Both rheumatics and asthmatics are also subject to attacks of urticaria or "hives" (nettle-rash), from these and other special articles of diet.
As to principles of treatment in a disease of so varied and indefinite a character, due to such a multitude of causes, obviously nothing can be said except in the broadest and sketchiest of outline. The prevailing tendency is, for the acute form, rest in bed, the first and most important, also the second, the third, and the last element in the treatment. This will do more to diminish the severity of the attack and prevent the occurrence of heart and other complications than any other single procedure.
After this has been secured, the usual plan is to assist nature in the elimination of the toxins by alkalies, alkaline mineral waters, and other laxatives; to relieve the pain, promote the comfort, and improve the rest of the patient by a variety of harmless nerve-deadeners or pain-relievers, chief among which are the salicylates, aspirin, and the milder coal-tar products. By a judicious use of these in competent hands the pain and distress of the disease can be very greatly relieved, but it has not been found that its duration is much shortened thereby, or even that the danger of heart and other complication is greatly lessened. The agony of the inflamed joints may be much diminished by swathing in cotton-wool and flannel bandages, or in cloths wrung out of hot alkalies covered with oiled silk, or by light bandages kept saturated with some evaporating lotion containing alcohol. As soon as the fever has subsided, then hot baths and gentle massage of the affected joints give great relief and hasten the cure. But, when all is said and done, the most important curative element, as has already been intimated, is six weeks in bed.
In the chronic form the same remedies to relieve the pain are sometimes useful, but very much less effective, and often of little or no value. Dry heat, moist heat, gentle massage, and prolonged baking in special metal ovens, will often give much relief. Liniments of all sorts, from spavin cures to skunk oil, are chiefly of value in proportion to the amount of friction and massage administered when they are rubbed in.
In short, there is no disease under heaven in which so much depends upon a careful study of each individual case and adaptation of treatment to it personally, according to its cause and the patient in whom it occurs. Rheumatism, unfortunately, does tend to "run in families." Apparently some peculiar susceptibility of the nervous system to influences which would be comparatively harmless to normal nerves and cells is capable of being inherited. But this inheritance is almost invariably "recessive," in Mendelian terms, and a majority of the children of even the most rheumatic parent may entirely escape the disease, especially if they live rationally and vigorously, feed themselves abundantly, and avoid overwork and overcrowding.
CHAPTER XV
GERM-FOES THAT FOLLOW THE KNIFE, OR DEATH UNDER THE FINGER-NAIL
Our principal dread of a wound is from fear that it may fester instead of healing quickly. We don't exactly enjoy being shot, or stabbed, or scratched, though, as a matter of fact, in what Mulvaney calls the "fog av fightin'" we hardly notice such trifles unless immediately disabling. But our greatest fear after the bleeding has stopped is lest blood-poisoning may set in. And we do well to dread it, for in the olden days,—that is, barely fifty years ago,—in wounds of any size or seriousness, two-thirds of the risk remained to be run after the bleeding had been stopped and the bandages put on. Nowadays the danger is only a fraction of one per cent, but till half a century ago every wound was expected to form "matter" or pus in the process of healing, as a matter of course. Most of us can recall the favorite and brilliant repartee of our boyhood days in answer to the inquisitive query, "What's the matter?" "Nuthin': it hasn't come to matter yet. It's only a fresh cut!"
Even surgeons thought it a necessary part of the process of healing, and the approving term "laudable pus" was applied to a soft, creamy discharge, without either offensive odor or tinge of blood, upon the surfaces of the healing wound; and the hospital records of that day noted with satisfaction that, after an operation, "suppuration was established." So strongly was this idea intrenched, that a free discharge or outpouring of some sort was necessary to the proper healing of the wound, that in the Middle Ages it was regarded as exceedingly dangerous to permit wounds to close too quickly. Wounds that had partially united were actually torn apart, and liquids like oil and wine and strong acids, which tended to keep them from closing and to set up suppuration, were actually poured into them; and in some instances their sides were actually burned with hot irons. There was a solid basis of reason underlying even these extraordinary methods, viz., the "rule of thumb" observation, handed down from one generation to another, that wounds that discharged freely and "sweetly," while they were slow in healing and left disfiguring scars, usually did not give rise to serious or fatal attacks of blood-poison or wound-fever. And of two evils they chose the less. Plenty of pus and a big ugly scar in preference to an attack of dangerous blood-poisoning. Even if it didn't kill you, it might easily cripple you for life by involving a joint. The trouble was with their logic, or rather with their premises. They were firmly convinced that the danger came from within, that there was a sort of morbid humor which must be allowed to escape, or it would be dammed up in the system with disastrous results.