In acute articular rheumatism ich thyol (25 to 100 per cent.), rubbed into the affected parts, has seemed to relieve pain without causing irritation. Per sonal preference, however, is for a mixt ure of salol, ether, and collodion—of the first two, a drachm each, to an ounce of the latter—painted on the affected joints twice or oftener daily; this has certainly resulted in relief of pain, even if no per manent benefit ensued. Sodium salicy late exerts a more prompt and decided action than salicylic acid, and should be given to an adult, 10 to 20 grains every two to four hours until the desired effects are obtained, or until tinnitus is induced, after which the dose may be lessened or salicin substituted. Baker (Amer. Pract. and News, July 11, '96).
Hydrotherapy recommended for rheu matism, the following methods being used: (1) the administration of pure, soft water at frequent intervals, about 4 litres being given to an average man per day; (2) irrigation of the intestinal tract with water to which a little liquid soap has been added; (3) thorough moistening of the body, either by bath ing, the wet pack, or by sprinkling. E. Lee (Jour. Amer. Med. Assoc., July 25, '96).
Lactophenin has a well-nigh specific effect in acute articular rheumatism, ad vantageously replacing salicylic acid and the salicylates where these are fruitless and intolerable. The dosage is 7 '/, to 15 grains, repeated several times a day. G. von Both (Wiener klin. Woch., vii, 37, '98).
Ichthyol applications, employing one of the following formulas, recommended in articular rheumatism:— 1. Ff, Ichthyol, 10 grammes. Distilled water, 10 grammes. Adeps lane, 30 grammes.
2. P Ichthyol, 10 grammes. Adeps lance, 20 grammes. Extract of bellad., 1 gramme.
3. 11 Ichthyol, 10 grammes. Diluted alcohol, 10 grammes. Distilled water, 40 grammes.
M.
Arendt (Jour. des Prat., No. 29, '98).
Methylene-blue employed in rheuma tism. It does not diminish pain, but lessens fever. In treatment of rheuma tism its value is equal to salicylate of soda. It is necessary to employ a pure product. Le Moine (Le Prog. M6d., Feb. 4, '99).
Aspirin has only a slight taste and can be easily administered, being given diluted with sugar and water on a spoon or in milk. As it is insoluble in acid fluids, it passes unaltered through the stomach into the intestinal canal, where it is decomposed and absorbed in the form of nascent salicylic acid.
Aspirin shortens the course and sever ity, and relieves the pains in rheuma tism. It does not act as the salicylates do on the stomach, and does not pro duce tinnitus or headache. It seems to reduce temperature, and has no bad effects on the heart or nervous system. C. A. Protin (Merck's Archives, July, 1901).
The complications of the acute articu lar rheumatism are to be treated accord ing to their nature and the indications of each; the hyperpyrexia and the cere bral rheumatism may necessitate the ap plication of tepid and even cold baths combined with large doses of antipy retics; in the complication with endo carditis digitalis must be employed, etc. When the fever declines, but one or more articulations remain swelled and pain ful, it has been recommended to employ bandage for some time. Also baths of hot water or, better, of hot air will in many cases bring relief.
Hot, dry air, though an old remedy, has recently been considerably used, such reliable writers as Landouzy and Dejerine, of Paris, having reported marked success with it at temperatures varying from 200° to 250° F., in the various forms of rheumatism.
According to A. Graham Reed (N. Y. Med. Jour., Sept. 17, '98), the blood be comes heated from 1° to 5° F., and this seems to be the therapeutic factor. The heat stimulates vascular activity, reduces localized congestion, and stimulates metabolism. Profuse diaphoresis is pro moted without the unpleasant head symptoms usual in a steam-bath, as the patient breathes the ordinary air of the room.
Various effects of local application of superheated air. Local and general per spiration is induced in amounts from 16 to 25 ounces; to this loss of perspiration the reduction of body-weight is due. The body-temperature rises, but usually less than 2° F. The pulse-rate increases slightly during the application of the method, and upon its cessation gradually returns to its normal rate. Hence the harmlessness of the method, and its slight and temporary influence upon the general condition. M. Mendelsohn (Zeit. f. Diiitetische u. Psysik. Ther., H. 1, S. 52, '98).
No treatment has been found able to prevent surely the complications or re currence, but most authors agree that the use of salicylates in sufficient doses continued for some time after the re turn of normal temperature gives the best results in both respects.