This is a disease characterized by pyrexia, pains in the joints, increased by the action of the muscles belonging to the joint, and heat of the part. The blood, after venaesection, exhibits an inflammatory crust. Rheumatism is distinguished into acute and chronic. The acute is preceded by shivering, heat, thirst, and frequent pulse; after which the pain commences and soon fixes on the joints. The chronic rheumatism is distinguished by pain in the joints, without pyrexia, and is divided into three species; lumbago, affecting the loins; ischias or sciatica, affecting the hip; and anthrodynia, or pains in the joints. The acute rheumatism mostly terminates in one of these species.

Rheumatism may arise at all times of the year, when there are frequent vicissitudes of the weather, from heat to cold, but the spring and autumn are the seasons in which it is most prevalent; and it attacks persons of all ages; but very young people are less subject to it than adults.

Obstructed perspiration, occasioned either by wearing wet clothes, lying in damp linen, or damp rooms, or by being exposed to cool air when the body, has been much heated by exercise, is the cause which usually produces rheumatism.. Those who are much afflicted with this complaint, are very apt to be sensible of the approach of wet weather, by finding wandering pains about them at that period.

Acute rheumatism usually comes on with lassitude and rigours, succeeded by heat, thirst, anxiety, restlessness, and a hard pulse; soon after which, excruciating pains are felt in different parts of the body, but more particularly in the joints of the shoulder, wrist, knees, and ancles, or perhaps in the hip; and then keep shifting from one joint to another, leaving a redness and swelling in every part they have occupied, as likewise a great tenderness to the touch. Towards evening there is generally a great exacerbation, or increase of fever; and during the night, the pains become more severe, and shift from one joint to another.

Early in the course of the disease, some degree of sweating usually occurs; but is seldom so copious as either to remove the pains or to prove critical. In the beginning, the urine is without any sediment; but as the disease advances in its progress, and the fever admits of considerable remissions, a late-ritious sediment is deposited; but this by no means proves critical.

Chronic rheumatism is attended with pains in the head, shoulders, knees, and other large joints, which at times are confined to one particular part, and at others shift from one joint to another, without occasioning any inflammation or fever; and in this manner the complaint continues often for a considerable time, and at length goes off.

No danger is attendant on chronic rheumatism; but a person having been once attacked with it, is ever afterwards more or less liable to returns of it; and an incurable anchylosis is sometimes formed, in consequence of very frequent relapses. Neither is the acute rheumatism frequently accompanied with danger: but in a few instances, the patient has been destroyed by general inflammation, and now and then by a metastasis to some vital part, such as the head and lungs.

Acute rheumatism, although accompanied with a considerable degree of inflammation in particular parts, has seldom been known to terminate in suppuration; but a serous or gelatinous effusion takes place.

Rheumatism seldom proving fatal, very few opportunities have offered for dissections of the disease. In the few which have occurred, the same appearances have been observed as in inflammatory fever, effusion within the cranium, and now and then affections of some of the viscera.

The faculty in the acute rheumatism, recommend the general antiphlogistic plan of treatment to be pursued, so long as the febrile and inflammatory symptoms are severe. When the patient is young, abstraction of blood, particularly when the disease attacks any important part, is necessary; but the great object after freely opening the bowels, is to procure a general and mild diaphoresis by antimonial and mercurial preparations, assisted by opium or other narcotic, which may also alleviate the pain, and occasionally by the Warm Bath, where the skin is particularly harsh and dry. Digitalis, by moderating the circulation, is sometimes usefully conjoined with these medicines. As the fever abates, and the strength appears impaired, tonics are given to promote the convalescence of the patient, and to obviate a relapse. When the disease is situated in a particular part, fomentations and other local means are employed. In the arthrodynia, or chronic rheumatism, the remedies of chief efficacy are stimulant diaphoretics in moderate doses regularly persevered in, assisted by various local means of promoting the circulation through the affected part.

Anodynes are used both internally and locally; and the greatest attention is, or ought to be paid to the several functions of the body.

This is the mode of treatment usually adopted by the faculty: I do not dispute the efficacy of such means as are here laid down, but I have cases to prove the inefficacy of them in many instances: the following testimonials must speak for me again.

My success, or good fortune, or, gentle reader, call it by what name you please, has been my very close attendant on every case of rheumatism that has come before me: - I may add, I have seldom failed in affording permanent relief; and I am still led on to hope, that I may be enabled to effect even more singular services to the afflicted, than I have yet, from time and circumstances, had it in my power to perform.