Bryonia. Lancinating or stitching pains, affecting the muscles rather than the bones, worse on the least movement, but relieved by rest; also febrile heat, gastric derangement, profuse perspiration, or coldness and shivering and irascibility. Cardiac, lung, or pleuritic complication are put extensions of the rheumatic disease, and are not, therefore, necessarily indications for any change from Bryonia or Aconite But it is sometimes necessary to change the remedy to Rhus. if the tendons become implicated, or to Cactus or Spigelia if the heart is specially involved.
Belladonna. Frequent doses at night for sleeplessness.
Sulphur. After the acute symptoms have subsided, to complete the cure and prevent obstinate sequelae; when the constitutional predisposition is strongly marked; and as an intercurrent remedy.?It is especially useful when the pains are drawing and tearing, worse when cold, and better when warm, with a marked aggravation at night.
DIET. During the fever the diet should be mainly restricted to water, milk and water, barley water gruel and arrowroot, at least at first. In Rheumatic Fever a strictly non nitrogenous diet has been found very useful. By thus temporarily cutting off the supply of nitrogenous matter, which by imperfect oxidation causes acidity, the end sought in the orthodox treatment by alkalines is obtained, and the natural process of cure assisted.
HYDROPATHIC TREATMENT. In the early stages of the disease is highly beneficial. Warm baths, hot air baths or hot compresses, are useful and comforting. Wet packings repeated as often as the fever returns, and enveloping the joints which are chiefly implicated, or even the whole body, with several folds of wet linen, are most useful adjuncts. Except, however, when the skin is hot and dry, and temperature high cold applications are contra indicated.
BLANKETS IN RHEUMATISM. An invaluable adjunct to the measures already suggested is that of enveloping the patient in blankets and flannel. Bedding in blankets greatly reduces the risk of Inflammation of the heart, diminishes it intensity and danger when it does occur, and a the same time does not prolong the convalescence.
Bandaging the affected joints lessens pain, shortens the attack, and secures rest.
54. Muscular Rheumatism.
DEFINITION. Pain in the muscular structures, increase by motion. The most familiar local varieties of this affection are Stiff neck, Lumbago, and Sciatica. Muscular Rheumatism is rarely accompanied by redness, swelling, or other external symptoms. It is probably an inflammation of the fibrous sheaths of the muscle bundles.
(I) STIFF NECK CRICK IN THE NECK.
DEFINITION. A Rheumatic affection of the muscles of the side of the neck, chiefly the sterno cleido mastoideus, which becomes rigid, hard, and swollen. The least attempt to turn the neck is attended with acute pain. Sometimes the Rheumatism extends to the articulations of the clavicle and intercostal muscles.
TREATMENT. Acon, (from exposure to draughts) Dulcamara (from damp weather); Belladonna (with tearing lancinating pains). For other remedies see Lumbago.
(2) LUMBAGO.
DEFINITION. Rheumatism of the sheaths of the fleshy mass of the lumbar muscles on one or both sides of the loins, extending often to the ligaments of the sacrum, the pain being aggravated by movement of the back, and by pressure.
TREATMENT. Rhus Tox, Lumbago from getting wet; increase of pain during repose, at night, on first moving the affected part, or on first getting up in the morning; rigidity; chronic Lumbago.
Arnica. Lumbago implicating muscles that have formerly been injured, as by over lifting, a sprain, or a blow.
Aconitum, Recent Rheumatism of the lumbar muscles, unassociated with injury.
Cimicifuga. An excellent remedy in most cases, particularly if the Sciatic nerve is at all affected.
Phytolacca, Excruciating pains suggesting renal inflammation.
Antim tart. Acute pain on movement, inducing nausea, cold, perspirations, and occasional cramps.
(3) SCIATICA.
DEFINITION. Inflammation of the sheath of the Sciatic nerve and sometimes also of the aponeurotic parts of the glutei muscles, accompanied by gradually increasing and intense aching, soreness, or darting pain, extending from the nates to the knee, and sometimes to the ankle, or the pain may be purely neuralgic without inflammation or again there may be pressure within the pelvis on the nerve roots form a tumour or some such cause. Care is needed in obstinate cases to ensure that some pressure of this kind is not being overlooked. The patient is often obliged to walk very carefully, or is unable to move. Examination will probably discover no redness nor swelling anywhere, not even swelling or thickening of the nerve at the seat of pain, which is usually where a nerve branch passes through a fascia, our out of a bony canal. or lies superficially.
