The various manifestations of the rheumatic state as exemplified in childhood and early life.

  • Cheadle, Walter B. (Walter Butler), 1835-1910.
Date:
1889
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Licence: Public Domain Mark

Credit: The various manifestations of the rheumatic state as exemplified in childhood and early life. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    and may even be absent altogether. It is however, I believe, nearly always present at some period of the rheumatic efflorescence. I have now under my care at St. Mary's Hospital, Kate B , a girl of fifteen, who was admitted with severe chorea. There was no sign of articular affection, or of any other condi- tion suggestive of rheumatism. The heart's sounds were clear and natural. There was no history of any previous rheumatic affection of any kind to be obtained by most careful inquiry, there was no his- tory of rheumatism of any form in the family, and the case was put down as an instance of non-rheu- matic chorea. Twelve days after admission, however, she suddenly complained of pain and stiffness of the right wrist and back of the hand, which were found to be slightly but unmistakably swollen and tender. The arthritis subsided in forty-eight hours. Three days later a similar pain and tenderness of the right wrist and hand developed, subsiding as quickly as the first. It would certainly have escaped serious notice had not my house physician been on the watch for the possible appearance of some rheumatic sign. Such cases give the key to many instances of unex- plained heart disease and chorea.1 The arthritis is, 1 This has subsequently received further illustration and con- firmation. Since the above was written, and three weeks after the occurrence of the transient arthritis above recorded, pericarditis has