Rheumatism, a painful disease which principally affects the muscular parts, and larger joints of the body, in the direction of the muscles; such as the shoulder, hip, knees, etc. - If attended with fever, it is called the acute rheumatism ; but, in the contrary case, the chronic: in the former, the pain generally shifts from one joint to another ; in the latter, it remains in most cases fixed to a particular part. After the disorder has tortured the patient for some time, the joint is commonly swoln, red, and extremely painful to the touch.
As it is often difficult to distinguish rheumatism from gout, it should be remarked, that, in the former, the stomach is less affected ; that the disease is more confined to the larger joints ; that it occurs at an earlier stage of life ; and that it is not hereditary. In young persons, the upper and in-ternal parts above the midriff, but in the aged, those below the diaphragm, are more frequently liable to be attacked.- It is termed according to the seat of the malady: thus it is called lumbago, when seizing the loins; and ischias, or sciatica, when it rages in the hip. Rheumatisms prevail in cold climates, and mostly in spring and autumn ; though they may appear at any season, in consequence of sudden alternations of heat and cold.
The inhabitants of this island, suffering frequently and severely from rheumatic complaints, we shall briefly enumerate the leading causes, from which they arise, namely : suppressed perspiration, by moist, cold air, especially at night; damp clothes ; partial heat or cold ; suppression of chronic eruptions ; inhalation of metallic vapours ; violent passions ; and often too, after recovering from other disorders, such as fevers, fluxes, etc. in which cases it is generally chronic.
The acute rheumatism, in most instances, terminates between the seventh and fourteenth day, by perspiration, or urinary secretion, the sediment of which is copious, and resemblesbrick-dust: the chro-nic sometimes produces a looseness or eruption, but always requires a critical perspiration to remove it completely. When it, however, changes its place from the external parts, to any of the interior organs, where it lodges, the patient is always in danger.
Cure:- If the disease be attended with fever, every thing must be avoided, that may tend to irritate the system, or increase the violence of the circulation. The acute rheumatism being an inflammatory af-fection, the advice of the profes I sion becomes indispensable; in order to determine upon the pro-priety or necessity of blood-letting, and whether this operation is to be repeated : beside which, it requires total abstinence from animal food ; fermented and spirituous liquors; the use of a mild vegetable, or milk-diet 5 together with copious draughts of bland, diluting beverage. To avoid the debilitating efects of too frequent venesection, in cases of excruciating pain, espe-cially when attended with swelling and redness, recourse may be bad to leeches applied to the purr, or to cupping. The principal relief is next to be expected from gentle sudorifics, when the perspiration should he promoted by lukewarm drink. If the disorder be transferred from the external to internal parts, blisters must be applied to the spot, which was previously af-fected all other local applications, except warmth, are in such cases proper. After the complaint is removed, the patient should avoid sudden changes of temperature, and at the same time apply friction to the parts formerly diseased,During the whole affliction, if will proper to preserve regularity of
The chronic rheumatism is frequently consequent on the acute, when the latter has been mismanag-ed: hence it will be advisable to re--sortto such external and internal remedies, as may restore vigour to the -parts, and promote the necessary evacuations, especially a proper State of perspiration.. Gentle sudo-rifics, such as infusions of elder-flowers, white-wine whey,and ipe-cacuanba in small doses, have often procured.relief ; but the more active medicines, for instance, the oil of turpentine, guaiacum, and antimo-nials, mustbe cautiously prescribed. With the same intention, we shall observe, that the extract of the Large Blue Wolf's-bane (Acomtum, Na-pellus, L.) has been found uncommonly efficacious in restoring perspiration, and dispersing the swelling ; but, like other narcotics recommended for this purpose, it requires great circumspection.
As costiveness frequently retards the cure, it ought to be relieved by the mildest laxatives. The diet should, in general, be nourishing ; and generous wine, moderately taken, will greatly conduce to recovery. The external means are, warmth by flannel worn next the painful part ; frictions, vapour-baths, electricity, exercise, and the volatile liniment; but the other oils and unctuous preparations must be avoided; as they are apt to check perspiration, and thus to protract the disorder.—Lastly, blisters, and cataplasms of mustard, horse-radish, leaven applied to the suffering parts, or to their vicinity, have often prov-ed beneficial.
The Lumbago, Sciatica, &:c. being a species of the same disease, require a similar treatment ; though the rheumatism of the hip may, in general, be successfully removed by a blister six inches long, and four broad, applied to the outside of the leg, immediately under the knee, and kept in a state of suppuration, till the pain ceases.