explain these
symptoms as the result of the rheumatism leaving the joints and
attacking the brain. Evidently, this being the case, the proper thing to
do was to irritate the joints so as to draw the rheumatism back to them.
This method was formerly practiced, and the almost invariable result was
death in a few hours.

In most if not all of these frightful cases of sudden accession of
severe nervous symptoms in rheumatism the temperature will be found, on
testing it, to be exceedingly high--108 deg., 109 deg. or even 110 deg.
Fahrenheit. If the views advocated in this paper be correct, it is not
the rheumatism, but the intense bodily heat, which causes the severe
symptoms, and finally death. The joints lose their sensitiveness, not
because the disease has left them, but because the heat so overpowers the
brain that it has lost its power of perception: the patient's leg might
be cut off without his feeling it. In such a case the proper treatment is
to take away the heat by plunging the patient into a cold bath. But can
there be anything more shocking to the universal belief and prejudices
than to put a patient dying of acute rheumatism into an almost ice-cold
bath?

Last spring there was in my ward in the Philadelphia Hospital a stout
young Irishman who had passed through an acute attack of inflammatory
rheumatism, and was suffering from a sharp relapse. Entering the ward
one day, I saw at once that the man was unconscious, and turning to the
resident physician asked, "What is the matter with James?" "Nothing,"
was the reply: "I saw him an hour and a half ago, and he was doing very
well, except that the fever was very high." "He is dying now, at any
rate," was my rejoinder. On going to the bedside the patient was found
perfectly unconscious, the skin dry and intensely hot, the affected
joints pale and devoid of sensibility, the breathing irregular and
jerking, the pulse 170 and scarcely perceptible, every muscle relaxed as
in death, every power of perception abolished. A thermometer placed in
the armpit registered 108-4/5 deg. Fahrenheit.

Believing that the symptoms were due simply to this excessive
temperature, I ordered the man to be at once stripped and put in a full
bath drawn from the cold-water spigot. The temperature of this bath
was found to be 60 deg. Fahrenheit. In one minute and a half after
the patient had been placed in the tub he recovered consciousness
sufficiently to put out his tongue when told to do