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We have carefully examined and considered this case and are
sorry to find observe that from the length of time that it has conti¬
nued and from the degree of frigidity that has taken place in the
joint, there are now little hopes of recovering the motion of it
However as it is not possible for us to be certain of that and
as there can be no harm in making certain trials, we shall propose
what we think most likely to be of service.

Let the joint be fomented twice a day with the Decoction
ordered below. It is to be done by a double ply of flannel
cloth wrung out of the warm Decoction and wraped round
the joint and when one cloth begins to cool, another
warm one is to be applied and the fomentation is thus to
be continued for an hour together. The Decoction is
kept almost boiling hot and cloths as taken out of it, are to
be wrung ou thrown into a strong towel and wrung strongly by
twisting the two ends of the towel, so that the flannel may be
wrung very dry and at the same time very warm. If they are
wrung very dry they may be applied very warm, but still should
be no warmer than Miss Campbell can easily bear. When they are
applied a piece of dry flannel may be applied above them to keep
in the heat the better.

While this fomentation is employed, every five minutes a
trial should be made to m bend the joint and to move it back¬
wards and forwards as far as Miss C. can easily bear it and it
is hoped that by gentley trials it may be brought by repetition
to bear motion more and more ––––

When the fomentation has been contd for an hour, the joint
is then to be dried and to be anointed diligently with the oil ordered
below. The oil is to be warmed by setting the Phial in a bason of
warm water and a part of it is to be poured out out upon a
teaplate, that has before been very well warmed by lying a
little in boiling water. From this plate the oil is to be taken
upon the tips of the fingers and with these the joint is to be
anointed all around rubbing in the oil gently but continuing
the unction for the space of ten minutes and then wraping
up the joint in a piece of dry flannel.

Not only during the fomentation & unction is the mo¬
tion of the joint to be attempted but also at many ↑other↑ times of the
day & particularly Miss C. should be enjoined to make fre¬
quent trials to move it with her other hand and some
other persons should try to move it as much as Miss C.
will easily bear, but always as we say fair and sofly, for
it is by repeated and gentle efforts & not by force that
it can be effected

By pains assiduously in this manner taken we
have seen some old and obstinate stiffnesses mended and
we hope that Miss C.s may be so too, but we must at
the same time observe that if in the space of a fort¬
tnight some progress is not made in recovering the
motion of the joint, we shall doubt if it is possible & we shall
hardly think it safe to push the trial much farther.