The Rheumatism may exist either with or without a Fever. The first of these may be classed among the Diseases, of which I have already treated; being an Inflammation which is manifested by a violent Fever, preceded by Shivering, a subsequent Heat, hard Pulse, and a Head-ach. Sometimes indeed an extraordinary Coldness, with general Uneasiness and Inquietude, exists several Days before the Fever is perceived. On the second or third Day, and sometimes even on the first, the Patient is seized with a violent Pain in some Part of his Body, but especially about the Joints, which entirely prevents their Motion, and which is often accompanied with Heat, Redness and a Swelling of the Part. The Knee is often the first Part attacked, and sometimes both the Knees at once. When the Pain is fixed, an Abatement of the Fever frequently happens; though in some other Persons it continues for several Days, and increases every Evening. The Pain diminishes in one Part after a Duration of some Days, and then invades some other. From the Knee it descends to the Foot, or mounts to the Hip, to the Loins, the Shoulder-blades, Elbow, Wrist, the Nape of the Neck, and frequently is felt in the intermediate Parts. Sometimes one Part is quite free from Pain, when another is attacked; at other Times many Parts are seized nearly at the same Instant; and I have sometimes seen every Joint afflicted at once. In this Case the Patient is in a very terrible Situation, being incapable of any Motion, and even dreading the Assistance of his Attendants, as he can scarcely admit of touching, without a sensible Aggravation of his Pains. He is unable to bear even the Weight of the Bed-clothes, which must be, as it were, arched over his Limbs by a proper Contrivance, to prevent their Pressure: and the very walking across the Chamber increases his Torments. The Parts in which they are the most excruciating, and obstinate, are the Region of the Loins, the Hips, and the Nape or hinder Part of the Neck.