On rheumatic fever.

Date:
[©1852?]
Catalogue details

Licence: Public Domain Mark

Credit: On rheumatic fever. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    undue preponderance of fibrin in the blood—hyperinofis, as it is termed—have each been claimants for this bad preeminence. It is not neceflary to occupy time in difculfing their refpeftive titles to this pofition, inafmuch as the queftion of the exaft nature of the rheumatic poifon, if fuch poifon there be^ is ftill, in my opinion, an open one, upon which I have no new data nor any fuggeftions to offer. The fuperabundance of fibrin in rheumatic fever, which I believe to be an admitted faft, has recently acquired additional importance. We know how rare is delirium in this difeafe, whatever its feverity. True, it is not unknown, but when prefent it would feem to depend upon fome peculiar and not well underftood condition, and not to be proportioned to the intenfity of the pyrexia fimply, as in other fevers. It is a curious thing that we do not fee varying degrees of delirium in rheumatic as in other fevers, whether eflential or fecondary. For example: in typhoid we fee, in different cafes, all (hades and degrees of delirium, from the flightefl to the mofl fevere. I do not mean to fay that delirium of rheumatic fever is always of equal intenfity; but, fo far as my experience goes, if any be prefent it is always confiderable and formidable. Now, the refearches of Drs. Charles Hood^ Marcet^ Erlenmeyer^ and Hittorf feem to fhow that there is always a marked deficiency of fibrin in the blood of maniacs, either acute or chronic. A fimilar condition was found by Andral in idiopathic fevers, of which, when at all fevere, delirium is fo common a feature. Are we then, juflified in fufpe£ling that there is any connexion between the hyperinofis of rheumatic blood and the in frequency of delirium in rheumatic fever ? A therapeutic teft would feem to fhow that when delirium does occur in this difeafe, the condition of the fyflem approaches that of typhus. I have feen fix well-marked cafes—one fome years ago, which was treated, I forget how, but certainly not with flimulants. It terminated fatally: no marks of inflam- mation were found in the head. Five others have been under my own care during the laft two years — one in the Queen's Hofpital, fupervening on diarrhcca and attended with bedfore,