During rheumatism the peripheral blood vessels are generally dilated

and the skin perspires profusely. This is caused not only by the

rheumatism, but also by the salicylates. The surface of the body

should be sponged with cold, lukewarm or hot water, depending on the

temperature, especially of the skin. The cold water will reduce the

temperature and tone the peripheral blood vessels; the hot water, if

the temperature is low and the skin moist and flabby, will cleanse

it and also tone the peripheral blood vessels. If the blood vessels

are dilated and the perspiration profuse, atropin is indicated, both

as a cardiac stimulant and contractor of the blood vessels and as a

preventer of too profuse sweating. The dose should be from 1/200 to

1/100 grain for an adult, given two or three times in twenty-four

hours, depending on its action and the indications. It should be

remembered that atropin is not a sleep-producer; it may stimulate

the cerebrum. Therefore at night it might well be combined with a

possible necessary hypodermic injection of morphin.

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