case of cold,
tonsillitis, or sore throat entering the house; the patient is promptly
isolated and treated on rigidly antiseptic principles, with the result
that epidemics of relapses of rheumatism in the inmates have greatly
diminished in frequency.

If every case of cold or sore throat were promptly and thoroughly
treated with antiseptic sprays and washes such as any competent
physician can direct his patients to keep in the house, in readiness for
such an emergency, combined with laxatives and intestinal antiseptic
treatment, and, above all, with rest in bed as long as any rise of
temperature is present, there would be a marked diminution in both the
frequency and the severity of rheumatism. If to this were added an
abundant and nutritious dietary, good ventilation and pure air, an
avoidance of overwork and overstrain, we should soon begin to get the
better of this distressing disease. In fact, while positive data are
lacking, on account of the small fatality of rheumatism and its
consequent infrequent appearance among the causes of death in our vital
statistics, yet it is the almost unanimous opinion of physicians of
experience that the disease is distinctly diminishing, as a result of
the marked improvement in food, housing, wages, and living conditions
generally, which modern civilization has already brought about.

So much for acute rheumatism. Vague and unsatisfactory as is our
knowledge of it, it is, unfortunately, clearness and precision itself
when contrasted with the welter of confusion and fog which covers our
ideas about the _chronic_ variety. The catholicity of the term is
something incredible. Every chronic pain and twinge, from corns to
locomotor ataxia, and from stone-in-the-kidney to tic-douloureux, has
been put down as "rheumatism." It is little better than a diagnostic
garbage-dump or dust-heap, where can be shot down all kinds of vague and
wandering pains in joints, bones, muscles, and nerves, which have no
visible or readily ascertainable cause. Probably at least half of all
the discomforts which are put down as "rheumatism" of the ankle, the
elbow, the shoulder, are not rheumatism at all, in any true or
reasonable sense of the term, but merely painful symptoms due to other
perfectly definite disease conditions of every imaginable sort. The
remaining half may be divided into two great groups of nearly equal
size. One of these, like acute rheumatism, is closely related to, and
probably caused by