388 DISEASES CLASS IV. 1.2. 16. 



tacking two similar parts at the same time, as both ankles and 

 both wrists, and these attacks being in succession to each other. 

 Whereas it is not probable that both feet or both hands should 

 at the same time be equally exposed to any external cause of the 

 disease, as to cold dt* moisture; and less so that these should oc- 

 cur in succession. Lastly, from the inflammatory diathesis in 

 this disease being more difficult to subdue, and more dangerous 

 in event, than other common inflammations, especially to preg- 

 nant women, and in weak constitutions. 



From this idea of the rheumatism being not a primary dis- 

 ease, like the gout, but a transferred morbid action owing to the 

 previous torpor of some other part of the system, we perceive 

 why it attacks weak people with greater pertinacity than strong 

 ones; resisting or recurring again and again after frequent evacua- 

 tions, in a manner very different from primary inflammations: 

 because the cause is not removed, which is at a distance from the 

 seat of the inflammation. 



This also accounts for rheumatic inflammations so very rarely 

 terminating in suppuration, because like the gout, the original 

 cause is pot in the inflamed part, and therefore does not con- 

 tinue to act after the inflammation commences. Instead of sup- 

 puration in this disease, as well as in the gout, a quantity of 

 mucus or coagujable lymph is formed on the inflamed mem- 

 brane; which in the gout changes into chalk-stones, and in the 

 rheumatism is either reabsorbed, or lies on the membrane, pro- 

 ducing pains on motion, long after the termination of the inflam- 

 mation, which pains are called chronic rheumatism. The mem- 

 branes which have thus been once or repeatedly inflamed, become 

 less mobile, or less liable to be affected by sympathy, as appears 

 by the gout affecting new parts, when the joints of the foot have 

 been frequently inflamed by it; hence as the cause of the inflam- 

 mation does not exist in the inflamed part, and as this part be- 

 comes less liable to future attacks, it seldom suppurates. 



Pleurodyne rheumatica. When rheumatism affects the mus- 

 cles of the chest, it produces symptoms similar to pleurisy, but 

 distinguished from it by the patient having previously suffered 

 rheumatic affections in other parts, and by the pertinacity or con- 

 tinuance of tjie inflammatory state of the patient. This should 

 be termed pleurodyne rheumatica. 



Enteralgia rheumatica. When rheumatic inflammation af- 

 fects the bowels, it produces a disease very different from en- 

 teritis, or common inflammation of the bowels, and should be 

 termed enteralgia rheumatica. The pain is less than in enteri- 

 tis, and the disease of longer continuance, with harder pulse and 

 the blood equally sizy. It is attended with frequent dejections, 



