TREATMENT.--Owing to our imperfect knowledge of the real nature of acute articular rheumatism, its treatment is still largely either empirical or intended to combat certain prominent symptoms or complications of the disease. Of the various methods of treatment which have been employed space will not permit a description; even of those advocated by authorities of the present hour only very few will be considered. The method which is now unquestionably the favorite one in both Europe and America, and which in its power of promptly relieving the articular and muscular pains and reducing the fever of acute rheumatic polyarthritis may without exaggeration be compared to that exercised by quinia over the paroxysms of ague, is that in which salicylic acid or salicylate of sodium is given in repeated and full doses. It was in July, 1875,[128] that Buss first asserted that salicylic acid was a specific for rheumatism, and in March, 1876,[129] Maclagan, after having employed salicine from 1874, published his experience of it as a valuable remedy in the treatment of acute rheumatism, its beneficial action being "generally apparent within twenty-four, always within forty-eight, hours of its administration in sufficient dose." Perhaps a sufficient time has now elapsed to permit of a just opinion of the power of these new remedies, the salicyl compounds, over acute articular rheumatism. The facts presented at the discussion recently held at the Medical Society of London[130] are sufficiently numerous and authoritative to justify, at least provisionally, some definite conclusions as to the remedial relations of the salicylates to acute articular rheumatism. [Footnote 128: "Die Antepyr. Wirkung der Salycylsäure," _Centralbl. f. d. Medic. Wissenschr._, 1875, 276.] [Footnote 129: _The Lancet_, March 4 and 11, 1876.] [Footnote 130: _The Lancet_, Dec. 17, 24, 31, 1881; Jan. 7, 14, 28, 1882.] 1. The articular pain and the fever of acute rheumatic polyarthritis are more or less speedily removed by the salicyl remedies (salicylic acid, sodium salicylate, and salicine); the pains very frequently persist after the temperature has become normal. Both symptoms were removed by five days' use of such agents in 50 per cent., and by eleven days' use in 80 per cent., of 355 cases treated at Guy's Hospital, and tabulated by Fagge,[131] and by five days' use in 60 per cent., and by eleven days' use {52} in 66 per cent., of the 60 severe cases treated and severely criticised by Greenhow.[132] [Footnote 131: _Ibid._, ii., 1881, 1031.] [Footnote 132: _Clinical Society's Transactions_, vol. xiii., 1880. See Dr. Fagge's table iv., _Lancet_, ii., 1881, 1032.]