New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1896-01-22
RHEUMATISM THE TOPIC.
DISCUSSION AT THE ACADEMY OF MEDI-
CINE.
THE VARIOUS THEORIES OF THE DISEASE EX-
AHMED By DRs. L. +. BISHOP. W. II.
DRAPER AND OTHERS.


DRAPER AND OTHERS.
The question before the Section on General Medi-
tine of the Academy OF Medicine last night was
contained in the topic of paper read by DR. Louis
Eaugeres Bishop. This The Theory ana
treatment of rheumatism" Now, II any pain
stricken patient on seeing this gliInmer o.
hone let him dismiss II at once. for there is no
nearer an approach to unanimity now than there
has ever regarding this troublesome and alto
eether mysterious disease. The speaker OF the
evening himself declared the very outset the df-
Guilty of approaching the subject, because II is OBJ
scre and because in the advance of modern pa thol-
osy rheumatism has been left behind Yet he ar
eued that while this is true it may be profitable to
debate certain theories which have come into prom
inence
The miasmatic theory he held TO be worthy Of
special consideration. although the Tactic theory
still holds its ground. One among the causes is ex-
posure TO cold and moisture. Heredity as factor
receives daily confirmation and when we watch
particular families for series OF years 1t becomes
very striking. The slightly deformed fingers of the
mother the distorted fingers of the grandmother.
but in an earlier stage. and the grandchild is jus,
beginning to complain of aching joints" The con-
stitutional nature of rheumatism. the speaker be-
eved is recognized in that II is believed to be the
cause of diseases Of the skin throat, eye nervous
system. and. indeed, of almost every tissue of the
body. The prevailing theories with regard to the
rheumatism bacterial disease. though there is
q strong and very general adherence TO the Tactic
acid theory. Aside from microscopical evidence.
which up to the present time is coniicting the asso
citation of rheumatism with tonslits. the analogy
between acute artcular rheumatism and the joint
conditions often observed in septic conditions and
the general appearance Of the patient all point to
an infectious disease"
on the other hand the speaker held that the i'm
perceptble graduations Of the disease the absence
OF specific bacillus coccus. the absence OF con-
tagion and inoculabllty all point a chemical.
least to a miasmatic, rather than bacterial
cause. Yet II has been shown he said, that there
micrococci present in the LESSONS of rheuma-
tsm. but it has TO be proved that they are the
cause OF the disease.
DR.. Bishop then proceeded to describe the various
forms Of rheumatism and the complications show
ing as he went along the danger Of attacks upon
the heart, the tendency TO pneumonia and the pos
sbity Of cerebral troubles. On the point of treat
ment he dwelt at some length. In the case OF ma
laria the physician gives sufficient qunine to render
innocuous the naarial organism. The same course
he said should be pursued in the administration Of
selicylic acid anti-rheumatc drug In the
presence Of an acute attack Of rheumatism, he
continued. 1--WE should give this drug In one OF its
FORMS either salicn or oil OF wintergreen, or fresh
salicylate of soda. in sufficient quantities TO relieve
pain and bring down the temperature The trouble
with dispensaries generally appears TO be the CIV
ing of the requisite mixture in too small quantities
TO be eficac;ous. In the matter OF diet ne would
forbid potatoes. while milk. he said Is often rood
food. and cOdliver oil is often an effective after
alive He held in his conclusion that the tic
theory is the best upon which 70 proceed o.,os
frs; upon DR.. W. n. Draper TO discuss the paper.
The speaker. in asking for proof that acute rheu-
fact that epdemcs Of acute rheunatism have ben
noted Artcular rheumatism is disease affected
by the OF the year. Physicians who have
had experience in hospitals must nave observed
ter In this 1t obeys the law of all other Infectious
diseases He himself had noted that typhoid fever
pneumonia and erysipelas are more hkely TO ap.
pear after rainfall following upon a long period
that OF infectious fever. he said. Many clrcum-
stances tend show that rheumatism mas some
specific cause. ana in iniamma tory rheumatism me
physician has to deal with infectious and speclnc
fever. he contended Yet rheumatism differs from
other infectious diseases, he declared, in that II
cannot be transferred by association
son. and he in turn by Dr. Robert w. Taylor. who
dwe.i upon some special phases tending TO snow
the bacterial of rheun atsm He felt that the
Tactic acid theory is rnteaabe. for the acid Is pres
ashes of the disease. he said and the mlcrobic the
ory is the one which appears 70 offer the most hight
Yet the profession wholly at sea as REGARDS the
actual presence Of the bacteria
ence in ali paris of the world has been OF the
most varied ard interesting character. Rheurna-
i!sm. ne declared. is not fout and never WI. De
He then went on al .ensth TO explain the oiner-
entlation between equity and rheumatic symptoms.
C;out when II visits joint leaves its mark In the
shape OF small white point. which never goes
away He asserted that prior TO the introdnction OF
lager beer into this country there no such thing
as gout in America. 1t has been endemic IN Eng
lard for years. lie said be could remember the time
even in this country, when We took our whskey
lows closely the tracks Of fermented liquors, ne
declared