Treating Rheumatism With Sulphur

The friction of rheumatic limbs with sulphur is as ancient at least as Pliny (lib. xxxv.), and attention was specially directed to it again some years ago by Dr. Fuller, Dr. O'Connor, and others (Medical Times, i., 1858). They found it useful also in sciatica and lumbago, adding to the frictions close and constant covering with flannel. Renard found it very serviceable in rheumatism affecting tendinous parts, in his own person, after an acute attack; it produced some degree of heat and increase of perspiration when it acted well. It should certainly be tried in all obstinate forms of rheumatism, and especially that form which attacks the soles of the feet in those who are exposed to damp and cold.

It is in the different forms of chronic rheumatism and chronic skin disease that baths of sulphurous waters, as at Bareges and Aix-la-Cha-pelle, are found most valuable.

Treating Rheumatism With Iodine (Iodum)

Dr. Graves was one of the first to indicate the value of iodide of potassium in rheumatism, and it is now well established. I connect its efficient anti-rheumatic action mainly with an eliminant action through the kidneys, and to promote this, recommend it to be largely diluted and combined with bicarbonate of potash in acute cases. To prevent irritation of the stomach, the medicine may be given in an effervescent form. Sometimes, if the patient be feeble, and the urine abundant and of low specific gravity, the iodide may be combined with hydrochloric acid and quinine, as recommended by Dr. Southey. When effusion has occurred into the pericardium or the joints, tincture of iodine or iodides are certainly indicated. In muscular rheumatism they are useful, especially in those cases where the pains are made worse by warmth. This is one character of periosteal and syphilitic pain, and possibly some of the good results obtained from iodide of potassium in cases of chronic painful joints, sciatica, and lumbago, may be explained by its removing a latent specific or mercurial, or other metallic taint. In cases of chronic rheumatism, small doses of iodide, continued for a long time, often act exceedingly well; but some patients are very sensitive to its physiological action, and need special care to secure its toleration (v. pp. 68, 94).

Treating Rheumatism With Bromine (Bromum)

The bromide of ammonium has been found extremely useful in acute rheumatism by Da Costa (American Journal, April, 1871). Gueneau de Mussy also praises the bromide for the same malady. For subacute cases, for rheumatic gout, and for the resulting stiffness and nodosity of joints, the bromide of lithium is recommended (Bartho-low). This remedy is certainly valuable for relieving the wakefulness and delirium of rheumatic fever; morphia may occasionally be well combined with it.

Treating Rheumatism With Citric Acid (Acidum Citricum)

To the observations already made on this subject (vol. i., p. 96), I have to add that citric acid is specially indicated in those perhaps exceptional cases of rheumatism when the urine is alkaline, either from some peculiarity in the attack or from too prolonged use of alkali, and when depression is a marked symptom. In such a condition occurring together with bronchitis and valvular disease in a gouty subject I have seen lemon-juice given with some alcohol relieve after failure of alkalies, iodides, etc.

In Scorbutic Dysentery, lemon-juice was commended by Sir William Ferguson (Edinburgh Medical Journal, October, 1837), and for ammon-iacal urine by Dr. Bence Jones. I have used it in the latter condition, and found it serviceable.

Treating Rheumatism With Kalium (Potassium)

The carbonate of potash, dissolved in a bath of warm water, is often useful to relieve pain in the joints, and irritable eruptions in rheumatic and gouty subjects. The sulphuret of potash, on the other hand, furnishes a bath which stimulates especially the muscular system, and has proved useful in plumbism, in locomotor ataxy, and other forms of paralysis; it has the distinctive properties of sulphur. The silicate of potash, or "liquid glass," applied on saturated band-.ages, makes an excellent splint for fractures (Darby: Medical Times, ii., 1870).

Treating Rheumatism With Zinc (Zincum)

Among the rarer uses of zinc salts may be mentioned that of the cyanide in articular rheumatism; it was strongly commended by Luton, as relieving pain and lowering vascular excitement (Bulletin, January, 1875). Other observers find it also of some, but not definite, value; it is apt to cause headache (Medical Record, i., 1877).