98 PRACTICE OF PHYSIC. 



CCCCLXX. Calomel, and some other preparations of mer- 

 cury, have been recommended in the acute rheumatism ; but I 

 believe they are useful only in cases of the chronic kind, or at 

 least in cases approaching to the nature of these. 



CCCCLXXI. Having now treated fully of the cure of the 

 acute rheumatism, I proceed to treat of the cure of the chronic, 

 which is so frequently a sequel of the former. 



" The character which I have given in general of rheumatism 

 will not apply here : there is no pyrexia, no inflammation of the 

 particular joints : on this and other occasions an imperfection 

 attends Nosology, for what we may consider as the same disease, 

 or very nearly so, appears in such various shapes as to elude 

 any general character. 



" In most instances, the parts affected with chronic rheumatism 

 feel almost constantly cold to the patient and bystanders ; and 

 when we endeavour, as we sometimes do, to cure the disease by 

 sweating, we frequently find, that when we can excite a free 

 sweat in every other part of the body, the affected joint remains 

 still cold and dry ; these parts are made to sweat with more 

 difficulty, and not without particular applications to them ; yet 

 after all, only a cold sweat is commonly produced on the part, 

 while the other parts are flowing with the warm one." 



CCCCLXXII. The phenomena of the purely chronic rheu- 

 matism, mentioned in CCCCXXXIX. and CCCCXL. lead 

 me to conclude, that its proximate cause is an atony, both of 

 the blood-vessels and of the muscular fibres of the part affected, 

 together with a degree of rigidity and contraction in the latter, 

 such as frequently attend them in a state of atony. 



u It remains to shew, why that contracted state or rigidity 

 is pained by the slightest distention caused by the increased 

 afflux of blood to the part. 



" This does not seem very difficult. When parts have a 

 considerable flexibility, they admit of much distention without 

 pain, and then only feel pain when their flexibility does not 

 yield to a further distention. Inflammation is painful by dis- 

 tention, as is shewn by its being often exactly correspondent to 

 the pulsation of the arteries. But under exercise the blood is 

 often impelled with as much force as in the case of inflamma- 

 tion ; but it is presumed to be painful here, because the vessels 



