Rheumatism, rheumatoid arthritis and subcutaneous nodules / by C.O. Hawthorne.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949
Date:
1900
Catalogue details

Licence: In copyright

Credit: Rheumatism, rheumatoid arthritis and subcutaneous nodules / by C.O. Hawthorne. Source: Wellcome Collection.

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    J course, at the present day is recognised medical doctrine. Similarly, other varieties of joint diseases have, with a fair measure of general agreement, been established as entities distinct from both rheumatism and gout. Thus the several joint affections which accompany pyaemia, gonorrhoea, haemophilia, certain nervous diseases, and some of the specific fevers, have at various times been removed from the rheumatic area, and placed in new positions and amidst new relationships.8 In these instances, however, at least for the most part, the questions in debate concern the position and limits of rheumatism, as this displays itself in the form of articular disturbances more or less acute in character. But there is also an attack upon the area of the rheumatic claim from an entirely different quarter—an attack in which the position of rheumatism as a chronic disorder of the joints is seriously challenged. And the contest, apart from minor issues, involves the large question whether those manifestations of articular disturbance commonly grouped under such terms as rheumatic or rheumatoid arthritis, rheumatic gout, osteo-arthritis, etc., are to be placed within or without the rheumatic boundary. The dispute here alluded to took origin fully a hundred years ago. It has produced very acute differences of opinion, and the controversy, so far from being concluded, is found in active progress in the medical writings of the present day. That the disease now known as rheumatoid arthritis existed from the earliest times there is not the slightest doubt, for its 8 There are no doubt dissentients from this general statement, at least as regards the inclusion of some of the instances named. For example, Mr. Hutchinson would not allow that gonorrhceal synovitis is non-rheumatic, but then the definition which he applies to the word rheumatism is a very wide one [“Under the term rheumatism we include all arthritic maladies' which are not proved to be gouty. Whenever arthritis occurs in connection with food we call it gout, and whenever such association is wholly absent we name it rheumatism.” —Hutchinson. “Transactions of International Medical Congress, 1881. Vol. II., pp. 92, 93], and those who would enter the lists against him must either accept his definition or propose an alternative, and there are difficulties about either course. The attacks of synovitis that are sometimes associated with scarlet fever have long been a subject of controversy. The arguments and opposing conclusions are well stated on the one side in Oairods “ Treatise on Rheumatism,” and on the other in “ A Manual of Infectious Diseases,” by Goodall and Washbourn, 1896.
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