Notes on rheumatism and its allies in childhood : introduction to a discussion in the Section of Diseases of Children / by Thomas Barlow.

  • Sir Thomas Barlow, 1st Baronet
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on rheumatism and its allies in childhood : introduction to a discussion in the Section of Diseases of Children / by Thomas Barlow. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    may help us as an intermediate form between acute rheumatism and some cases of rheumatoid arthritis. This, however, carries us a very short distance, for it seems possible that there may be at least two distinct groups of rheumatoid arthritis. I have been anxious to show that the children’s rheumatism which radiates round the central type of the adult acute febrile attack is extremely protean in its forms, but that, when carefully considered, these forms may after all be regarded as the several factors of the acute adult attack, which have, so to speak, been analysed in the child’s life, and separately manifested at different periods. I have endeavoured to point out that individual symptoms, which, when considered as isolated phenomena, are perhaps indeterminate, may nevertheless deserve to be considered rheumatic when taken in conjunction with the antecedent and subsequent life-history. What I have to say about treatment can be summarised in a few words. I am far from wishing to disparage the use of Ihe salicin compounds in the rheumatism of childhood. But it must be re- membered that the great clinical indications for the apparent bene- ficial employment of these compounds are joint-effusions with pain and fever. I have shown, however, that a great deal of the rheu- matism of children is insidious, being attended with ill-defined joint- affection, slight pain, and little fever. The golden indications for treatment of the rheumatism of childhood are indeed homely enough. Let us not make light, nor allow parents to make light, of the minor manifestations, or of what may turn out to be the minor manifestations of rheumatism. Keeping a child in bed for a day or two for slight rheumatic symptoms may have a tremendous influence o-n his future ; and, when once a tendency to rheumatism, however slight, has become manifest, careful avoidance of fatigue and the maintenance of good cutaneous circulation are of such vital importance, as to deserve the most emphatic directions that we are able to give.
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