Rheumatism, its nature, its pathology and its successful treatment / by T.J. Maclagan.

Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Rheumatism, its nature, its pathology and its successful treatment / by T.J. Maclagan. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    The inflammation of the joints, which gives rise to the suffering of acute rheumatism, forms the most prominent and characteristic feature of the disease. As a rule, it is confined to the large joints; the knee, ankle, wrist, elbow, shoulder, and hip joints being attacked with a frequency which corre- sponds very much to the order in which they are enumerated. Of the small joints those of the fingers are most apt to suffer. In striking contrast with what is observed in gout, the joints of the foot, other than the ankle, are very rarely affected. The local symptoms of the disease are pain, swelling, and great tenderness, of the inflamed joints. Occasionally there is redness of the surface. But such redness is less marked and less common than in gouty inflammation. In acute rheumatism the inflammation shows a marked tendency to shift from joint to joint. This alternation of pain, and freedom from pain, may be experienced by all the large joints of the body more than once during one attack of the disease. The invasion of fresh joints is not always accompanied by diminution of the inflammation in those already affected. But occasionally there is noted what seems to be, and is by many regarded as, a true metastasis—a sudden retrocession of the inflammation from one joint to another. Febrile symptoms are marked. The pulse and respirations are increased in frequency. The temperature varies from 100° to 104° Fahr., but has no distinctive range. The general course of the fever is remittent rather than continued. Just as the local joint affection is made up, not of one long continued attack, but of a succession of short ones, so the febrile symptoms consist, not of one long continuous seizure, but of a series of short ones, whose duration and severity correspond very much to the duration and severity of the local inflammatory attacks. During the whole course of the