276 . THE NATURE AND TREATMENT OP 



and painful, a local application may be of some service, and in 

 this view I recommend the following : — 



Cod Lirer Oil, 3 ounces. 



Tincture of Lobelia, 1 ounce. 



Glycerine, 2 ounces. 



Chloroform, 2 ounces. 



Mix, apply a portion to the affected limb or joint, twice daily. 



In an inflammatory state of the joints, it is customary to 

 apply cooling applications, yet the practice is open to the fol- 

 lowing objection ; viz., it may augment the acute symptoms in 

 and around the joints, while it lessens them on the surface ; 

 nevertheless, if an action of the cutaneous vessels can be main- 

 tained, refrigerating lotions cannot do harm. 



So soon as the inflammatory symptoms have subsided, and 

 all danger of internal disease seems to have disappeared, we 

 must commence a different plan of treatment. I then give 

 tonics, not only to promote the convalescence of the patient, 

 but also in order to prevent the disease assuming a chronic type, 

 which is very apt to be the case when the prostrating plan of 

 treatment has been too long continued, or practised with undue 

 severity. From among the following agents the practitioner 

 can select a suitable tonic : Sulphate of iron, cascarilla bark, 

 gentian, quijl bark, quinine, goldenseal, camomile flowers, to 

 either of which a small portion of ginger may be added pro- 

 vided a stimulant be indicated. 



CHRONIC RHEUMATISM. 



Chronic rheumatism is generally a sequel to the acute, yet 

 if the subject be closely watched, a train of phenomena may 

 be observed very similar to those attending the acute stage, 

 yet differing in its gradual accession, obscure state of the phe- 

 nomena, and less functional and structural changes. 



At times, chronic rheumatism is nothing more than a mod- 

 ified and protracted state of the acute stage ; it is migratory, 

 like the former, attacking this, that, or other tissues, without 

 reference to its original locality. For example : a horse may, 

 after brisk driving and subsequent exposure, become lame in 



