RHEUMATISM, CHRONIC, 481 



So much then for the internal remedies for chronic rheumatism. Let us no\v 

 consider what local applications are at our disposal for the treatment of this 

 obstinate complaint. 



Iodine liniment may often be painted around the affected joints with advantage. 

 It in many cases quickly relieves the pain. 



When the pain is confined to one joint, a mustard or linseed poultice will often 

 afford relief. 



The application of flowers of sulpt ar often proves of use. When the complaint 

 is situated in the lower extremities, it is not by any means a bad plan to resort to 

 the old-fashioned custom of dusting the inside of the stockings with sublimed 

 sulphur. A sulphur and linseed-meal poultice, equal parts, may be tried. The 

 local application may be combined with the internal administration of sulphur, 

 the dose being twenty or thirty grains in milk. 



Concentrated essence of Jamaica ginger often proves efficacious. A tea-spoonful 

 should be taken two or three times a day in wine and water, or other vehicle, 

 and the affected part well rubbed with a mixture of equal parts of the essence 

 and brandy. Should no benefit be experienced, a piece of flannel should be 

 wetted with this mixture and worn on the part, the application being repeated 

 as often as the skin will bear it. 



There are several accessory means of treatment which may be adopted with advan- 

 tage. For instance, the dull aching in the joints which often remains after an attack 

 of acute rheumatism will often yield to galvanism. This is a mode of treatment 

 which is most likely to prove of service when only one or two joints are affected. 



The cold douche is often useful in removing the pain and stiffness of joints 

 crippled by chronic rheumatism. 



The cold pack is also frequently successful in these cases. 



Warm baths are of great service, and especially baths of salt water at a 

 temperature of not less than 100. 



The Turkish bath will in many cases afford prompt and complete relief, and 

 this is a mode of treatment which we have in many cases seen followed by the most 

 satisfactory results. 



Very frequently a course of shampooing would prove successful. A professional 

 shampooer may usually be obtained from the nearest Turkish bath establishment. 



When the symptoms are very chronic, the cold sulphurous waters of Harro- 

 gate, or the hot sulphur springs of Aix-la-Chapelle, may be resorted to. 



Sometimes drinking the alkaline waters of Vichy will do good, or when there is 

 constipation in addition to the rheumatism, benefit may be experienced from a 

 course of Carlsbad waters. 



For rheumatic people ^who can afford it, Ventnor, Hastings, Rome, and Nice 

 would be good winter quarters. A temporary residence at a hydropathic establish- 

 ment, such as Ben Rhydding or Limpley Stoke, might prove beneficial. 



It may be said that we have here a very large number of remedies recommended, 



but which should we begin with 1 In the majority of cases we should commence 



treatment with the iodide of potassium mixture and the Turkish bath. We believe 



that iodide of potassium is of all others the drug which proves most successful, and 



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