518 R H E R HI damp and chill, and to protect the skin by suitable under- clothing. In chronic rheumatism the remedies are innumerable. This form of the disease is less under the power of medicinal agents than the acute, although much may be done to alleviate the suffering produced by it as well as to limit its extension. Salicin and the salicylates so useful in acute rheumatism are not found as a rule to be of much service, while on the other hand alkalis in combination with sulphur, iodine, arsenic, and tonics, such as iron, quinine, cod-liver oil, <fcc., are the most serviceable remedies. Turpen- tine is also recommended. Friction of the affected parts with stimulating or soothing liniments, counter-irritation with blisters, iodine, or the button cautery are useful local applications, as is also galvanism. Hot baths or Turkish baths may occasionally be used with advantage. The mineral waters and baths of various well-known resorts are of undoubted benefit, especially those of Buxton, Bath, Strathpeffer, or Harrogate in Great Britain, or those of Aix- les-Bains, Wiesbaden, Homburg, Ems, Wildbad, Aix-la- Chapelle, and many others on the Continent. Changes to warmer climates during the colder season where practicable are also to be recommended, as well as every other measure calculated to improve the general health. RHEUMATOID ARTHRITIS. This term (syn. chronic rheu- matic arthritis, arthritis deformans) is employed to desig- nate a chronic inflammatory affection of joints, involving specially the sy no vial membranes and articular cartilages, of slow development and progressive character, resulting in stiffening and deformity of the parts. This disease is held by some to partake of the nature of both rheumatism and gout (hence occasionally termed rheumatic gout) ; others regard it as simply a variety of chronic rheumatism ; while in the opinion of several eminent authorities it is an independent constitutional affection occurring in persons with a strumous or tubercular tendency. It does not appear to be hereditary. It is more common in women than in men, and occurs at all ages. It is closely connected with conditions of ill health ; and hence its frequent occurrence among those whose blood is impoverished by insufficient food, by hardship, or by any drain upon the system. It occasionally follows an attack of acute rheumatism ; hence the supposed connexion. The disease in most cases is slowly developed, and shows itself first by pain and swelling in one joint (knee, wrist, finger, &c.), which soon subside and may remain absent for a considerable time. Sooner or later, however, another attack occurs either in the joint formerly affected or in some other, and it is noticed that the affected articulation does not now regain its normal size but remains somewhat swollen. The attacks recur with increasing frequency, gradually involving more joints, until, in course of time (for its progress is very chronic), scarcely an articulation in the body is free from the disease. Thickening of the textures, with stiffness, is the result, and often considerable deformity from the joints being fixed in certain positions. The muscles of the affected limbs undergo atrophy and contrast strikingly with the abnormally enlarged joints. Painful inflammatory attacks often occur in the affected joints, and the patient is much reduced in strength by the constant irritation of the disease. In the young the hands are very liable to suffer, and the disease gradually extends to involve other parts ; while in old persons it is apt to fasten upon one joint, often the hip, and is not so apt to spread. The chief changes in the joints are (1) in the synovial membrane, which is at first simply inflamed and contains fluid, but ultimately becomes much thickened, and (2) in the articular cartilage, which tends to split up and become gradually absorbed, leaving the articular ends of the bone exposed. The osseous surfaces thus brought into contact become hard and polished by friction. These changes and others affecting the ligaments are apt to produce partial dislocation as well as stiffening of the joint, rendering it deformed and useless. This disease often lasts for many years, sometimes continuing for a lengthened period without much change, but tending gradually to progress and to render the patient more and more helpless. It is not attended with the complications of rheumatism, and is not inconsistent with long life, but its weakening effects upon the system and the ill health with which it is usually associated render the subject of it more liable to the inroads of other diseases. Rheumatoid arthritis is less amenable to treatment than rheumatism, the remedies for which are not found to be of much value in this disease. Most success is obtained if it is recognized early and measures are taken to strengthen the patient's general health. The best medicinal agents are iron, quinine, cod- liver oil, arsenic. Chalybeate mineral waters, such as those of Schwalbach, Spa, Pyrmont, &c., are often of service. Locally blisters or milder counter-irritation to the affected joints, as well as the employment of galvanism, may be advantageously resorted to. (j. o. A.) RHEYDT, a manufacturing town of Rhenish Prussia, is situated on the Niers, 14 miles to the west of Diissel- dorf. The principal products of its numerous factories are silk, cotton, woollen, and mixed fabrics, iron goods, machinery, lamp wicks, and roofing pasteboard. Dyeing and finishing are also carried on. The most prominent buildings are the old parish church and a new one erected in 1866. Rheydt is an ancient place, but its industrial importance is of very recent growth. At the beginning of the present century it did not contain more than 2000 to 3000 inhabitants, whereas in 1880 the population of the municipal commune Avas 19,087, two-thirds of whom were Protestants. RHIN, HAUT-, a department of France before 1871. See FRANCE, vol. ix. p. 508. RHINE (Lat. Ithenw, Germ, Shein, Fr. Shin, Dutch Shijn), the chief river of Germany and one of the most important in Europe, is about 800 miles in length and drains an area of 75,000 square miles. 1 The distance in a direct line between its source in the Alps and its mouth in the German ocean is 460 miles. Its general course is north-north-west, but it makes numerous deflexions and at one point is found running in a diametrically opposite direction. About 250 miles of its length are in Switzer- land, 450 in Germany, and 100 in Holland; but the German half is in every respect so much the more import- ant that it is no misnomer to call the Rhine a German river, even if the word German be confined to its modern political signification. The name Rhine, which is apparently of Celtic origin, is of uncertain import, but has been supposed to mean "flowing" or "clear." The sources of the Rhine are found in the Swiss canton of Grisons, where the drainage of at least 150 glaciers unites to form its headwaters. Among these streams, all of which are termed Rhin in the Ladine dialect of the district, two are generally recognized as the main sources of the river, viz., the Vorder Rhein and the Hinter Rhein. The chief feeder of the former rises in the small Lake of Toma, situated on the south-east slope of the St Gotthard, 2 at a height of 7690 feet above the sea and at no great distance from the source of the Rhone, which rises on the west side of the same mountain mass. It first flows to the east, receiving the waters of the Medelser Rhein and several other glacier streams, and after a course of about 1 This is the current estimate, but Strelbitzki, the latest authority, does not allow the Rhine a length of more than 710 miles. 2 " Rseticarum Alpium inaccesso ac prsecipiti vertice," says Tacitus.
