olchicum given in the common purging mixture, with calomel and colocynth in moderate doses till the bowels are freely acted upon, and the secretions become more healthy; after which, I commonly give calomel and compound ipecacuanha powder at bed time, and repeat the colchicum mixture in the morning, till the disease begins to decline or to remit, at which time I begin with quinine, according to the debility and state of the pulse. If the pain or fever should return, I omit the quinine, and give the purging mixture every morning for a day or two, and then return to the bark, &c. In this neighbourhood it is usual to apply scalded leaves to all inflamed joints, and great relief is frequently afforded by the application. I have seldom found it necessary to give calomel so as to affect the constitution, unless when the heart or its membranes have become implicated in the disease. Though the heart is very frequently affected in this disease, I have only seen one case in which the inflammation left the extremities and attacked the heart; in this case the disease as suddenly left the heart and fixed upon the membranes of the brain; the patient ultimately recovered, but no inflammation returned in the extremities. In one case of rheumatic fever which occurred in a delicate girl of fourteen, suppuration took place in several parts of the body and limbs; I think more than twenty abscesses required to be opened before she recovered. I have never considered chronic rheumatism as a frequent disease here, but I must observe that I have generally considered those pains which are commonly called rheumatic, as depending upon a disordered state of the digestive organs, and treated them as such.
