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Case Tx

pain and free

CASE TX. A man, met. 35.. Had an attack of rheumatic fever when 18 years of age. Was laid up for two months. Has suffered from occasional pains in the joints almost ever since. Thinks he has never been more than three months together quite free from pain. Its usual seats are the knees, ankles, and wrists. Generally only oue joint is affected at a time. For the last few mouths the pain has been more troublesome, especially in the right knee.

December 8th, 1878: Has pain and stiffness of the right knee and ankle. Neither joint is swollen, but both are tender on firm pressure. Heart sounds normal; pulse 74, temperature 98.6. To have thirty grains of salicin every two hours.

9th : Feels decidedly better.

11th: Is free from pain and more comfortable than he has been for many months. Has had in all 31;0 grains of salicin.

He continued it three times a clay, in twenty-grain doses, for several weeks ; and by my advice took it for sonic mouths twice a clay.

In December, 1879, he wrote to me as follows : "It is just a year since you prescribed the salicin for me. I thought it might interest you to know that I have continued to take it ever since, off and on. The 'dose I take is twenty grains once or twice a clay. I have never passed more than a week without it. I was never better in my life than I have been during the past year, and never so free from pain." The heart is less apt to suffer in the chronic than in the acute and subacute forms ; but it does sometimes become involved. The cardiac trouble partakes of the general slowness of the ailment, and is dom detected till the patient begins to suffer from some of the sub jective phenomena of heart disease.