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Related post: affection the name of nodose rheumatism or arthritis deformans. Confounded from remote antiquity under the name of arthritism, gout and chronic rheumatism have been now grouped in the same description, now constituted as distinct entities, according as writers have taken for their basis the etiology, the symptomatology, or the pathological anatomy of these two affections. To-day this question, after many vicissitudes, seems to Buy Hyzaar have re- verted to the point from which it started, and if we observe between gout and rheumatism differences radical and complete, we recognize also that they may derive their origin from one common hereditary source. To this hereditary cause of these two diseases we give the name of arthritism, and if gout and rheumatism have at their origin many points of contact, they soon separate in two divergent directions, of which the two extremes are chronic arthritis deformans, on the one hand, and acute gout on the other. This opinion, which 1 defended at the time of the discussion which arose in the Society of Hydrology, between the partisans of arthritism and those who, like Durand Fardel, persist in seeing in gout, chronic rheumatism, and acute rheuma- tism distinct morbid entities, I maintain to-day, for when you carefully trace back the genealogy of arthritic patients, you almost always find either rheumatism in all its forms, or gout in all its modalities. At the same time, take note that quite recently our colleague Lancereaux has withdrawn arthritis deformans and dry arthritis from the category of arthritism to place this affection in the group of herpetic disorders. But this is a new view which needs to be discussed before being adopted. Scarcely recognized at the beginning of this century, chronic rheumatism with articular deformity, which is described under the name of nodose rheumatism, has not been well understood till within a few years, and it is especially to the School of Salp^tri^re and its eminent master. Prof. Charcot, that we are indebted for the ex- position, both from the standpoint of symptomatology and pathological anatomy, of the palpable and striking ^ Translated from advance sheets by E. P. Kurd, M.D., of Newburyport, Mass. differences between gout and arthritis deformans, to the latter of which even now some authorities persist in giving the name of gouty rheumatism. Even if we well understood the lesions of chronic rheumatism (arthritis deformans), the pathogeny and the course of the affection, it must be confessed that the therapeutics of this disease has made little progress, and our efforts remain well-nigh impotent to arrest the pro- gressive and invading march of those lesions which eventually constitute incurable infirmities, Purchase Hyzaar and condemn the unhappy patient to a life of invalidism. The treatment of chronic rheumatism comprises ex- ternal and internal means. The internal treatment comprehends but few medicaments ; those most in use are arsenic and arsenical preparations, iodine and the iodides, and salicylate of soda. Arsenic Cheap Hyzaar is given «in- ternally, as Charcot recommends, or employed in the form of arsenical baths (which have been especially vaunted by Noel Gueneau de Mussy) ; this treatment, whether it consists in the internal administration of arsenic or in the use of the baths, often provokes a return of the painful crises; hence this medicament should not be resorted to when there are any acute symptoms.' However different these two modes of exhibiting arsenic may be, their principle of action is essentially the same, namely, by absorption of the medicament and its penetration into the Buy Hyzaar Online economy, the rate of whose nutrition is raised. It must be confessed, however, that cutaneous absorption from baths is infinitesimal or nil. Iodine has been employed in Order Hyzaar chronic rheumatism by Las^gue. He made use of the tincture, of which he was in the habit of giving large doses, as much as a drachm and a half a day (6 grammes). It is given diluted in water, or, what is better still, in a little old Spanish wine, which constitutes a mixture which is but slightly disagreeable and is easily taken with the meals. Instead of iodine, iodide of potassium may be given. Besnier proposes to give the iodide in syrup of coffee, which he thinks is the best adjuvant, and from i to 3 grammes a day (15 to 45 grains) may be given in this way. Iodine and the iodides in these cases act espe- cially by stimulating the organism and energizing nutrition. These are the most important indications to fulfil in the treatment of chronic rheumatism, and 1 Gueneau de Mussy has recommended two kinds of arsenical baths ; the arsenical bath pure, which contains ft-om fifteen grains to two drachms of arseniate of soda per bath, and the compound arsenical bath, which with the same quantity of arseniate of soda has from three to five ounces of carbonate of soda. Apropos of the application of these baths, Gueneau de Mussy distinguishes two forms of rheumatism : chronic rheumatism with little pain, and rheumatism with subacute attacks. In the first kind he would employ the compound arsenical bath, in the second the bath con- taining only the arsenical salt. The temperature of the bath varies from 86® to 95° F. (30° to 35® C.) ; as for its duration, that depends on the degree of excitability of the patient. (Gueneau de Mussy, Clin. Med., t. i. p. 271, Paris, 1874.) 422 TREATMENT OF CHRONIC RHEUMATISM AND GOUT. [Medical News, Garrod has justly insisted on this point in showing us that the dominant fact of the treatment ought to be to fortify the system and to excite the nutritive activity, which is considerably lessened; consequently, he recommends ferruginous preparations, cinchona bark, and, above all, cod-liver oil. 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