The subject is one beset with difficulties, and still needs investigation. It is reasonable to infer that as the salicylates promptly arrest the articular inflammation and allay the fever of uncomplicated acute rheumarthritis, they will prevent the visceral inflammations so apt to develop when the disease runs its course uninfluenced by treatment; but experience has shown that they do not control or arrest rheumatic inflammation of the heart or pleura or the attending pyrexia, although capable of subduing the articular inflammation and the pyrexia that accompanies it. The most eminent therapeutists are divided on the subject. Maclagan, while admitting that the salicyl compounds do not ward off cardiac complications, or cure them when they exist, maintains that their existence is an additional reason for giving those remedies freely and in large doses.[148] Broadbent,[149] while believing in the protective influence of the salicylates "when brought to bear upon the fever in the first days of its existence," finds in the presence of any cardiac inflammation a reason for at once discontinuing those remedies. Flint[150] believes that rheumatic endo- and {55} pericarditis are more common since the introduction of the salicyl treatment than when the alkaline method was relied upon almost entirely, and advises[151] the administration of alkalies with the salicylates to protect the heart. Vulpian[152] thinks the protective power in question probable, but not established; while the latest French authority, Homolle, is of opinion that "cardiac affections are really less frequent in patients treated by salicylate of sodium than in others."[153] [Footnote 148: _Lib. cit._, pp. 266, 275.] [Footnote 149: _Lancet_, i., 1882, 138.] [Footnote 150: _New York Med. Record_, 1882, 66.] [Footnote 151: _Pract. Med._, 5th ed., 1098.] [Footnote 152: _Du Mode d'Action du Salicylate du Soude dans le Traitement du Rheum. Artic. Aigue_, Paris, 1881, 11.] [Footnote 153: _Nouveau Dict. de Méd. et de Chir._, xxxi., 1882, 648.]