Chapter 13 - Diseases of the General System and Miscellaneous Diseases
Introduction to Diseases of the General System and Miscellaneous Diseases
Blood Aneamia
Typhoid Fever
Prevention of Typhoid
Bilious Remittent Fever
Congestive Fever
Fever and Ague
Yellow Fever
Purple Disease
Bubonic Plague

13.14 Rheumatism


THIS is an inflammation of a peculiar character, being caused by acid or poisonous matter in the blood, and having for its seat the fibrous tissue or that thready texture which enters largely into the composition of the cords and muscles of the human body. The synovial, or lining membrane of joints, is also peculiarly subject to rheumatic inflammation. Hence the terms, muscular rheumatism, and synovial rheumatism. There are also acute and chronic rheumatism.

Lumbago is rheumatism in the muscles of the back, aggravated perhaps by sudden cold from sitting in a draught or by wet feet or other exposure.

For external application use the following:
White Soap, 4 ounces Oil of Rosemary, ounce
Camphor, 2 ounces Opium, ounce
Alcohol, 1 1/3 pints

Mix and filter. Apply as a liniment. This acts like a charm on the affected parts.
For prescription and general treatment of rheumatism see pages 526 and 527.

Acute Rheumatism

Is a very painful affection. It is most frequently brought on by exposure to wet and cold after violent and fatiguing exercise of the muscles.

Symptoms. Its principal characteristics are: high fever, with a full, bounding pulse; furred tongue; profuse sweat, which has a sour smell, and seems to increase the weakness without relieving the pain; scanty and high colored urine, with brick dust settlings; and swelling of the joints, with slight redness, great tenderness, and severe pain, which is particularly agonizing when the patient attempts to move.
This affection often changes suddenly from one part of the body to another, or from one set of joints to another. This sudden shifting, termed metastasis, is peculiarly dangerous; for sometimes the inflammation, seeming to regard the constantly moving heart as a large central point, suddenly seizes upon its lining membrane and occasionally proves speedily fatal.

Treatment. For articular rheumatism, some form of the salicylates must be used and continued till all pain and soreness have entirely ceased for several days. Omit all sweets, condiments, and much meat from the diet.
For relief of a pain locally in the joints a mixture of wintergreen oil, known in the drug store as gaultheria, and laudanum, two parts of the oil and one of laudanum, may be spread on ordinary cotton batting and wrapped around the joints, and a teaspoonful of this mixture which has been warmed in an iron spoon and then placed on the joints with the cotton batting will soothe the joint from two causes, the quieting effect of the opium preparation and the absorption of the wintergreen oil will produce the same effect as the salicilates which are of the same family and which it is recommended to take internally. This preparation is deadly poison and must be kept from the reach of children.
Salicylic acid and its salts, or salicin, the active principle of the willow bark, when given at the commencement of an attack, oftentimes arrests the course of the malady as effectually as quinine arrests the intermittent fever, or as opium and ipecacuanha arrest dysentery. It exerts such a beneficial influence that it is recognized by the profession as a specific. From ten to fifteen grains of salicylic acid, or the salicylate of soda should be given every two hours until relief is obtained. This usually takes place in from twelve to thirty~ six hours. In most cases the fever and swelling will abate within the above time. If not entirely arrested, the disease is very much shortened.
When the specific effect is produced on the system, it causes vertigo, headache, ringing in the ears. These symptoms indicate that the medicine should be reduced in amount.

Chronic and Muscular Rheumatism.

The, chronic form of rheumatism may follow the acute as its consequence, but is more often an independent disease. It is seldom attended by fever, and in this differs from the acute rheumatism. It often lasts a long time, and causes much suffering.

Symptoms. These are various, but are generally understood, even by the common people, to consist of pain, lameness, stiffness, etc., in the joints and muscles. The joints are often swollen, but not as much as in the acute disease. It is peculiar to this form of the complaint, that when the patient remains at rest for a time, he will have pain and stiffness in the affected part on beginning to move, but as he grows warm both will disappear.

Treatment. This complaint is often palliated, and sometimes cured, by passing a current of electro magnetism through the affected part. The diet is all important; no sweets nor fats should be allowed, nor spices and other rich condiments are to be taken; meat is to be eaten but once a day,
The tincture or the fluid extract of black cohosh, taken in full doses. is one of the best remedies. It may be taken alone or mixed with the tincture of poke berries, and a tincture of prickly ash bark, if convenient.
Opium and nitre (127) form a valuable remedy. Colchicum is much used, and has a deservedly high reputation (292), (301).
Liniments often have a good effect (190), (195), (196), 198). it is well to wear a piece of oiled silk over the affected part. It keeps up a gentle perspiration from the rheumatic surface, and materially hastens a cure. Iodide of potash in ten to thirty grain doses, with one third glass of water, after food, three times daily, is an old but very efficacious remedy. The salicylates in this form are not without their special value, but are not so useful as in the acute form. The 11 Wonderful Wintergreen," lodia, Tongalin, are a few of the well-known reliable preparations that may be found on the market, each of which well deserve a trial in chronic rheumatism.
To bathe the affected joint at bed time with hot sweet oil, and then envelop it in cotton batting, to be kept on through the night, will often give much relief. Oil of cajeput relieves a large proportion of cases.
The bowels must be kept regular, and all exposure to wet feet or clothes, and to currents of cool air when sweating, must be carefully shunned.

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