Chronic Rheumatism.

This name should, according to all medical usage, represent
the continuation of an acute rheumatism in a less violent and pain­
ful form, and such cases are actually found under the name chronic
rheumatism. Yet this name, as ordinarily employed, designates
several affections, all of which are characterized by pains in the
joints or in the muscles, which have a tendency to persist indefinitely.
There is a form of chronic rheumatism which affects the patient like
the acute disease, except that the symptoms are less marked ; there
may be no fever, the pain and soreness are less intense, the tender­
ness on pressure is comparatively slight, and the swelling of the
joints may be scarcely noticeable. As in the acute variety, various
joints are affected successively; the disease may finally become con­
centrated and remain fixed in a single joint. In this disease there
is but little disturbance of the general health, insufficient, indeed,
to disturb the patient’s avocation. Yet there are instances in which
movements of the affected part cause considerable pain, and
patients may be even confined to the bed. After long continuance
of the disease the affected joints may present irregular enlargements
and stiffenings, while the muscles of these limbs become small from
lack of use.

In many cases of acute rheumatism, the severity of the pain
varies extremely with the weather ; so that such individuals are
usually able to foretell, by a few hours, the occurrence of cold and
moist weather. There is a variety of rheumatism, so-called, in
which the pain is felt chiefly along the leg bones, the “ shins,” and
occurs especially at night. This affection is often due to a syphilitic
taint, and will be discussed in speaking of syphilis.

Treatment.—One of the most important features of treatment
of chronic rheumatism, is care in wearing flannel next to the skin
throughout the year. The administration of drugs is by no means
certain to produce beneficial results. Some cases are materially
benefited by the regular employment of the hot air, or hot vapor
bath, the Turkish bath, etc. The fact is, that the treatment of
each case of chronic rheumatism is largely an experiment which
can be successfully accomplished after considerable time has been
spent in trials of drugs and remedial measures. Among the
medicines which are most frequently useful, are the iodide of potas­
sium, guiac, and cod liver oil.

The following formula may be
given :
Iodide of potassium, - - - Five drachms.
Tincture of guiac,            -                       Two ounces.
Water,                       -                               Two ounces.
Mix, and take a teaspoonful four times a day.

Other cases will be benefited by using colchicum with the
alkalies. An example of such mixture is the following :
Wine of colchicum root,           - - One drachm.
Bicarbonate of potassium, - - Three drachms.
Rochelle salts,                 -;         -             Three drachms.
Peppermint water          -                         Four ounces.
Take a tablespoonful three times a day.

Some of the various mineral waters are reputed to be effica­
cious in the treatment of chronic rheumatism, though they
generally seem to be valuable, if at all, merely as a subordinate
element in the treatment.

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