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36
I am deeply grateful at the result of this letter. A number of
replies have been received. If one subject be taken annually, very
helpful information will be obtained by us all. I have given below the
salient features of the replies received.
Letter number 1. A frequent cause of Chronic Rheumatism is
septic teeth. Case: a male, age 41, a compositor, worked all his life
amongst newspapers. Strong and healthy. Teeth apparently good.
For one or two years the patient had very severe cramp in left leg
every night, coming on an hour after going to bed. Eight months'
treatment of no avail. Could it be due to lead poisoning ? Sent
patient to Guy's Hospital where teeth were cleaned and X-rayed. A
septic tooth was found. This was extracted and within a week the
cramp had left him. He has now been free of the pain for over a year.
I find aspirin gives the best relief from pain in all forms of
rheumatism, especially muscular. In lumbago, I find twenty-five
grains of ammonium chloride, three times a day, acts like a charm.
2. So-called rheumatism may be due to many different causes, but
if the case is of pure rheumatic origin, I find that aspirin, and secondly
guaiacol carbonate give the best results. I am a firm beliver in Spa
treatment if accompanied by strict dietary regimen.
3. After many years practice in this neighbourhood I believe that
persistently wet weather is good for the general health ; it improves
the general health of the community. The reason is that there is a
constant washing of the atmosphere, roofs, drains, etc., causing amongst
other things purification of the atmosphere. In addition, contrary to
popular ideas, persistently wet weather decreases the tendency to
rheumatic fever. On this account, we have not had a case in our triple
practice since the wet weather began.
With regard to chronic rheumatism, those bad forms which one sees
in hospital and infirmary practice do not exist in middle class family
practice in this neighbourhood. The form of chronic rheumatism which
exists here usually affects both knee joints and the fingers, with
occasionally the shoulder joint. Rarely are the other joints affected.
These are usually helped by local applications, such as Scott's dressing.
Persistent cases are nearly always benefited, and sometimes cured by
three months' stay at one of the Spas, Droitwich being my favourite.
I do not think that internal medication helps in any way.
4. The term chronic rheumatism is used to include rather vague
complaints, hence one hesitates to dogmatise as to the treatment.