TREATMENT. Aconite (recent inflammatory excitement in the nerve sheath), Coloc., Arsenicum, Rhus. and friction, Cimic., Phyto. (chronic); Staphysagria, Spigelia For other remedies see under Lumbago. Friction must be judiciously used, but skilled massage often gives great relief.
ACCESSORY MEANS. Liniments medicated with the same remedy as administered internally, or even simple Olive Oil, rubbed into the affected parts, are very useful. The frictions should be performed in a warm room, currents of air guarded against. A wet compress, simple or medicated, greatly assists the cure. In this and other varieties of muscular Rheumatism, rest and warmth are of great importance. The application of the common flat iron of the laundry, as hot as can be borne, with flannel between the skin and iron, is very valuable. In Lumbago, noting is so instantaneously beneficial as strapping the back from the level of sea upwards, in layers that overlap each other with strips of unbleached cotton wool wrapped across the loins, next he skin, is very comforting. Where persons are very liable to lumbago from slight exposure to cold or damp, wearing a skein of silk round the waist is an excellent preventive, Generous, nutritive diet is desirable. Lemon juice is a grateful and remedial beverage.
RHEUMATISM AND MUSCULAR WEAKNESS. Muscular Rheumatism is apt to be confounded with the painful muscular affections followed prolonged or excessive exertion, or with the soreness or stiffness which occur during convalescence from any long illness which occur during convalescence from any long illness, or accompany general debility. These affections are generally better after the repose of the night, but increase with fatigue; and the pain in the affected part is mitigated by relaxing or supporting it. The diagnosis is important, especially to medical men, because if we fail to prescribe appropriate medicines, nourishing diet, and proper rest and support to the weak muscles until they regain their tone, we shall fail to benefit the patient, who possibly in his contempt for medicine, as Dr. Tanner remarks, will hasten to try the good diet and pure air of some hydropathic establishment, and then circulate reports of his extraordinary cure, after having been given over by the faculty.
55. Chronic Rheumatism.
DEFINITION. Chronic pain, with stiffness, welling, and possibly distortion of various joints.
This is sometimes s sequel of the acute form of Rheumatism, at other times it is a separate constitutional affection, coming on quite independently of any previous attack. It is generally very obstinate, prone to recur, and is often worse at night. In time the affected limbs loose their power of motion, and lameness results; the knee joint being often affected; sometimes there is emaciation of the muscles; sometimes permanent contraction of a limb, or bony stiffness of the joint. There is but little febrile disorder, no perspiration, and less swelling than in acute Rheumatism.
TREATMENT. In the treatment of chronic Rheumatism, dyspeptic symptoms, often associated with it, are primary considerations, and little hope of a cure can be expected till they are remedies. Suitable medicines will be found in the following list and in the Sections on Acute Rheumatism and Dyspepsia.
Rhus Tox. When the sheaths of tendons, muscles, etc., are chiefly affected; the pains being worse during rest at night in the warmth of the bed, and on first moving, but wearing off with continued exercise. Creeping sensations may also be present. In rheumatic lameness generally, Rhus is often curative.
Bryonia. Chiefly when the lower limbs are affected; severe pains down the calf of the leg; shining red swelling, with heat and dryness of the parts; pains aggravated by motion. Indigestion, Constipation, etc., are often associated with thee disease.
Aconitum is often of service, and sometimes curative. It is more especially adapted to Rheumatism of the shoulder, and of the large joints generally, when there is not rigidity. Rheumatism of the heart, with congestion and sense of anguish; and during febrile disturbance.
K. Hydriod. Excruciating pains produced by the least variation or irregularity of motion; inverted hands; swollen, stiffened, almost immovable joints; slightest attempt to rise occasions torture in the lumbar vertebrae; chronic induration and enlargement of the glandular structures; affection of periosteum, syphilitic complications.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."