Woolen cloths, moistened with alkaline solutions, may
with advantage be applied to the affected joints. To these laudanum
may be added for its anodyne effect. The patient must be sedulously
protected from vicissitudes of the temperature and be in bed between
blankets. The alkaline treatment relieves the pain, abates the fever,
and saves the heart by lessening the amount of fibrin in the blood. A
long time ago Dr. Owen Rees, of London, introduced the use of lemon
juice. This remedy was thought to convert uric acid into urea, and to
so help elimination. Though the treatment is practically correct, the
theory of it is all wrong. Lemon juice does good in mild cases, but
cannot be relied upon in severe attacks. During the febrile stage of
acute articular rheumatism the diet should consist mainly of farinaceous
and mucilaginous preparations, with lemonade and carbonic acid water as
drinks. The cloths applied to the joints should be changed when they
become saturated with sweat, and in changing them the patient should be
protected from the air. The sweating may be controlled by small doses
of atropia, from the one-sixtieth to the one-thirtieth of a grain. To
prevent subsequent stiffness the joints should be bathed with warm oil
and chloroform, and wrapped in flannel cloths.
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