A practical treatise on medical diagnosis for students and physicians / by John H. Musser.

  • Musser, John Herr, 1856-1912.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on medical diagnosis for students and physicians / by John H. Musser. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    absent especially in babies and very young children. Sometimes children have choking spells without much coughing and without the whoop. Ao-ain, when pneumonia or measles occurs as a complication, the whoop usually ceases for the time, but may reappear later. Third Stage. The third stage is less well defined than the first two. It may be said to begin when the nocturnal exacerbations become less frequent and severe. The number of paroxysms during the day dimin- ishes, and vomiting is a less frequent accompaniment. Appetite improves, and the child gains in flesh and passes more restful nights. The duration of the disease is variable. Ordinarily it lasts from six to eight weeks, but it may be prolonged for several months. The patient is liable, whenever he catches a fresh cold, to a temporary return of the spasmodic cough, sometimes with the whoop. The great majority of the cases occur before the sixth year, and most of these between the second and fourth years. Rheumatic Fever. Kheumatic fever is an infection associated with local symptoms of joint, endocardial, and pericardial inflammation. The local symptoms are so intense as to call attention at once to the nature of the infection apart from the course of the fever, as it is largely upon these symptoms that the diagnosis is made. An acute, general, febrile, non-contagious disease, characterized by specific inflammation of the joints and contiguous structures, hence called acute articular rheumatism. It is further characterized by a tendency of the inflammation to involve the larger joints successively, to skip from one joint to another, and to be associated with endocarditis or pericar- ditis. The predisposing causes of rheumatic fever are heredity, which is operative in 25 or 30 per cent, of the cases; age—81 per cent, of first attacks occur between the eleventh and thirtieth years (Pye-Smith) ; sex— in childhood girls are more frequently affected, than boys, but after that period sex appears to have no influence. Multiarticular inflammations, sometimes rheumatic in nature, are met during convalescence from scar- latina and dysentery. They also occur in association with the puerperal state and gonorrhoea, when they are probably pysemic. The nature of the polyarthritis which occurs in connection with dengue and haemophilia is obscure. Symptoms. The onset of the disease is not characterized by constant symptoms. Sometimes the fever and joint-inflammations are preceded a day or two by debility, wandering pains in the joints or muscles, and loss of appetite. Other cases are marked by a chill or repeated attacks of chilliness, followed in a day or two by fever and inflammation of the joints. In rare cases the onset may be followed not by inflammation of the joints, but by inflammation of the serous membranes, particularly those of the heart and its sac. The temperature may rise a day or two before there are any joint- symptoms, or fever and arthritis may begin almost simultaneously. The