MEDICINE. 
absorption of the putrescent matter, are 
sometimes so much swollen as to endanger 
or induce suffocation. 
Causes. This disease is produced by a 
specific contagion, and those will be more 
liable to be attacked by it who are of a 
sickly habit of body, and who have been 
exposed to the remote causes of the Typhus 
Gravior. It has been frequently observed 
of this, as of most other epidemics, that it 
is most fatal on its first appearance, gradu- 
ally becoming milder till towards the end, 
when it is attended with scarce any danger ; 
at the same time other complaints seldom 
prevail much while it rages, or if they do, 
are generally catenated with its symptoms. 
Treatment. In the management of this 
often fatal and insidious disease, we must 
keep its tendency to depression of strength 
and gangrene, constantly in view, and 
at the same time attend to certain trou- 
blesome symptoms which frequently accom- 
pany this disease. Emetics, at the com- 
mencement, must on no account be dis- 
pensed with; but as in this species of Cy- 
nanche there is so great a tendency to 
diarrhoea, they should in general consist of 
ipecacuanha only; sometimes, however, 
a small portion of Dr. James’s powder may 
be added with advantage. The intestinal 
canal must be evacuated by the most gentle 
laxatives, for which purpose the mercurial 
cathartics are particularly recommended; 
in the more advanced stages of the disease 
they will be improper, as there is gener ally 
a spontaneous diarrhoea : the regular expul- 
sion of the feces should be solicited by 
clysters only; but towards the termination, 
when the bowels are loaded with putrid 
sordes, accumulated in them during the 
disease, which protracts the fever and im- 
pairs the appetite, gentle cathartics will be 
serviceable : even in this case we must not 
venture to employ them, unless the fauces 
have a healthy appearance, and there is a 
considerable abatement of the febrile symp- 
toms. Small repeated blisters should be 
applied to the external fauces: rubefacients, 
however, may in general be employed with 
equal advantage and more safety. The 
fauces must be preserved from the effects 
of the acrid matter discharged from the 
ulcers by the diligent use of antiseptic, or 
rather stimulating gargles, as the decoction 
of bark with muriatic or sulphuric acid, or 
the bark in port wine, a small quantity of 
which should be frequently employed or 
injected into the fauces by means of a sy- 
ringe : a small quantity of a gargle, com- 
posed of alum, in the proportion of an ounce' 
to a pint of water, is recommended to be 
frequently injected into the fauces, which 
is said to remove the fetor from the ulcers. 
But the most powerful gargle is prepared 
by mixing a tea-spoonful or two of the cap- 
sicum annuura, or Guinea pepper, and a 
tea spoonful of sea-salt, with three ounces of 
distilled vinegar, and the same quantity of 
boiling water, a small quantity of which is 
advised to be taken into the fauces every 
two hours, so as to produce and keep up a 
moderate degree of excitement on the ton- 
sils, uvula, and fauces. Wine, opium, bark, 
mineial acids, and the other remedies re- 
commended in the treatment of the Typhus 
Gravior, must be employed with assiduity. 
As children can rarely be prevailed upon to 
take the necessary medicines in sufficient 
quantities, the bark and cordials should be 
exhibite d by clysters. Diarrhoea is to be 
checked by opiates and astringents, except- 
ing it arise as a salutary crisis towards the 
close of the disease, in which case rhubarb 
in gentle doses is the very best moderating 
remedy. 
Rheiimatismus, Rheumatism. Of this dis- 
ease there are two species, the Acute and the 
Chronic. The former generally commences 
with the usual symptoms of fever, preceded 
or succeeded by acute and pungent pains 
in the joints: the pain is not, however, con- 
fined to the joints; but it frequently shoots 
along the muscles from one joint to ano- 
ther: the parts most commonly affected #6 
the hips, knees, shoulders, and elbows, 
more rarely the ankles and wrists : the pain 
is much increased upon the slightest mo- 
tion, or even by the heat of the bed : there 
is some degree of swelling and redness in 
the parts most affected, which are painful 
to the touch: the pulse is frequent, full, 
and hard : generally costive : the urine at 
the commencement of the disease is high- 
coloured, and generally without sediment; 
but on the remission of the symptoms it de- 
posits a lateritious one, and there is a ten- 
dency to sweating in the course of the dis- 
ease, which rarely brings relief ; an exacer- 
bation of the febrile symptoms takes place 
every evening, and a remission towards 
morning, and the pains are most severe and 
most apt to shift their place in the night- 
time. Dr. Darwin suspects that rheumatism' 
is not a primary disease, but the conse- 
quence of the translation of morbid action 
from one part of the system to another, 
which idea, he observes, is countenanced by 
the frequent change of place in rheumatic 
