390 DISEASES CLASS IV. i. 2. 16: 



thartics. Antimonials. Diluents. Neutral falts. Oil. Warm 

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

 anha j but not till the patient is confiderably weakened. Sweats 

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

 the difeafe prolongs it. In the laft kind, gentle ftimulants, as 

 wine and water, mucilage, forbentia. 



In acute rheumatifm, when the fwelling of the joints firft af- 

 fected fubfides, a return of torpor in the part primarily difeafed 

 commences previous to an inflammation of the joints fecondari- 

 ly affected. Hence when the tumor of the joints firft affected 

 fubfides, 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 previoufly 

 been properly evacuated, and is not now too much inflamed. 



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

 largely ia acute rheurnntifrn, a metaftafis frequently took place 

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

 adds, that during the laft fit teen years of his practice this has 

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

 rheumatifm. Third diflertation on fever by G. Fordyce, M. D. 

 London, Johnfou. On this fubject it may be remar) ,:d, that as 

 rheumatifm like gout is a fecondary difeafe, the inflammation 

 of one part being fymptoraatic, the feat of torpor exifting in 

 ibme other part, it may not be fo conftantly neceffary to bleed 

 fo copiouily in thofe fecondary inflammatory difeafes, as in thofe 

 primary ones, where the inflamed part was previoufly the feat 

 of torpor,, as in pleurify, peripneumony, and intends j but in 

 rheumatifm, as well as in eryfipelas, I am convinced, that where 

 the inflammation of the fyftem is great, repeated venefection is 

 not only ufeful ; but that thofe, who perifh by either of thofe 

 difeafes, perifti for the want of venefection 'early, where the at- 

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

 ftrong ftubjects, as I know by experience on myfelf, a moderate 

 venefection fhortens the fit, and leflens I believe the hazard of 

 metaftafis. 



The following is a cafe of fuppurative rheumatifm. Mr. 



F , about fixty, was fuppofed to have the gout in his hand, 



which however fuppurated, and it was then called the fuppurai- 

 tive rheumatifm. He had lived rather intemperately in refpect 

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

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

 propped up with pillows, and alfo flept in "that pofture, his lower 

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

 the mufcles was fufpended. The mucus of his mouth antl 

 throat became quite dry, and at length was fucceeded by floughs ; 



this 



