INFLAMMATIONS 97 



fit in those cases only, in which the phlogistic diathesis is al- 

 ready much abated ; and where, at the same time, the exacer- 

 bations of the disease are manifestly periodical, with consider- 

 able remissions interposed. 



" As I consider this disease as essentially consisting in a phlo- 

 gistic diathesis, I hold the bark to be absolutely improper, and 

 have found it manifestly hurtful, especially in its beginning, and 

 in its truly inflammatory state. 



But it is possible that after rheumatism has continued for 

 some time, and especially after the use of antiphlogistic reme- 

 dies and sweating, the inflammatory state may be abated, and 

 the disease, in consequence, admit of considerable remissions, 

 and become a periodical disease. The bark, in such cases, may 

 prove a proper remedy ; and I have sometimes found it to be 

 so, but it requires some caution ; for, in some instances, where 

 even a remission was evident, and appeared particularly by a 

 copious sediment in the morning's urine, I have exhibited the 

 bark with a bad effect, as the exacerbations became more vio- 

 lent, and the remissions less considerable ; in so much, that I 

 was obliged to have recourse again to antiphlogistic remedies 

 and sweating. 



In another case of acute rheumatism the bark may prove a 

 remedy ; and that is, when the rheumatism is combined with, 

 and makes part of an intermittent fever, as that and other 

 phlegmasia may sometimes be ; and here the conduct may be 

 the same as I have already said to be proper in such cases. 



I know of no other cases of acute rheumatism in which the 

 bark may be employed ; but there are certain circumstances of 

 the human body, in which pains of the joints resembling rheu- 

 matism may occur, and in which perhaps the bark may be use- 

 ful. So far, however, as I know such cases, they are without 

 any phlogistic diathesis, and therefore not properly acute rheu- 

 matism. I have met with some cases of hysteric women, 

 troubled with pains and tumours of the joints, so much resem- 

 bling rheumatism, that I have thought it necessary to try blood- 

 letting ; but though the blood was drawn in the manner most 

 proper to shew an inflammatory crust, yet no such crust in any 

 degree appeared ; and therefore such cases do not exclude the 

 use of the bark. M.M. 



VOL. !! G 



