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37
Excluding peri-articular arthritis and osteo-arthritis, there remains
chronic articular rheumatism and the group comprising lumbago,
torticollis, etc. In neither of these groups do I find much benefit from
the administration of salicylates, but frequently give a course of
potassic iodide and guaiacum, followed by an alkaline tonic.
5. Chronic rheumatism. I have had most success with the
following line of treatment—Exclusion of red meat and acids from the
diet. Colloidal sulphur and iodine taken alternately for a week at a
time for a period of several months. Aspirin when the pain is severe.
Inunction of methyl salicylate and Iodex into painful areas, and
occasionally the use of the hot sand bath or the use of Antiphlogistin.
6. Chronic rheumatism. Constitutional. Remove any possible
source of infection that can be found, e.g., pyorrhoea, septic tonsils,
chronic appendix. Cut down intake of sodium chloride and carbohydrates.
Promote healthy action of skin by rubbing, or if possible
massage and Turkish baths.
Local (l) For relief of pain. Iodine ointment with 10 per cent,
methyl salicylate. Hot fomentations. Hot sand in bag wrapped round
the joint. Radiant heat bath if possible. (2) To reduce swelling,
Scott's dressing and strapping.
Drugs. (a) Aspirin in mixture, not tablets. (b) Sodium salicylate
with twice the quantity of sodium bicarbonate in each dose.
Vaccines (stock). Have had little experience and no success.
7. I have never found any appreciable influence exercised by the
use of sodium salicylate in chronic rheumatism. It frequently led
to ear-ringing, occasionally deafness and also digestive disturbances.
Aspirin is useful but depressing and is unsuitable for prolonged use.
Undoubtedly sodium bicarbonate in large doses is useful in many cases.
I have found that a combination of Salol and large doses of sodium
bicarbonate is very useful. Certain cases seem to be due to some
intestinal intoxication. I have found Salol and Yadil both act well, and
this I put down simply to their intestinal antiseptic action. Curiously,
sodium salicylate did not appear to me to have the same effect. One
case did well with guaiacol carbonate, and one interesting case of a very
chronic description and a " heart," which defied all other treatments,
began to improve quickly with a vaccine prepared after bacterial
investigation of the urine.
Another similar case with chronic rheumatism and frequent and
marked urticarial attacks did well with a somewhat similar vaccine,
combined with administration of lactates. Another case with a chronic