rheumatism; 



lant clals. He admits that (mall dofes of antimonial powder, 

 combined with calomel and opium, are certainly uleful in 

 allaying pain and irritation ; but he believes that their 

 efficacy confifta rather in palliating fymptoms, than in curing 

 the difeafe, when it is confiderable in degree and obltinate in 

 kind. " Tlie fame obfervation," he fays, " will nearly 

 apply to the ufe of flimulant remedies, fuch as refin of 

 guaiacum, the clafs of terebinthinates, and of effential oils. 

 In the molt aggravated inftances of general chronic rheu- 

 uiatifm, where great torpor and debility prevailed, guaiacum, 

 in fuch large dofes as the ftomach and bowels would bear, 

 was found to be a powerful auxiliary ; and certainly the 

 molt generally efficacious of all the internal remedies that 

 were employed. But I have feen no inftance of its com- 

 plete fuccefs, when unaided by topical applications, in any 

 Ipecies of the difeafe where much local injury of the joints 

 had taken place. It adtcd moft beneficially when exhibited 

 in fubitance, well triturated with mucilage ; to which was 

 occafionally added gum kino, or tindiure of opium, to 

 prevent its effedts on the bowels. In many obltinate cafes, 

 the ammoniated tindture of guaiacum, incorporated with mu- 

 cilage, and joined to a itrong decodtion of bark, proved of 

 great fervice, where the conititution was broken down by 

 the violence and length of the difeafe. There were but few 

 protradted cafes in which the Peruvian bark was not pre- 

 fcribed with advantage as a tonic, efpecially at the clofe of 

 the difeafe. It was, however, never adminiltered with any 

 other defign than as an auxiliary." (Loc. cit. p. 16.) We 

 have quoted this paragraph, as containing the refult of the 

 deductions from a large number of cafes, treated in a public 

 hofpital, by a careful and intelligent obferver ; and, there- 

 lore, as affording a probable approximation to the general fadt 

 c i the operation of thefe medicines. The fame obfervations, 

 we believe, are applicable to fome of the other remedies, 

 of a ftimulant atid diaphoretic quality, which are often re- 

 iorted to ; iuch as the preparations of ammonia, infufion of 

 -radifh, decodtions ot mezereon and rhododendron, 

 ruiiftard-ieed, and all the terebinthinate fubltances and hot 

 The oil of turpentine itfelf has been much employed, 

 and perhaps conftitutea a part of the celebrated noftrum called 

 the effence of muftard ; but our experience of its effedts ac- 

 cords with that of Dr. Bardlley, who fays, that, in every 

 form, turpentine was found to bean ungrateful medicine to the 

 ftomach : often impairing the appetite, and not producing, 

 when even duly perfilted in, effedts as falutary as the guaia- 

 cum and other remedies already mentioned. Neverthelefs, 

 we mu ft remark, that in different individual inftances, one of 

 thefe remedies will fometimes fuccced when the others have 

 fail) d, and that therefore none of them fhould be excluded 

 from the catalogue of ufeful expedients. 



Some other fubttances have been employed, with occafional 

 fuccefs, in the cure of different cafes of chronic rheumatifm, 

 which do not appear to poflefs any quality in common, and 

 t lie operation ot which, therefore, cannot be latisfadtorily 

 1 splained. Among thefe we may mention fulphur, which 

 has long poHcll'ed a fort of popular reputation for the cure 

 ot lumbago, and fome other varieties of the difeafe. Taken 

 nightly in a confiderable dofe, fo as to adt gently upon the 

 bowels, it has fuccceded, in fome inftances, in affording a very 

 [pei >ly and marked alleviation of the fymptoms ; but, on the 

 other hand, it has very often failed to produce any effedt what- 

 ever ; and under what circumltanrcs thefe rofpedtivc variations 

 in its operation occur, we have not been able to afecrtain. 

