Transactions_, 1816, p. 485.

[Footnote 15: The spinal marrow, within the canal of the
sixth vertebra dorsi, was completely destroyed by a musket
ball. The person lived four days.]

In two of the cases already noticed, symptoms of rheumatism had
previously existed; and in Case IV. the right arm, in which the
palpitation began, was said to have been very violently affected with
rheumatic pain to the fingers ends. The consideration of this case, in
which the palpitation had been preceded, at a considerable distance of
time, by this painful affection of the arm, led to the supposition
that this latter circumstance might be the cause of the palpitations,
and the other subsequent symptoms of this disease. This supposition
naturally occasioned the attention to be eagerly fixed on the
following case; and of course influenced the mode of treatment which
was adopted.

_A. B._ subject to rheumatic affection of the deltoid muscle, had felt
the usual inconveniences from it for two or three days; but at night
found the pain had extended down the arm, along the inside of the
fore-arm, and on the sides of the fingers, in which a continual
tingling was felt. The pain, without being extremely intense, was such
as effectually to prevent sleep: and seemed to follow the course of
the brachial nerve. Whilst ascertaining the propriety of this
conclusion, the pain was found to ramify, as it were, on the fore and
back part of the chest; and was slightly augmented by drawing a deep
breath.

These circumstances suggested the probability of slight inflammation,
or increased determination to the origin of the nerves of these parts,
and to the neighbouring medulla. On this ground, blood was taken from
the back part of the neck, by cupping; hot fomentations were applied
for about the space of an hour, when the upper part of the back of the
neck was covered with a blister, perspiration was freely induced by
two or three small doses of antimonials, and the following morning the
bowels were evacuated by an appropriate dose of calomel. On the
following day the pains were much diminished, and in the course of
four or five days were quite removed. The arm and hand felt now more
than ordinarily heavy, and were evidently much weakened: aching, and
feeling extremely wearied after the least exertion. The strength of
the arm was not completely recovered at the end of more than
twelvemonths; and, after more than twice that time, exertion would