§156. A. Rheumatism of the extremities.

This is the most frequent form of acute rheumatism. The pain is violent, tearing, following the course of the muscles, generally limited to one extremity or only a portion of it; not continuous, but generally characterized by paroxysms of violence, aggravated by pressure and motion; the affected limb is stiff and sometimes swollen and red. The rheumatism is scarcely ever seated, wanders from the forearm to the upper arm, or from the upper to the lower limbs, or vice versa. The fever is generally mild, with profuse sweat and thirst.

§ 157. Aconite should be resorted to for this rheumatism, when the usual Aconite symptoms are present; violent orgasm of the circulation, congestion of blood to the head and chest, sympathetic affection of the heart, pleura or brain, etc. In most cases, however, Bryonia will be found indicated from the commencement, particularly by tearing or tensive-sticking pains in the muscles and joints, generally striking from above downwards, excited or aggravated by motion and pressure, and worse in the evening and at night, attended with stiffness and shining-red swelling; by tearing or sticking pains in the whole body, particularly in the wrist, elbow, knee and tarsal joints, with swelling and heat and radiating redness of the skin, violent headache, beating in the forepart of the head and vertex, profuse sour sweats and great thirst. Belladonna may likewise be of service for those symptoms.*

Colchicum is nearly related to Bryonia, particularly in affections of the joints without swelling or inflammatory redness, with general painfulness of the whole body, and great irritability during the pain which is frequently felt on one side of the body only, is most violent and frequent in the evening and at night, and is aggravated by motion and contact, particularly in individuals with great disposition to sweat and liable to be troubled with acidity, with a white and delicate skin, deficient and irregular action of the skin and increased irritability. Colchicum is moreover indicated when the rheumatism was occasioned in wet and cold weather, in the fall and spring.

* Bell. cures 'heumatism of the upper limbs, particularly the right, when the symptoms are violent a: d distressing, with creeping and tingling in the bones, excruciating, cutting or tearing pain, striking from the shoulder to the elbow-joint on raising the arm; see the pathog. sympt. - Hempel.

Other remedies for this kind of rheumatism are: Pulsatilla, Nux vomica, Chamomilla, Rhus t., Rhododendron, Dulc, Tinctura acris, Thuja,, etc. Pulsatilla* corresponds particularly to rheumatic pains, shifting rapidly from one limb to another, causing a swelling and redness, with evening exacerbations, violent tearing, drawing or jerking pains with numbness, lameness or swelling of the affected parts. Excessively acute rheumatisms and disposition to sthenic inflammations are not curable by Pulsatilla. Nux vom. is suitable for drawing pains with sensation as if the affected parts had gone to sleep and were lame, particularly in the afternoon hours; the pains appear periodically, and seem to point to an affection of the spinal marrow, the large muscles of the back, loins, chest and small of the back, with bruised pain and immobility of the small of the back and nape of the neck. Chamomilla is suitable to drawing or tearing pains, with sensation of lameness or numbness, particularly in the parts where the pain has abated; the tendons and the ligaments seem to be affected more than the muscles; there is no swelling; the pains are aggravated excessively at night, and by the warmth of the bed. Belladonna is useful for rheumatism with red, erysipelatous swelling, the least motion causing a most violent pain: the pains are wandering, with stiffness and swelling of the posterior cervical muscles, headache, aching-tearing pains deep on the bones, striking to the adjoining articulation like an electric shock, and terminating in the articulation in the shape of a dull pressure which is relieved by counter-pressure, aggravated by motion and exacerbating at night. Rhus tox. is indicated by tearing, tensive and drawing pains when worse during rest and at night by the warmth of the bed, relieved by motion, brought on by cold and by getting wet when perspiring; or it is indicated by rheumatic pains with pale-reddish swelling, intolerable creeping and throbbing, or lame feeling in the affected part. Rhododendron is excellent for drawing and tearing pains in the joints and limbs, most violent at night and during rest, leaving a feeling of stiffness and lameness in the joints, attended with periodical tearing pains in the lower limbs, with sensation of formication, swelling or redness of single joints, aggravated by stormy weather and rest, and not allowing the patient to sleep at night. Dulcamara cures the following symptoms: sticking, drawing and tearing pains in the limbs, as are frequently observed after the disappearance of acute cutaneous eruptions, or after a cold, generally exacerbating at night or in the evening, also during rest; the accompanying fever is characterized by great heat, dryness and burning of the skin, thirst, and exacerbates at the above-mentioned periods. The tearing, sticking pains in the joints in consequence of a cold, with numbness and deadness of other non-affected parts, and aggravation of the pains towards evening or in a cooler temperature, are cured by Causticum. Thuja removes a beating sticking in the joints and limbs, with painful cracking on stretching the affected parts, swelling of the cutaneous veins in the affected parts, and aggravation of the symptoms in a warm temperature.

+ Pulsatilla corresponds to rheumatic redness and swelling of the upper portion of the foot from the toes to the middle of the leg; the cure is effected very speedily. Sec the pathogenetic symptoms. - Hempel.