The guardian. [volume] (Boston, Mass.) 1901-1960, 1940-02-24
THE PEOPLES HEALTH
By Samuel 9. PavIo, MD.
Rheumatism

The chronic forms of Rheumatism is
the most prevalent chronic disease in
the United States. In Massachusetts
alone here are at least 100000 indi-
viduals suffering from Rheumatism
and because of the fact that this all
ment attacks people whose families
depend upon their manual labor the
social problems created by this di-
sease become very serious.
Rheumatism is an affection of the
joints and muscles characterized by
pain and swelling. So many different
diseases, however, are called Rheuma-
tism by non-medical people that a
more or less complete description of
the forms of Rheumatism will be re-
quired for an intelligent understand
ing of the matter under discussion.
In this article we shall discuss:
Rheumatic Fever
This is an acute Inflammation of the
joints and muscles. The swelling trav-
els from one joint to another not in
frequently involving several of them
at the same time. The fever and the
pain are severe enough to confne the
patient to bed. The slightest motion of
the bed or even of the bed clothes is
sufficient to cause agonizing pain. In
fact, the patient is drenched in pers-
piration and his clothes have to be
changed several times a day.
Exposure to wet, cold, and abrupt
temperature changes predisposes peo-
pie to Rheumatic Fever. It is COM
monest in laborers, sailors, laundres-
ses, and domestics. The disease is fire.
quent in temperate climates, and is
not observed in tropics or in the arctic
region. 1t has some hereditary ten
dency.
Rheumatic Fever is undoubtedly an
infectious disease although the defn-
lite germ has not been discovered yet.
1t has been proven that organisms
isolated from tonsils of rheumatic pa
tents will induce Rheumatic Fever
when injected into animals. Infected
tonsils are the portals of entry of the
infection. Permanent cure
of rheumatic tendency has frequent
ly followed removal of tonsils. Other
organs may act as the focus of infec-
ton, such as abscessed teeth, diseased
etc.
The outlook for recovery from Rheu-
matte Fever is quite favorable. few
cases die from the disease. Usually
the illness terminates in two to six
weeks without having caused perman-
ent injury to the joints involved. The
complications which frequently ac-
an attack of Rheumatic
Fever, however, are of a serious ma
ture.
Heart trouble, especially of the val
vular type is the most frequent COM
plication Of Rheumatic Fever. The
damage of the heart valves,-leaky
valve-is so common in Rheumatic
Fever that physicians who find these
conditions while examining patients
would Immediately question whether
or not the patient has ever had Rheu-
matism. Some medical observers place
the incidence of valvular heart disease,
as a complication in Rheumatic Fever
as high as so to rs per cent.
1t is evident that physicians who
are treating patients for Rheumatic
Fever are very much concerned about
preventing this dreaful complication.
fortunately, not all patients who de-
velop valvular disease remain so
throughout their life. Some recover
very shortly after their Rheumatism
clears up.
Complete rest in bed, plenty of milk
and fruit juices and indications is
the accepted treatment. Flannel should
be worn by the patient because it alb
serbs the sweat and the patient should
be sleeping between blankets instead
OF sheets for the same reason. The
convalescence should be long, for pa
tlents are quite exhausted and anemic
after an attack of Rheumatic Fever.