 Another remedy has enjoyed a very high reputation in fome 

 parts of the country, efpecially in Lancafhire ; we mean the 

 :ud-livcr oil, or ling-liver oil ; for it appears that the oil ob- 

 tained from the liver of cither of thefe fifli is equally effica- 



Voi.. XXX. 



cious. Of this remedy many teitinionies might be adduced 

 in proof of its occafional efficacy in the moll unyielding 

 cales of chronic rheumatifm. From long and repeated ex- 

 perience, Dr. Bardfley affirms that he is enabled to fpeak ot 

 it as a medicine of confiderable but limited powers : in fome 

 inftances, where every other means had proved unfuccefsful, it 

 has operated in a manner fo decidedly beneficial, as to excite 

 aitonilhment ; but, on the other hand, lie found it to fail 

 often in the more mild and common rheumatic affections. He 

 believes it to be molt beneficial in the chronic rheumatifm of 

 perfons advanced in age, which is accompanied with extreme 

 rigidity of the mufcles, and inflexibility of the joints, in 

 confequence of much expofure to cold and moifture, with 

 hard fare and much fatigue. It was commonly taken* in 

 warm table-beer by the hofpital patients, in dofes of halt 

 an ounce, or from that to an ounce and a half twice or thrice 

 a day, according to its effedts, or to its agreement with 

 the patient's Itomach. Its operation is various, fometimes 

 upon the kidnies, and fometimes upon the bowels ; and occa- 

 fionally it produced an eruption on the (kin : but thefe effedts 

 occurred only at the firft taking; for after a Ihort continuance, 

 it ceafed to produce any fenfible operation. When it pro- 

 duced relief, this was obvious by the end of a fortnight, and 

 continued (lowly to increafe ; and in thefe cafes the patients 

 generally began to increafe at the fame time in bulk and 

 fatnefs. Nevertholefs, the objedtions to the general ufe of 

 this medicine, from its extremely naufeous fmell and taite, 

 which render it abfolutely intolerable to many itomachs, 

 however difguifed, and the admiffion of Dr. Bardfley, that 

 it is only to be deemed an auxiliary, and in many refpedts 

 inferior to guaiacum, do not lead us to expedt that it will 

 ever be generally adopted, notwithftanding its reputation 

 and extenfive employment in the Manchefter Infirmary, where 

 the annual confumption has been nearly fixty gallons for 

 about forty years. Bardfley, loc. cit. p. 22. 



As another expedient for the cure of chronic rheumatifm, 

 the arfenical folution of Dr. Fowler has been recommended by 

 Mr. Jenkinfon and others. For our own part we have not 

 been fo fortunate as to difcover any remedial properties of 

 this fort in that folution ; but from the evidence of two or 

 three cafes adduced by Dr. Bardfley, it appears probable 

 that this medicine is capable of producing very beneficial 

 effedts in protradted chronic rheumatifm, where the vital 

 powers are much diminifhed, and the ends of the bones, 

 periofteum, capfules, or ligaments of the joints, are likewife 

 partially affedted ; though in the milder c.ifes, where the 

 mufcles and their inverting membranes are the feat of the 

 complaint, it appears to be ufelefs. 



External Remedies. — Among the remedies which arc 

 ufually employed externally for the cure of chronic rheu- 

 matifm, and which, when aided by the adminiftration 

 of medicines internally, have been found moft fuccefsful, 

 are principally the warm and vapour barlj, and various epif- 

 pajlic, rubefacient and flimulant platters, liniments, and em- 

 brocations, employed with or without COnfiderable/ridtan. 



The warm or tepid bath, from the temperature of 85" to 

 95 of Fahrenheit's thermometer, i? very ufeful in foothing 

 pain, and in relaxing the ltiffened joints and rigid fibres of 

 the mufcles, efpecially in elderly patients, whole (trcngth is 

 c inliderably reduced by the length and violence of the dif- 

 order. But the ufe of a warmer bath, fo aa to excite 

 fweating, is apt to induce both local and general debility 111 

 protradted cafes, and affords but a temporary relief to the 

 difeafe. But on the whole, the application of the vapour 

 of hot water to the furfacc is a more efficacious remedy. 

 Dr. Bardfley fays, " whenever 1 lie joints were found fo rigid 

 as to be nearly immoveable, and the pains upon motion ck- 

 X quifitclv 



