The preventive treatment of rheumatism consists in thoroughly clothing the body, wearing flannel next to the skin, protection from exposure to cold and damp, especially sudden checking of the perspiration, and avoidance of too free use of animal food of all kinds. The excessive use of salt, and of the various condiments, together with the use of alcoholic liquors and tobacco, produce an undoubted tendency to this disease. As soon as possible after the attack begins, the patient should be placed in a hot blanket pack, in which he should be kept for several hours. As a general rule, the longer the pack is continued, the better the effect. The pack should be continued two to four hours at least, and may be repeated two or three times within the twenty-four hours with advantage. In the Mt. Sinai hospital, of New York, this plan of treatment has been adopted almost to the exclusion of other methods, and with marked benefit. In some cases, the patients were left in the pack all night. We have employed this plan of treating rheumatism for a number of years with most excellent success, patients having all made good recoveries without complications. Hot air, vapor, Turkish and Russian baths are also valuable, as well as the hot pack, but less serviceable on account of the pain occasioned by moving the patient in the administration of the bath. Hot fomentations applied over the affected joints give great relief.

The joints should be kept constantly enveloped in warm applications. Moist heat may sometimes be exchanged for dry heat, in the form of bags filled with salt, sand, or corn-meal, or some similar substance, as hot as can be borne. Hot-water bags constitute the best method of applying dry heat in these cases. The patient should be allowed an abundance of drink. Lemonade, with a very little sugar, is one of the best drinks, as the juice of the lemon seems to have some influence upon the disease, in some cases. The sour perspiration should be frequently removed from the skin by rubbing with dry flannels. Warm sponge baths often add to the patients comfort. An eminent French physician has recommended the application of cold water to the sound part of the body, the water being injected into the tissues near the joint corresponding to the affected joint, by means of the hypodermic syringe. He claims to have obtained almost marvelous results from this mode of treatment. When the fever rises very high, it is, in some cases, necessary to administer a prolonged cool bath. The patient should be put into a bath about the temperature of the body, the temperature of the water being gradually lowered to seventy-five or seventy degrees. The bath should not be prolonged sufficiently to produce marked chilliness on the part of the patient. We have never resorted to this measure, though it is highly recommended by some eminent authors. It is a somewhat severe one, and is attended by slight danger of occasioning rheumatism of the heart, and when employed should be used with very great care on this account. The employment of tepid sponge baths, repeated every hour or two, or more frequently, if necessary, is a safer means in these cases. When hot fomentations seem to increase the pain in the joints, cool or cold applications may be employed.

The diet of the patient during the attack should consist wholly of simple preparations of fruits and grains. Meat, beef-tea, and all other animal food, excepting milk, should be wholly avoided. The use of meat after convalescence is begun, is a frequent cause of relapse, hence flesh should not be eaten for some weeks after recovery.

If symptoms of inflammation of the heart arise, the patient should be kept upon a very low diet, or should take little or no food for a day or two. Hot fomentations and poultices should be constantly applied to the chest, covering the whole left side. The patient should have an abundance of fresh air, but should not be exposed to drafts.

The number and variety of drugs which have been employed for rheumatism are almost endless. Scarcely a month passes which does not bring to light some new remedy, which is pronounced to be a panacea for this disease. The unreliable character of these remedies is shown, however, by their great number and variety, which is sufficient evidence that they do not accomplish what is claimed for them.

Prof. Niemeyer expresses very little confidence in medication of any sort as a means of shortening the duration of this disease, and the investigations of Dr. Flint and Dr. Sutton, already referred to, show that good nursing, without any medication whatever, secures as speedy recovery as the use of any known remedies. If any remedy at all is to be taken, ordinary baking-powder, taken in doses of half a thimble-full, dissolved in water, once in three or four hours, answers as good a purpose as anything which can be used. It is well to allow the patient to take lemon juice or eat lemons as freely as he desires. Several may be eaten every day with advantage. Salicylic acid, which has been recently recommended for rheumatism, does not sustain the reputation given to it, and sometimes serious symptoms have been produced by its free use. In severe cases of rheumatism, a physician should be called when one can be obtained.

Sub-acute Rheumatism is a form of the disease in which the symptoms are less acute, but continue a longer time, the patient being subject to frequent relapses. It often follows the acute form of the disease. The treatment is essentially the same as that described for acute rheumatism.