied to this gentleman's ankles, than he was enabled to walk abroad. The consequence was, he returned with an appetite greatly improved, and with a universal glow and moisture of the skin, which are most successfully promoted

by action in the open air, and of more real benefit to a rheumatic patient, than all the sudorifics in the world.

On the 15th of December last, I was called to a young man, Simon Stewart, at the west end of the town, whom I found in a condition that almost beggars description. Pale, ghastly, emaciated, he had been a martyr, for three years uninterruptedly, to rheumatism in its most cruel forms. His fore-arms, half bent, felt like two boards, and were so immoveably fixed in the prone position, that he could not see the palms of his hands. till they were elevated above his eyes. Had no motion at the wrists; the right carpus, especially, was pained, swelled, distorted, and the command he had over his fingers was so small, that for a considerable time he was under the necessity of being fed by others. In the left knee, there was great effusion and pain; it had very little flexion and extension, being almost fixed in the half-bent posture. Both his ankles were pained, swelled, and distorted. He had not been able to stand even, on the soles of his feet, for the last twenty-three months. Sometimes, indeed, within that period, he had walked a little, but he did so by turning his heels outwards, and resting his weight on the outer edges of his feet. In this way he would crawl from his bed, along a range of chairs, to the fireside. Such was this man's situation when I first saw him. At the beginning of his illness he had declined going to the hospital, where he was offered the warm-bath free of expense; but had, notwithstanding, been attended by a host of medical men in succession; one of these, in particular, had done every thing for him that skill could devise, or philanthropy suggest, but, long before I was called in, had also given him over as incurable. Having satisfied myself as to the state of the patient, I applied a roller of flannel to the arms, from the wrists to the elbow-joints inclusive; in like manner to the knee; and, lastly, to both ankles. This done, I desired the patient to come out of his bed and dance. He descended very slowly and timorously, but getting his feet to the ground, and finding he could stand, he at last stepped out, declaring, that if his knee had not been bound so tightly he could have leaped the height of his stick.

December 21st. Has had great pain in the knee, especially in the night time, ever since the bandage was applied, which

has therefore been laid aside. Some rotatory motion of the fore-arms. Apply a compress of flannel to the aponeurosis plantaris of the left foot.

December 25th.-Rotatory motion of the fore-arms increasing; motion of the left wrist very considerable; had none at the beginning. Some pain among the tarsal bones of the left foot, but can stand on both soles. The compress to the left foot a great improvement to his walking; to which, he thinks, there is no obstacle but the knee.

December 28th.-Fore-arms more plump in their appearance, and the skin of a more kindly feel. Walked from his bed to the fire-side, without a stick, or any other support. This is the first time he has done so under my care. Feet quite the natural shape, and sets them down without fear or dread. No impediment to his walking abroad but the knee. Can turn his hands half-way to the supine posture.

To be rubbed with great diligence all over the knee-joint, twice a-day.

December 31st.-Circumference of the knee diminished three-eighths of an inch. Attempted to walk without the bandages about his feet and ankles; could not set down his feet with confidence and firmness. Applied the bandages, when he walked with the utmost ease, knee excepted.

January 5, 1815.-Had pain among the tarsal bones of the right foot night before last;-gone to-day. Thermometer yesterday and to-day at 40; weather hazy and damp. What is the reason that people subject to rheumatism are so much affected upon the change of weather? I firmly believe it is owing to sympathy between the parts affected and the lungs. This is no extravagant idea. According to our theory, the white parts are the chief seat of rheumatic affections. Now, a great proportion of the lungs consists of cellular substance. Besides, we every day observe sympathies much less explicable than this: between the parotid gland, for instance, and the testes; the kidneys and the stomach; and, what is more directly in point, betwixt the urethra and eye, in gonorrhea. I am aware of a question that may be started here, namely, can a part distant from the lungs