s; resisting or recurring again and
again after frequent evacuations, in a manner very different from primary
inflammations; because the cause is not removed, which is at a distance
from the seat of the inflammation.

This also accounts for rheumatic inflammations so very rarely terminating
in suppuration, because like the gout the original cause is not in the
inflamed part, and therefore does not continue to act after the
inflammation commences. Instead of suppuration in this disease, as well as
in the gout, a quantity of mucus or coagulable lymph is formed on the
inflamed membrane; which in the gout changes into chalkstones, and in the
rheumatism is either reabsorbed, or lies on the membrane, producing pains
on motion long after the termination of the inflammation, which pains are
called chronic rheumatism. The membranes, which have thus been once or
repeatedly inflamed, become less mobile, or less liable to be affected by
sympathy, as appears by the gout affecting new parts, when the joints of
the foot have been frequently inflamed by it; hence as the cause of the
inflammation does not exist in the inflamed part, and as this part becomes
less liable to future attacks, it seldom suppurates.

Secondly, when rheumatism affects the muscles of the chest, it produces
symptoms similar to pleurisy, but are distinguished from that by the
patient having previously suffered rheumatic affections in other parts, and
by the pertinacity or continuance of the inflammatory state of the patient,
this should be termed pleurodyne rheumatica.

Thirdly, when rheumatic inflammation affects the bowels, it produces a
disease very different from enteritis, or common inflammation of the
bowels, and should be termed enteralgia rheumatica. The pain is less than
in enteritis, and the disease of longer continuance, with harder pulse, and
the blood equally sizy. It is attended with frequent dejections, with much
mucus, and previous griping pains, but without vomiting; and differs
perhaps from dysentery from its not being attended with bloody stools, and
not being infectious.

Fourthly, there is another kind of rheumatism attended with debility, which
suppurates, and should be termed rheumatismus suppurans. It is generally
believed to be the gout, till suppuration takes place on the swelled joint;
and, as the patient sinks, there are sloughs formed over the whole mouth;
and he seems to be destroyed by inflammation or gangrene of the mucous
membra