Several species of rheum, and garden varieties of them, are cultivated for the sake of the petioles of the leaves, which are much used to make tarts in spring. The cooling and gently aperient properties of these render them grateful and beneficial to most persons ; but indi viduals prone to ealculom complaints should carefully avoid thein,and all vegetables which owe their acidity to oxalic acid, as the formation of the oxalate of lime, or mulberry calculus, may be the consequence of indulgence. This observation applies equally to the species of Rumex which are used as sorrel. [CrcEn. Antrus:Em.] (Pereira's 'Mat. Mel') It1IEU3IATISM (from iSevaarserabs," a deflexion"). It is probable that this term was originally adopted during the prevalence of the doctrines of the humeral pathology, when every disease attended with swelling was attributed to the flow fof some morbid humour to the part affected. Before the year 1642, rheumatism and gout were usually described as one disease, under the name of arthritis; the dis tinction between the two is said to have been first accurately made by Bellonius, a physician who suffered much from rheumatism.
Acute rheumatism, called also rheumatic fever, has been so well described by Sydenham, that we make use of his own words : " This disease," he observes, " happens at any time, but especially in autumn, and chiefly affects such as are in the prime of life. It is generally occasioned by exposing the body to the cold air immediately after having heated it by violent exercise or some other way. It begins with chilliness and shivering, which are soon succeeded by heat, restlessness, thirst, and the other concomitants of fever. In a day or two, and sometimes sooner, there arises an acute pain in some or other of the limbs, especially in the wrists, shoulders, knees ; which shifting between whiles, affects these parts alternately, leaving a red ness and swelling in the part last affected. In the beginning of the illness the fever and the sbove7mentioned symptoms do sometimes come together, but the fever goes off gradually, while the pain con tinues and sometimes increases." Acute rheumatism varies considerably in intensity Sind duration ; the patient may have great fever, and severe pain in .nearly every joint, so as to render him perfectly helpless; or the fever may be slight, and the local inflammation limited to one or two joints. There is not always a relation between the severity of the local symptoms and the constitutional disturbance. The duration of this disease is much the same under any mode of treat ment; it may be terminated in a few days, or may endure ns many months ; in nearly every case the general symptoms cease before the local inflammation is stopped. Acute rheumatism simply, is seldom if ever a fatal disease, but complicated with pericarditis, endocarditis, or pleurisy, it is highly dangerous. It behoves us therefore in every case of rheumatism to be on our guard against these complications ; they are so frequent and come on so insidiously, that a recourse to the aid of the stethescopo should never be neglected. [HEART, DISEASES OF THE.] With respect to what is called chronic rheumatism, it may be either a continuance of acute rheumatism in a milder form, or may originate in this chronic, or, more properly speaking, subacute character. In either case all the characters of acute rheumatism are present, but in a leas violent degree ; thus, there is.a quickened pulse, some increased heat of skin, a furred tongue, and loss of appetite and sleep, the feb rile action undermines the general health, while the local inflammation, although indolent, disorganises the joints. This state of things may endure for an indefinite period, or the febrile symptoms may after a time disappear and the morbid action in the joints cease, not however without leaving behind them such ravages as require a special local treatment. Dr. Elliotson has distinguished chronic rheumatism into hot and cold : in the former, tho joints affected are above the natural temperature of the other parts of the body, and are relieved by the application of cold; in the latter, the contrary is the case. Whether
the pain of the joints is relieved most by hot or by cold applications, it is generally aggravated in cold moist weather, and diminished dur ing an opposite condition of the atmosphere. The only diseases with which rheumatism can be confounded are gout and periostitis ; for its distinction from the former of which see Goma The term rheumatic, whether properly or not, has been applied to various affections which have very little resemblance to one another, except in being attended with pain. Thus a class of cases has been called rheumatic gout. This is a disease partaking of the characters both of gout and rheumatism. It may be rheumatism attacking the small joints, or it may be gout extending to the largo; in either case the distinction is not of much importance, as the treatment is the same.
When rheumatism is seated in the back, it is called lumbago, from Iambus, the loin ; when in the 'back of the neck, the patient is said to have a stiff neck, or a "crick in the neck ; " when in the head, one half only is usually attacked, and it is called hemierania. When the pain occupies the more fleshy parts of the limbs, as the muscles or their aponeuroses, the term rheumatalgia is use of. In this last-named affection there is neither redness nor swelling, and pain Is experienced only when the muscles of the part affected are called into action. Many persons believe that the nerves themselves may be affected with rheumatism, and refer to sciatica and hemicmnia as examples. Iu these cases the pain is generally of an intermittent character. This intermittance of pain is not peculiar to nervous rheumatism, but is met with also when the aponeuroses of muscles are the seat of the disease, as in hemierania. " It usually attacks one half of the organ (the head), and the pain generally comes on in the evening about six o'clock, and continues very violently for a few hours. Occa sionally when it is intermittent in this way, the parts are hot, swollen, and throb, and the eyes water; but in other cases this is not felt." (Elliotson.) Many physicians of eminence deny that the above-named affections are rheumatic, and consider them to he of nervous origin ; hemicrania and lumbago they call neuralgia, and rheumatalgia they designate by the term inyositis. From this contrariety of opinion WO may conclude that little is known respecting the structures actually affected in these varieties of rheumatism; of the morbid changes which they undergo we are likewise in equal ignorance. In the true or articular rheumatism it is the synovial membrane lining the cavity of the joints and the fibrous tissues external to them that principally suffer. The respective degree in which each of these structures is implicated is not the same in every case. Thus, in one case, we shall find the joints dis tended with fluid, the fluctuation of which is very perceptible to the hand ; while in another there shall be swelling, but it will be more diffused and without fluctuation, showing that little or no effusion has taken place into the joint, but that the swelling results from the inflammation of parts external to it. This difference has led some persons to speak of rheumatism as fibrous and synovial ; but inasmuch as it is not always easy to determine to which variety the case under examination may belong, and is besides of no practical importance, the distinction is not usually regarded. The fluid which is found in the joints maybe either gelatinous or purulent, according to the severity of the inflammation. The synovial membranes which lino them are red and thickened; the ligaments external to the joints are thickened and rigid, the limbs frequently contracted, and the muscles wasted. In rheumatic gout there is often found a deposit of hithate of soda in the joints affeeted,—a proof that, in many cases at least, this disease partakes more of the character of gout than of rheumatism. The appearances presented in the heart and its coverings, where this organ has been attacked, have already been described in the article HEART, DISEASES OF THE.