RHEUMATISM 219 



as the extremes of the train of rheumatic conditions and 

 the pathological entities known as rheumatic. 



Rheumatism once initiated there is a great danger of 

 its progressing through more than one of its recognised 

 stages, and it becomes our bounden duty, if consulted 

 early enough, to devise a treatment so as to arrest the 

 disease at the earliest stage possible, in order to prevent 

 its progress towards its succeeding and permanently dis- 

 abling stages. 



It is allowable, consequently, to conclude that, when an 

 attack of acute rheumatism is imminent, that attack may 

 be averted or modified by a smart appeal to the excretory 

 functions of the skin through the peripheral nerve-endings 

 and sudoriferous glands, which may, in this case, be con- 

 sidered the easiest and safest exits from the nervous system 

 of the cerebro-spinal fluid occupying the spaces and inter- 

 spaces, in which we hold the materies morbi of the attack 

 is lodged, and whence it invades the muscular system and 

 associated parts in order to prevent it forcing itself along 

 the motor nerve trunks or structures into the muscular 

 tissues. 



By anticipation we may thus prevent the occurrence, 

 shorten the duration, or mitigate the severity of an attack 

 of acute or sub-acute rheumatism by inducing free dia- 

 phoresis, combined with physiological rest of the entire 

 muscular and nervous systems, and the use of the other 

 subsidiary therapeutical and dietetic desiderata necessary 

 in the particular case. 



The toxic matter, which, at this juncture, is stored in 

 the nervous system, and, it may be, in the act of invading 

 the muscular system or individual groups of muscles, will 

 thereby find a natural exit through the cutaneous sweat 

 organisms on to its outer surface, leaving only that which 

 has found an entrance into the motor nerve inter-spatial 

 channels, nerve terminals, and sarcolemmar sheaths and 

 sarcous elements proper of a greater or lesser number of 

 the muscles to be dealt with. 



This latter, the toxic matter, the "real element of dis- 

 cord" or exciting cause of acute rheumatism and, it may 

 be, other forms of the disease as well, must also be medi- 

 cally dealt with in such a way as that it will be neutralised 



