R II E 



ftretches rather down the thighs to the toes ; that it is 

 chiefly fevere on affuming the erect poll lire ; that it is not 

 accompanied by ficknefs or vomiting ; and that the urine is 

 not changed in quantity or quality. Dr. Home, and fome 

 others, have believed that the fc:atica is feated in the great 

 fciatic nerve, or in its (heath, and the lumbago in the lumbar 

 nerves. 



Of Arthritis rheumatica, or rheumatic gout. This term, 

 though improper, and calculated to miflead us in our notions 

 reflecting the nature of the difeafe, is retained in confequence 

 of the want of a more correct appellation. The difeafe, in 

 fact, is not a compound of gout and rheumatifm, but pro- 

 bably rheumatifm refembling, in fome refpe&s, the gout in 

 its appearances. It has been called, by an able teacher at 

 a large hofpital in Southwark, the rheumatdgra, or acuto- 

 chronic rheumatifm. In fome cafes, the difeafe is merely a 

 partial degree of acute rheumatifm, affecting only one or two 

 of the fmaller joints, as the wrill or even the knuckles, with 

 fwelling, rednefa, and acute pain. This is often called gout ; 

 but as it occurs under circumftances which differ materially 

 from thofe under which gout appears, is not preceded by in- 

 digeilion, and does not terminate in the formation of chalk- 

 ltones, it is obvioufly a different difeafe. In many cafes, 

 however, it is the confequence of acute rheumatifm, in which 

 the joints laft occupied by that difeafe, efpecially the ankles 

 and wrifts, remain fwelled, ft iff, and painful, and fometimes 

 (edematous, for many weeks. The pain, in thefe cafes, is 

 generally aggravated at night, or by external heat; but it is 

 accompanied by very little or no feveili'hnefs. 



The more acute cafes require nearly the fame treatment 

 as is employed for the cure of acute rheumatifm. But 

 when they aflame more of a chronic form, when the liga- 

 ments and membranes of the joints are the peculiar feat 

 of the difeafe, or an enlargement of the extremities of the 

 bones appears to have taken place, efpecially in young 

 or vigorous fubjects, the firll attempts to relieve fhould 

 be made by means of heal bleeding, either by the appli- 

 cation of leeches, or, what is perhaps preferable, by the 

 operation of cupping and lcarifying. Thefe local evacua- 

 tio i ; fhould be repeated, if the pain and irritation are not 

 materially relieved; and the good effects may be aided by 

 the application of blijlers over the affected joints. Dr. Bardf- 

 lev Itrongly recommends the opening of a drain from the 

 parts by means of ijfues, made by caullic ; and affirms that, 

 in obltinate cafes, which have relilted all other means, he 

 has found the happieft effects from iffues. The tepid bath 

 will often aid the operation of thefe remedies, together with 

 the ufe of mild diaphoretics, followed by tonic bitters, fuch 

 as the Peruvian bark, chalybeates, the myrrh mixture 

 with fleel, and the occafiotia! life of antimonials with ca- 

 lomel. 



