This course may be continued for a week, or longer, if the case proves obstinate, and the patient’s strength will permit. It ought then to be omitted for a few days, and repeated again. At the same time leeches or a blistering-plaster may be applied to the part affected. What I have generally found answer better than either of these, in obstinate fixed rheumatic pains, is the warm plaster[[140]]. I have likewise known a plaster of Burgundy pitch worn for some time on the part affected give great relief in rheumatic pains. My ingenious friend, Dr. Alexander of Edinburgh, says, he has frequently cured very obstinate rheumatic pains by rubbing the part affected with tincture of cantharides. When the common tincture did not succeed, he used it of a double or treble strength. Cupping upon the part affected is likewise often very beneficial, and is greatly preferable to the application of leeches.
Though this disease may not seem to yield to medicines for some time, yet they ought still to be persisted in. Persons who are subject to frequent returns of the rheumatism, will often find their account in using medicines, whether they be immediately affected with the disease or not. The chronic rheumatism is similar to the gout in this respect, that the most proper time for using medicines to extirpate it, is when the patient is most free from the disorder.
To those who can afford the expence, I would recommend the warm baths of Buxton or Matlock in Derbyshire. These have often, to my knowledge, cured very obstinate rheumatisms, and are always safe either in or out of the fit. When the rheumatism is complicated with scorbutic complaints, which is not seldom the case, the Harrowgate waters, and those of Moffat, are proper. They should both be drank and used as a warm bath.
There are several of our own domestic plants which may be used with advantage in the rheumatism. One of the best is the white mustard. A table-spoonful of the seed of this plant may be taken twice or thrice a-day, in a glass of water or small wine. The water-trefoil is likewise of great use in this complaint. It may be infused in wine or ale, or drank in form of tea. The ground-ivy, camomile, and several other bitters, are also beneficial, and may be used in the same manner. No benefit however is to be expected from these, unless they be taken for a considerable time. Excellent medicines are often despised in this disease, because they do not perform an immediate cure; whereas nothing would be more certain than their effect, were they duly persisted in. Want of perseverance in the use of medicines is one reason why chronic diseases are so seldom cured.
Cold bathing, especially in salt-water, often cures the rheumatism. We would also recommend riding on horseback, and wearing flannel next the skin. Issues are likewise very proper, especially in chronic cases. If the pain affects the shoulders, an issue may be made in the arm; but if it affects the loins, it should be put into the leg or thigh.
Persons afflicted with the scurvy are very subject to rheumatic complaints. The best medicines in this case are bitters and mild purgatives. These may either be taken separately or together, as the patient inclines. An ounce of Peruvian bark, and half an ounce of rhubarb in powder, may be infused in a bottle of wine; and one, two, or three wine glasses of it taken daily, as shall be found necessary for keeping the body gently open. In cases where the bark itself proves sufficiently purgative, the rhubarb may be omitted.
Such as are subject to frequent attacks of the rheumatism ought to make choice of a dry, warm situation, to avoid the night-air, wet clothes, and wet feet, as much as possible. Their clothing should be warm, and they should wear flannel next their skin, and make frequent use of the flesh-brush.
CHAP. XXXIX.
OF THE SCURVY.
This disease prevails chiefly in cold northern countries, especially in low damp situations, near large marshes, or great quantities of stagnating water. Sedentary people, of a dull melancholy disposition, are most subject to it. It proves often fatal to sailors on long voyages, particularly in ships that are not properly ventilated, have many people on board, or where cleanliness is neglected.
It is not necessary to mention the different species into which this disease has been divided, as they differ from one another chiefly in degree. What is called the land-scurvy, however, is seldom attended with those highly putrid symptoms which appear in patients who have been long at sea, and which, we presume, are rather owing to confined air, want of exercise, and the unwholesome food eaten by sailors on long voyages, than to any specific difference in the disease.