=RHEUMATISM OF THE CHEST.=--In this form there is more or less
constant pain, much increased by coughing, sneezing, taking long
breaths, or by movements. It attacks usually one side, more often the
left. It may resemble neuralgia or pleurisy. In neuralgia the pain is
more limited and comes in sharper attacks, and there are painful
spots. The absence of fever in rheumatism of the chest will tend to
separate it from pleurisy, in which there is, moreover, often cough.
Examination of the chest by a physician, to determine the breath
sounds, is the only method to secure certainty in this matter.
Muscular rheumatism also affects the muscles about the shoulder and
shoulder blade and upper part of the back; sometimes also the muscles
of the belly and limbs.
=Treatment.=--Rest, heat, and rubbing are the most satisfactory
remedies. In stiff neck, rub well with some liniment, as chloroform
liniment, and lie in bed on a hot-water bag. Phenacetin or salophen in
doses of ten grains, not repeated more frequently than once in four
hours for an adult, may afford relief; only two or three doses should
be taken in all. In lumbago the patient should remain in bed and have
the back ironed with a hot flatiron, the skin being protected by a
piece of flannel. This should be repeated several times a day. Or a
large, hot, flaxseed poultice may be applied to the back, and repeated
as often as it becomes cool. At other times the patient may lie on a
hot-water bag. Plasters will give comfort in milder cases, or when the
patient is able to leave the bed. A good cathartic, as two compound
cathartic pills, sometimes acts very favorably at the beginning of the
attack. Salicylate of sodium is a useful remedy in many cases, the
patient taking ten grains three times daily, in tablets after eating,
for a number of days. In rheumatism of the chest, securing immobility
by strapping the chest, as recommended for broken rib (Vol. I, p. 84),
gives more comfort than any other form of treatment. Many other
measures may be employed by the physician, and are applicable in
persistent cases, as electricity and tonics. The hot bath, or Turkish
bath, will sometimes cut short an attack of muscular rheumatism if
employed at the onset of the trouble.
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