Arizona republican., 1893-04-02
RHEUMATISM.
nv WIN. W. HrBBARp. M.D.l


The usual history OF an attack OF acute
rheumatism IL that one Joint after an.
OI her in Quick succession becomes in.
famed, until many have become al.
fe, ted. Cases do cccur, however, in
WHICH the aft, ctiOn il limited TO a single
joint, while in other cases many juints
are infiamed ut the same time, the or
der OF sue essiOn not taking place. An
other peculiar " of this disease Is the
RhTupIneSs with which the intamma-
ton at times leaves the part aft, CIed.
4 patient may he suff, ring sever ly one
day and have intense pain IN the part
involved, while on the next day he may
b. comparatively free from distressing
81 mproms as TO the part referred 10.
Rheumatism may attack other parts
than the authorizations, a., for instance,
the back Of the hand or the sole of the
foot; likewise, the ligaments OF the neck
and back, as also c r ain pats OF the
eye. There il always more or l-ss fever
connected with this disPase. although it
is net as marked in degree as the
amount OF iutlammRtory sympr oms, as
iGdlcaled by rain, heat, re mess and
swelling would seem To warrant.
The length Of time involved in On at
tack at acute rheumatism Is somewhat
uncertain. " may pass from one joint
t. another, the irint affected yesterday
being nearly well today, 80 far as suffer
ing is concerned, and little later on 1t
may again be severely affected In this
way most oi the iDints m y be attacked,
even IN the cOnrse Oh q week. After a
time he di-ease seems 10 exhaust itself
and the parts hitherto involved get hack
to their normal status, at least for
time.
Ii may he trnthfully said that Fheu-
maiism has at hast two kinds Of pain,
one OF a severe character, causing much
pain in various parts OF the limbs and
trunk and accompanied with cOnsidera.
bic muscular soreness. Such pains are
similar to those experienced when one
catches a VI lent cold, and az s"Ch can
not be considered AS dislinciively char.
a, teristic. The other kind OF pains are
actually situated in the ariiCulaIiOns,
and are Of the nature OF sharp twinges
these pains are rapidly shifting IN their
cha aCrtr, going from one joint to an
other in the spare Of few hours.
From what has been heretofore writ
ten upon tnis subject the reader will
have noted the mentioning Of certain
symptoms a. Characteristic o. this dis.
ease Briefly put. they generally are
as follows: A more or less chilly SEN
sation for few days prior to the at
tack followed by hot flashes and fe-
vered-likp condition Of the whole sys-
ten, the developing of rain in different
joints, more often in the larger once,
like the shoulder, hip, wrist and ankle,
somt times coming on rapidly and very
severe, with greet tenderness on pres.
sure and the exp, rience of much pain
from the sIight"st movement, the pulse
ranges from Sh TO los per minute and
may 90 mnCh higher, the temperature
is raised correspondingly and sometimes
even more than the .pulse would rela-
lively indicate. Not infrequently there
IL increased Precipitation, having a
mnsty, sour smell, and the respiration
is quickPned. Usually there is ronsid-
cradle thirst and the tongue becomes
coated the digestion ia slow the appe
tite is impaired, though in many cases
not entirely suspended.
Complicated cases of acute rheuma-
tism ere necessarily more protraCted
IN their course, the most common COM
as has been previously re-
marked. is Inflammation Of certain
paris Of the heart. When inflammation
Of the membranes Of the heart occurs,
it generally develops imperceptibIy and
the symptoms pertaining to the same
are at the beginning suCh as not TO
arouse much anxiety. There is rarely
a warning by way Of sharp chill or
acute pain; sometimes the PATIENTS
suspicion il fret aroused in noticing
that he IL breathing faster than form
erlv. and II this symptom is manifest
and continurd after ore has had an at.
tack Of rheumatic fever, he should i'm
mediaielv have his heart examined by
an intelligent and experienced physi.
elan, since many distressing conse-
quences involving serious results follow
from structural changes Of the heart.