RHEUMATISM, CHRONIC, AND RHEUMATIC GOUT.–Chronic rheumatism is often a direct consequence of an acute attack. When the fever passes off, the joints remain permanently enlarged, stiff and painful; and when the inflammation has been very intense, the joints may be left perfectly rigid and immovable.
But this is not always the history. In many cases rheumatism is chronic from the first, beginning as pains in the joint without fever. This may subside and be cured or it may go on to cause crippling. Rheumatic gout is really a different disease, though closely resembling chronic rheumatism, and allied to it. It has nothing to do with ordinary gout, as its name might lead us to suppose. It is a chronic inflammation of the joints, with increase in the size of the bones, causing a peculiar deformity. When it attacks the hands and feet, the fingers and toes are turned outward. As far as treatment is concerned, both forms may be conveniently taken together.
General Treatment.–In all cases of acute rheumatism, when the symptoms of active inflammation have subsided, great attention must be paid to the joints. They must not be allowed to become stiff. Movement must be insisted on, though it will cost the patient some pain. If he is unable to move the joints himself the nurse must do it for him. Rubbing the affected part with olive oil is useful. The patient should have nourishing diet; all food, especially meat, must be taken warm; watery fruits and vegetables should be avoided; stewed celery is good as a vegetable. When cold water disagrees, toast-water or barley- water may be substituted. The clothing should be warm, wool should be worn next the skin; it may be thin in summer and thicker in winter, but it must be all wool, containing no admixture of cotton. Whenever possible, a dry, chalk soil should be chosen for residence; damp localities, clays and even gravel on clay are especially bad.
When stiffness of joints, whether rheumatic or gouty, does not yield to medicinal treatment, hot-air baths may be tried. These are made to take single limbs or the whole body, as may be required. The air is heated to 300 degree Fahrenheit and upwards by means of electricity or gas.
Medicines.—(Three or four times a day.)
–Rheumatic gout; burning pains; great prostration, anxiety.
–Pains aggravated by the slightest chill or movement.
–Attacks excited by bad weather; change of weather brings on a relapse; pains aggravated by rest, better by motion.
Mercurius sol. 6.–Pains excited by slightest chill ; worse by motion and heat of bed; joints red and hot to touch; stiffness of the joints.
–Pains excited by slightest chill; every change of weather causes a relapse.
–Useful after Mercurius