A system of practical medicine. By American authors. Vol. 2

by Unknown

¹³⁰ The Lancet, Dec. 17, 24, 31, 1881; Jan. 7, 14, 28, 1882.

1. The articular pain and the fever of acute rheumatic polyarthritis are more or less speedily removed by the salicyl remedies (salicylic acid, sodium salicylate, and salicine); the pains very frequently persist after the temperature has become normal. Both symptoms were removed by five days' use of such agents in 50 per cent., and by eleven days' use in 80 per cent., of 355 cases treated at Guy's Hospital, and tabulated by Fagge,¹³¹ and by five days' use in 60 per cent., and by eleven days' use in 66 per cent., of the 60 severe cases treated and severely criticised by Greenhow.¹³²

¹³¹ Ibid., ii., 1881, 1031.

¹³² Clinical Society's Transactions, vol. xiii., 1880. See Dr. Fagge's table iv., Lancet, ii., 1881, 1032.

Again, in 190 cases of acute and subacute rheumatism the average duration, under salicyl remedies, of pyrexia was 5.5 days and of joint disease, 5.3 days (Warner¹³³); in 156 cases at St. George's Hospital the average duration of pyrexia was 3.66 days, of pain 4 days (Owen¹³⁴); in 82 at the Middlesex the average duration of pyrexia was 5 days, of pain 5.6 days (Coupland¹³⁵); and in 55 at the Westminster the average duration of pyrexia was 7 days, of pain 7.25 days¹³⁶—that is, a general average duration in the whole series for the pain and pyrexia of 5.4 days.

¹³³ Ibid., p. 1080.

¹³⁴ Ibid., p. 1081.

¹³⁵ Ibid., i., 1882, 10.

¹³⁶ Ibid., ii., 1881, p. 1080.

Further, 36 per cent. of Fagge's cases and 58 per cent. of Greenhow's were relieved of both the above symptoms on the fourth day; 24.8 per cent. of Fagge's and 50 per cent. of Greenhow's on the third day; and 13.5 per cent. of Fagge's and 26.6 per cent. of Greenhow's on the second day. In Clouston's 27 cases, treated in private, 66.6 per cent. were free from pain and 59 per cent. from fever within three days, and 85.2 per cent. were devoid of pain and 72.7 per cent. of fever within four days.¹³⁷ Finally, all who have had much experience of this method of treating acute rheumatism will agree that the first or second dose frequently relieves the articular pains like a charm, and the local swelling then frequently subsides in from sixteen to forty-eight hours.