^74 THE NATURE AND TREATMENT OF 



use of guiacum, nitrate of potassa, and liquor acetate of 

 ammonia. 



The theory of treatment of acute rheumatism, contemplates 

 antiphlogistics, to be continued so long as inflammatory symp- 

 toms shall be severe ; yet, we must exercise ordinary discretion 

 in the use of antiphlogistic remedies ; for, should we continue 

 them until all inflammatory symptoms have subsided, we may 

 purge, nauseate, and bleed our patients into the vicinity of 

 death's door, without accomplishing our object. 



The old-fashioned method of combating an inflammatory 

 diathesis, in the use of lancet and drastic cathartics, is fast 

 dying out, or at least a very marked change for the better is 

 observed ; and practitioners now depend more on sedatives, 

 diuretics, febrifuges, and nauseants, than on the above. One 

 of the principal objects in the treatment of acute rheumatism 

 is to excite diaphoresis; and in this view I recommend a 

 solution of acetate of ammonia, known as Liquor Ammonice 

 Acetatis. This is an excellent febrifuge and diaphoretic, and 

 may be given in broken doses to the amount of eight ounces per 

 day. One or two drachms of nitrate of potassa (common salt 

 petre) may also be given in the form of drink ; yet, in order to 

 insure diaphoresis, and to prevent these agents passing off by 

 the kidneys, the heat of the body must be augmented by clothing. 



Practitioners of human surgery are often in the habit of 

 using nitre, in much larger doses than I have dared to adminis- 

 ter, yet, ir; some cases, with marked benefit to the patient.* 



* Nitrate of Potassa. — In a case of synovial rheumatism, this 

 remedy was given by a Boston physician, in a single dose of one ounce, 

 dissolved in a pint and a half of barley water. This was followed by 

 one grain of opium. In fifteen hours the pulse was found reduced, and 

 the pain absolutely gone ; and in a few days the tongue was clean, and 

 the swelling entirely abated. The remedy caused neither emesis nor 

 catharsis, but passed off by the kidneys. . In another case of acute syno- 

 vial attack, following chronic rheumatism, the same dose was prescribed 

 without any good effect, causing active catharsis. Again, half an ounce 

 of nitrate of potassa, largely diluted, was given every two to four hours, 

 until the patient took three ounces in eighteen hours, with two doses of 

 opium of one grain each, with entire relief to tiie pain and fever. When 



