RHEUMATIC FEVER, OR ACUTE RHEUMATISM. 469 



capsicum to half a pint of water will be found useful. It should be employed three 

 or four times a day. Pr. 81 is a good one. An alum gargle Ls often recommended, 

 but it is far inferior to the glycerine of tannin. 



The inhalation of steam impregnated with some stimulating volatile principle is 

 of the greatest service. An excellent formula is, three drachms each of creosote 

 and glycerine added to three ounces ot' water; a tea spoonful to be added to a pint 

 of hot water and the steam inhaled for live minutes (.wire or three times a day. 



Jn chronic sore throats spray inhalations often prove vn-v useful. The following 

 ingredients are most to be recommended : 



- 



(1) Alum . . . 1.") ur.iins tu tin- <mn<-e <>f \v,itT. 



( % J) Tannin . . . 1"> grains ,, ,, ,, 



(!J) JVivhlonde of Iron 1 -r;iin 



(1) Sulphate uf Zinc . '> grains ,, ,, 



The quantity of either of these solutions to be used at each inhalation is two or 

 three tea-spoonfuls. They are all astringent, and we are unable to say which should 

 be employed in any particular case. 



if you are suffering from sore throat you should either temporarily give up 

 smoking or should smoke in the very strictest mod'-ration. If you can possibly get 

 away for a holiday, do so at once. 



REMITTENT FEVER (>'"' Tvi'IlOlD, Tvi'IIUS, AM) OI1IKR FEVERS). 

 RHEUMATIC FEVER, OR ACUTE RHEUMATISM. 



Rheumatism may occur either as an acute or as a chronic disease. When it 

 occurs in the acute form we call it acute rheumatism, or rheumatic fever. 



Rheumatic fever is in this country one of our commonest, most painful, and in 

 some respects most perilous diseases. Jt is perilous, not because it kills the sufferer 

 outright, but because it too frequently lays the foundation of heart disease. 



The commonest exciting cause of rheumatic fever is cold or cold, and wet 

 combined. A young man goes out for a walk, gets wet through, comes home, 

 neglects to change his clothes, and sits about in his wet things, ^ets a chill, and a 



O '^ ' 



few days after is taken ill, and is found to be suffering from acute rheumatism. 

 This is a common story, and one which is familiar enough to every one who has seen 

 much of sickness and suffering either in the wards of our hospitals or in the privacy 

 of home life. There are, of course, differences in detail : one person gets overheated 

 and sits in a draught, another is put into damp sheets, and so on, but the principle 

 is the same. Scarlet fever is sometimes followed by a complaint which, if not 

 identical with rheumatic fever, very closely resembles it. It is probable that the 

 eruption of scarlet fever, by arresting the functions of the skin, acts in very much 

 the same way as does exposure to cold and wet. In a certain number of cases of 

 rheumatic fever the patient is unable to attribute the complaint to any definite 

 cause, and it is probable that when there is a strong family predisposition it may 

 arise, as we say, spontaneously. 



