Sinossi
This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1914. Excerpt: ... PART III A STUDY OF ACUTE RHEUMATISM BASED UPON THE RESULTS OF THE PREVIOUS RESEARCHES 1. THE ETIOLOGY AND PATHOLOGY 2. SYMPTOMATOLOGY 3. DIAGNOSIS AND PROGNOSIS 4. TREATMENT 5. PREVENTION THE ETIOLOGY AND PATHOLOGY We shall attempt in this article to consider the disease termed "acute rheumatism " by the light of the preceding investigations, indicating their bearing upon the aetiology and pathology, symptoms, diagnosis, prognosis and treatment. In writing this paper we realise the inadequacy of the terms "acute rheumatism" and "rheumatic fever," but present usage has prevented us from abandoning them and employing as we should prefer the general term rheumatism. (a) The etiology The first step is a consideration of the older explanations of the causation and the part that they take in the evolution of the present position of the question. It is not to be supposed that the suggestions put forward by earlier writers, crippled though they were by limitations in methods of inquiry, can be thrown aside as useless, for they were based upon observations made by physicians of high intelligence and deep clinical insight. Cullen attributed the disease to the direct influence of cold upon the joints which he believed to be vulnerable on account of their comparatively thin covering. Here he thought the inflammation commenced, and from them to generalise, and we have in this theory a recognition of the important factor of chill in the causation of the disease. J. K. Mitchell suggested that the primary lesions would be localised in the spinal cord. Chill and exposure irritated the sensory nerve fibres over a wide area and set up this central disturbance which was in turn reflected to the nerves of the various organs and tissues and thus produced the manifestations. T...
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