90 DISEASES CLASS IV. 1. 2. 16. 



thartics. Antimonials. Diluents. Neutral salts. Oil. Warm 

 bath. Afterwards the bark. Opium with or without ipecacu- 

 anha; but not till the patient is considerably weakened. Sweats 

 forced early in the disease do injury. Opium given early in the 

 disease prolongs it. In the last kind, gentle stimulants, as wine 

 and water, mucilage, sorbentia. 



In acute rheumatism, when the swelling of the joints first af- 

 fected subsides, a return of torpor in the part primarily diseased 

 commences previous to an inflammation of the joints secondarily 

 affected. Hence when the tumour of the joints first affected 

 subsides, half a grain of opium, every night, and Peruvian bark, 

 or other bitter medicine, may be given to prevent this return of 

 torpor with great advantage; if the patient has previously been 

 properly evacuated, and is not now too much inflamed. 



Dr. Fordyce asserts, that when it was the practice to bleed 

 largely in acute rheumatism, a metastasis frequently took place 

 to the interior parts of the body, and destroyed the patient. And 

 adds, that during the last fifteen years of his practice this has 

 rarely happened, as he has entirely left off bleeding in the acute 

 rheumatism. Third Dissertation on Fever by G. Fordyce, M. D. 

 London, Johnson. On this subject it may be remarked, that as 

 rheumatism like gout is a secondary disease, the inflammation 

 of one part being symptomatic, the seat of torpor existing in 

 some other part, it may not be so constantly necessary to bleed 

 so copiously in those secondary inflammatory diseases, as in those 

 primary ones, where the inflamed part was previously the seat 

 of torpor, as in pleurisy, peripneumony, and enteritis; but in 

 rheumatism, as well as in erysipelas, I am convinced, that where 

 the inflammation of the system is great, repeated venesection is 

 not only useful; but that those who perish by either of those 

 diseases, perish for the want of venesection early, where the at- 

 tack is violent. And lastly, that even in the gout of young and 

 strong subjects, as I know by experience on myself, a moderate 

 venesection shortens the fit, and lessens, I believe, the hazard of 

 metastasis. 



The following is a case of suppurative rheumatism. Mr. 



F , about sixty, was supposed to have the gout in his hand, 



which however suppurated, and it was then called the suppura- 

 tive rheumatism. He had lived rather intemperately in respect 

 to wine, and was now afflicted with a tendency to inflammation 

 of the mucous membranes. As he lay on the bed half resupine, 

 propped up with pillows, and also slept in that posture, his lower 

 jaw dropped by its own weight, when the voluntary power of 

 the muscles was suspended. The mucus of his mouth and 

 throat became quite dry, and at length was succeeded by sloughs; 



