From the nature of the disease, treatment is for the most part palliative.  Salicylates are only of service during the exacerbations attended with pyrexia.  The application of soda fomentations, turpentine cloths, or electric or hot-air baths may be useful.  Improvement may result from the general and local therapeutics available at such places as Bath, Buxton, Harrogate, Strathpeffer, Wiesbaden, or Aix.  In selected cases, a certain measure of success has followed operative interference, which consists in a modified excision.  The deformities resulting from chronic rheumatism are but little amenable to surgical treatment, and forcible attempts to remedy stiffness or deformity are to be avoided.

#Arthritis Deformans# (Osteo-arthritis, Rheumatoid Arthritis, Rheumatic Gout, Malum Senile, Traumatic or Mechanical Arthritis).—­Under the term arthritis deformans, which was first employed by Virchow, it is convenient to include a number of joint affections which have many anatomical and clinical features in common.

The disease is widely distributed in the animal kingdom, both in domestic species and in wild animals in the natural state such as the larger carnivora and the gorilla; evidence of it has also been found in the bones of animals buried with prehistoric man.

The morbid changes in the joints present a remarkable combination of atrophy and degeneration on the one hand and overgrowth on the other, indicating a profound disturbance of nutrition in the joint structures.  The nature of this disturbance and its etiology are imperfectly known.  By many writers it is believed to depend upon some form of auto-intoxication, the toxins being absorbed from the gastro-intestinal tract, and those who suffer are supposed to possess what has been called an “arthritic diathesis.”

The localisation of the disease in a particular joint may be determined by several factors, of which trauma appears to be the most important.  The condition is frequently observed to follow, either directly or after an interval, upon a lesion which involves gross injury of the joint or of one of the neighbouring bones.  It occurs with greater frequency after repeated minor injuries affecting the joint and its vicinity, such as sprains and contusions, and particularly those sustained in laborious occupations.  This connection between trauma and arthritis deformans led Arbuthnot Lane to apply to it the term traumatic or trade arthritis.

The traumatic or strain factor in the production of the disease may be manifested in a less obvious fashion.  In the lower extremity, for example, any condition which disturbs the static equilibrium of the limb as a whole would appear to predispose to the disease in one or other of the joints.  The static equilibrium may be disturbed by such deformities as flat-foot or knock-knee, and badly united fractures of the lower extremity.  In hallux valgus, the metatarso-phalangeal joint of the great toe undergoes changes characteristic of arthritis deformans.