Nodo/ily of fhe Joints. — Before we conclude the fubject of 

 rheumatifm, it feems neceffary to notice a flate of the joints 

 which d rheumatic. Dr. Haygarth, how- 



r, obferves, that it is nearly allied to gout in itB character, 

 and in the perfoas whom it attacks. Thefe nodes, which 

 occur mi. II ci mmonly about the lingers, hands, and wrifts, 

 but occafionally alto on the knees, ankles, feet, elbows, 

 moulders, and other joints, produce llrange diftortions of 

 the parts, twitting the fingers, kc. in various directions, and 

 rendering the joints almoit immoveable. They are not fe- 

 parate tumours, but feel as if they were an enlargement of 

 the bones themfclves. Dr. Haygarth, indeed, is of opinion, 

 that the ends of the bones, the periofteum, and the capfules 

 or ligament:, which form the joints, are the feat of this dif- 

 eafe ; though I if appear to have ever examined the 

 matter anatomically. In bad inveterate cafes, he believes 



R H E 



that the joints are not merely diftorted, but diflscated. The 

 iwcllings are generally painful, efpecially in the night, 

 though not leverely, and often fore to the touch. In a tew 

 patients, a crackling noife is perceived in the joints when 

 moved, particularly in the neck. The fkin is feldom, if 

 ever, affected with inflammation. There is one diftrefsful 

 circumftance belonging to this difeafe, that it has no inter- 

 miffion, and but flight remiffions : for during the remainder of 

 the patient's life, the nodes gradually enlarge, impeding more 

 and more the power of motion. The malady alfo fpreads 

 to other joints, without producing any alleviation in thofe 

 which it had previoufly attacked. In one cafe, mentioned 

 by Dr. Haygarth, the fingers, wrifts, knees, ankles, elbows, 

 (houlders, neck, and hips, were all affected with this difeafe 

 at the fame time, that is thirteen joints, exclufive of the 

 numerous joints of the hands : if each individual joint of the 

 hands had been taken into the account, they would have 

 amounted to not lefs than forty. In this cafe, the malady 

 had been rapidly advancing for ten years : yet, though 

 thefe nodes, in their gradual progrefs, fadly embitter the 

 comforts, they do not fhorten the duration of life : for 

 Dr. Haygarth's firft patient lived to the age of ninety-three. 

 From the experience of this veteran phyilcian it appears, 

 that women are much more frequently the fubjedt of no- 

 dofity at the joints than men, and that it commonly firft 

 begins to fhew itfelf about the period of the eeffation of 

 the menfes. 



Various remedies have been recommmeded for the relief 

 of thefe nodes ; but they have not been found in general to 

 be poffeffed of much efficacy. On the whole, the warm bath, 

 a ftream of warm water, fuch as the Bath pumping, or a warm 

 douche on the nodes, together with the repeated application 

 of leeches, appear to be productive of the moft decided be- 

 nefit in this difeafe ; and the ufe of the leeches appears to 

 conftitute a very important part of that practice. In bad 

 cafes, from four to ten fhould be applied to the affected 

 joints once or twice a week. The temperature of the pump- 

 ing and douching fhould be varied, and that which appears, 

 from the patient's report, to agree the beft, and to be 

 productive of the molt decided effect in alleviating the pain 

 and fwelling, and in improving the power of motion in the 

 joints, fhould be adopted. This will be found to vary, in 

 different perfons, from 8 1 to 113 degrees of Fahrenheit's 

 thermometer. 



Some authors have conceived that, together with thefe 

 external remedies, the ufe of loda, or the vegetable alkali, 

 internally, has been attended with confiderable benefit. And 

 Dr. Bardfley relates a cafe, in which the continued ufe of 

 mercury, fo as to excite a moderate ptyalilm, was apparently 

 remedial. See Haygarth's Clinical Hiftory of Dileafes. 

 pt. ii. ; and Bardfley's Reports. 



RHEXIA, in Botany, derived from p'ofif, a rupture, 01 

 fracture, is the fynonym in Pliny of a plant, reputed to be 

 endowed with numerous virtues, and, amongft others, with 

 the powers of curing ruptures, or fimilar complaints. 11:: 

 defcription leaves us in no doubt as to his plant ; fo far, at 

 leall, as its being of the Alkanet tribe, a fpecies of Anchufa, 

 or perhaps of ' Echium. Why Gronovius and Linnaus chol 

 tins name for the prefent elegant American genus, doe 

 appear. — Linn. Gen. 187. Schreb. 249. WiUd. Sp. PI. 

 v. 2. 301. Mart. Mill. Did. v. 4. Ait. Hort. Kew. v. 2. 

 340. Purfli v. 1. 257. .luff. 330. Lamarck Illullr. t. . 

 Gxrtn. t. 112. — Clafs and order, D.Uindrui Monogyr.i.i. 

 Nat. Oni. Calycantheme, Linn. Melafiomts .lull. 



Gen. Ch. Cm. Perianth inferior, of one leaf, tabular, oblo 

 fwelling in the lowi r pari ; limb in four deep, acute fegmenl . 

 without any intermediate teeth or fcalea ; permanent. 



X 2 1 • 



