RHEUMATISM. 595 



There is a marked alteration in the urine, it is scanty and very high in colour, and if 

 tested with litmus-paper it gives a strongly acid reaction. There are other alterations in the 

 urine, which only a professional man can detect. The bowels are confined. Paralysis of the 

 hind-quarters, either complete or partial, is not an unusual concomitant of acute rheumatism. 



Diagnosis. There is hardly any mistaking a case of rheumatism, but the lameness, fever, 

 pain to the touch, and acidity of the urine, are sufficient to guide us. 



Prognosis. Favourable, as a rule, unless, very much complicated. It will generally run its 

 course in from two weeks to a month. 



Treatment. The treatment must be both constitutional and local. 



Constitutionally, the indications of treatment are to allay the pain, and assuage the fever. 

 We may fulfil the first indication by opium and belladonna in conjunction, as by a pill like 



the prescription 



9> Opii pulv gr. J ad gr. iij. 



Ext. bellad gr. \ ad gr. ij. 



Ext. tarax gr. v. ad gr. xv. 



F- bolus. M. 



given every night, and if there seems to be very much distress give also from three to ten or 

 fifteen grains of this powder 



$> Pulv. ipecac.") 



r> , ( a a 5 ij. 



rulv. opn } 



Pulv. pot. nitr 3 ij. 



F' pulv. M. 



three or four times a day. Let the dog have a soft, warm, comfortable bed, with plenty of 

 fresh air, but with freedom from draughts. Let his water, in which a teaspoonful or two of 

 nitre should be mixed, be placed handy to him, and always kept fresh. And let him have 

 from ten to thirty grains of nitre, with from five to fifteen grains of bicarbonate of potash, made 

 into a bolus, with fat or any simple extract, or even mixed in water as a drench, three times 

 a day. When the dog is first attacked his bowels ought to be cleared with a saline purgative, 

 and afterwards kept open with from a drachm to four drachms of Epsom salts every morning, 

 combined with three to ten drops of tincture of hyoscyamus, and five to twenty of dilute 

 sulphuric acid. Sometimes from five drops to a drachm and a half of the tincture of colchicum 

 may be added with advantage to the morning draught. 



Food low at first, but we must take care not to allow the dog himself to get too low ; if 

 signs of weakness are exhibited, resort to beef-tea, mutton-broth, milk, or eggs. 



Locally, in a case of really acute rheumatism, very little can be done. In small dogs, the 

 warm bath may effect some good, but we must remember the difficulty we shall experience in 

 getting the animal thoroughly dried again. Embrocations and stimulating liniments are better 

 suited to chronic or sub-acute cases. Heat applied to the seat of pain by means of a common 

 flat iron we have found do most good, or the use of bags of heated sand. After the acute stage 

 is got over, you may begin with advantage to administer iodide of potassium and quinine three 

 times a day, and the diet ought now to be more generous. 



9> Quinae sulph. ... ... gr. j. ad gr. ij. 



Pot. iod. gr. j. ad gr. v. 



Ext. tarax. ... ... q. s. 



F. pil. ter die. 



