Occasional lectures on the practice of medicine : addressed chiefly to the students of St. Mary's Medical School; : to which are appended the Harveian Lectures on the Rheumatism of Childhood; / revised and corrected up to date by W.B. Cheadle.

  • Cheadle, Walter B. (Walter Butler), 1835-1910.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Occasional lectures on the practice of medicine : addressed chiefly to the students of St. Mary's Medical School; : to which are appended the Harveian Lectures on the Rheumatism of Childhood; / revised and corrected up to date by W.B. Cheadle. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    known rheumatic phase with an indeterminate febrile attack of apparent insignificance. It is essential, then, in children especially, to examine the heart carefully in every case of the slightest articular affection — even a stiff neck or a stiff knee; and in chorea, in tonsihitis, in erythema, in an evolution of nodules, and, indeed, in every pyrexial condition of every form. Whenever there is suspicion of rheumatic inflammation—even if no cardiac affection be perceptible—enforce absolute rest in bed. Complete physical repose and external warmth are of the first, possibly of vital, importance. Cases of slight rheumatism rule, treated far too lightly by both parents and doctors. What a vast difference it would have made in the future condition of the schoolboy, H. G , for instance, if, instead of being allowed to follow athletic sports, and thus strain his heart's muscle and court fresh chill, he had been kept secure in rest and warmth. Dr. Sibson found that a much larger proportion of cases—more than two to one—treated by absolute rest escaped permanent heart mischief than those allowed free action. With regard to drugs I may point out that tha heroic treatment by large and repeated doses of sali- cylate of soda is rarely called for in the rheumatism of children, since the articular affection is usually slight, and the pyrexia as a rule not severe. Salicin may be given in place of salicylate of soda in most articular cases with advantage, as being less depressant—and with the salicin, alkalies. The general evidence of the statistics of the Collective Investigation Committee