The external treatment is that which offers most hope. It is necessary to mitigate the pains, to strengthen and to accelerate the circulation of blood in the affected joints, to remove or reduce the swellings, and to pre serve or regain the movability of the joints. A great many methods of procedure arc at the disposal of the physician, who will decide upon the proper one according to the condition of the patient and the probable causa tion of the disease. Irritating or pain-allaying inunctions, applications of niustard-plaisters or other blistering agents, massage, electricity, sanitary gymnastics, dry and moist heat—all arc useful under certain conditions. Continued warm baths have proved very beneficial. Pure water may be used ; or salt or lye may be added.
In obstinate cases electric-light baths, hot-air baths, Mud-baths, sulphur baths, or sand-baths are serviceable. For patients who can afford it, a sojourn at a thermal spring may he useful.
In an affection which is very often protracted, and which exhausts the patience of the sufferers, it is quite natural that a large number of remedies are tried, with or without the knowledge of the physician. Many a patient
may even despair, and become the victim of impostors who extol " infallible " remedies and miraculous " cures." A great many secret remedies are on the market, " guaranteed " to cure chronic articular rheumatism. Many of these medicines contain active poisons (opium, colchicum, etc.), so that their use, without a physician's directions, is bound to cause serious results. Among other remedies may be mentioned the various contrivances (rings, belts, etc.) said to produce an electric current when carried on the body. These are absolutely worthless. If they cause any electric current at all, it is so slight that it can have no curative action.
To prevent recurrences or aggravations of the affection, patients will do well to subject themselves to a rational and carefully practised hardening of their bodies (see HARDENING). Damp dwellings must, under all circum stances, be avoided. In some cases it may become necessary for the patients to change their occupations or to move to another climate.