A PECULIAR acid, in rheumatic complaints, is now generally admitted to secrete, or accumulate, in the system; and, though this acid is found to pervade the entire body, yet this form of disease has been thought to be rather a local complaint—that the joints, or parts affected, are particularly in fault, and the remedies used are to be of a local, and external character; or, if general, are particularly to act on the seat of the pain.

The more we study the human frame, and become familiar with the organism of the human body, the more convinced we are that, whenever one organ or function of the system is deranged, all others feel its effects. In rheumatism, therefore, we have always discovered that the stomach and liver are diseased; these notions we have had very well substantiated by many. The internal irritation, renders the nutritive energy of certain parts at the periphery, (namely, the fibrous sheaths and covering of the muscles,) feeble, and their power of resisting external causes of disease, deficient. When cold and damp, therefore, are applied to the skin, the blood is driven thence toward the parts most ready, from their want of organic energy, to retain it, and least able to resist its flow. Those parts are the tissues which have been most violently employed—the tissues connected with the organs of voluntary motion, and the fibrous tissues of the muscles and joints. In some persons, these tissues are congenitally weak, the hereditary predisposition exists, and there is morbid sympathy always existing between them and the centre of nutrition. The laboring man who keeps his stomach and liver in a constant state of irritation, with spirituous drinks—who uses his voluntary muscles hard and long every day, and is exposed to all kinds of weather, is the most eligible, and the most frequent victim of rheumatism; for in him the condition of the stomach, the limbs, and the exciting cause, meet in all their strength. Hence, in places where perry and cider abound, the peasantry are especially subject to rheumatism.

Why the rheumatism seizes one joint or set of muscles, more than another, we know not, positively; but we do know, that more or less digestive derangements are present at the time. I never saw a rheumatic attack, in which such derangements were not present, previously to its commencement. How often does it happen that a patient, racked with pain is instantly relieved by a copious vomiting of bile, or by a common diarrhoea.

We come to the conclusion, then, that rheumatism is not a mere inflammatory pain of the sheaths of the muscles, but has its origin in some digestive irritation—exhibited by a certain kind and amount of fibrous inflammation, and this may be caused by the circulation of this acid blood, in its passage through the minute cappillaries of the joints and tendons, since nothing but the white and thin blood can pass through the circulation of the tendons and ligaments. Perhaps this blood may be almost entirely of an acid character; it has no red particles, and may lack those qualities which render it subservient to nutrition and assimilation.

If this view of the subject is correct, we readily perceive how the bleeding, cupping, leeching, and blistering processes, tend directly to weaken the energy of the organs, and render them more liable to distension and congestion.

A peculiar odor also arises from the patient, which I have thought quite symptomatic of the disease, while the evacuations are thin, dark, watery, and extremely offensive. The eruption on the skin I have observed, but am not able to say whether or not it is present in all cases; I have never been able to see it in negroes, neither do I know whether it is perceptible at all in such subjects, but I am inclined to the opinion that it is not. The eruption, as I have observed, is various in appearance. It consists of small, rosy blotches, of a roundish, or lenticular shape, scarcely, if at all, raised above the general surface of the skin on which they appear.

I have observed another eruption in this disease, called “petechiÆ.” This eruption is most perceptible on the chest, and interior part of the arms. There is still another eruption which I have frequently observed, but it is not peculiar to this disease; I have also often observed it in other forms of disease. It makes its appearance about the neck, and the eruption varies in size, from a mere point to that of half a pea, and is filled with a transparent fluid; it looks not unlike large and small drops of dew, scattered about over the neck; this eruption I have often observed on negroes.

Shortly after the termination of the disease, and sometimes even before its termination, the skin commences desquamating. This desquamation is particularly apt to take place on the inner surface of the hands, and bottoms of the feet; the hair also frequently falls off, and even the nails are sometimes shed. Patients recovering from this disease, frequently have a numbness of the arms or legs, which sometimes amounts to a complete paralysis.

Abscesses often form about the thigh, leg, or some other part, which burrow in the inter-muscular substance, and are very hard to cure.