The prevention of valvular disease of the heart : a proposal to check rheumatic endocarditis in its early stage and thus prevent the development of permanent organic disease of the valves / by Richard Caton.

Caton, Richard

Date:: 1900

Credit: The prevention of valvular disease of the heart : a proposal to check rheumatic endocarditis in its early stage and thus prevent the development of permanent organic disease of the valves / by Richard Caton. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$Rheumatic Fever1 by the application of small blisters adjacent to the joints, know how great was its efficacy. Personally I have always used small blisters when a rheumatic joint proved refractory, and rarely without good result. After employing this method in hundreds of cases (including my own person), there are few things about which I have less doubt, than in regard to the speedy and complete relief afforded, and also as to the trivial nature of the pain caused by the blister—if the latter be properly managed. It is rarely needful to employ a blister larger than the size of a florin. A small poultice should be applied after it. What is the explanation of the beneficial action of this so-called counter irritation ? Why do pain and swelling disappear so rapidly from a rheumatic joint if we apply one or two small discs of canthos or other form of vesicant to the skin adjacent to it ? The irritation of the sensory nerves of the skin probably causes excitant impulses to traverse the trophic and vaso-motor nerves of the part, whereby dilated arterioles are contracted and increased activity of the natural reparative process is promoted. Is there any other reasonable theory accounting for this well-established fact ? If there is I have yet to hear it. This so-called counter irritation is I believe in reality direct stimulation of the vaso-motor and trophic nerves of an ailing part. It is possible to stimulate not only the nervous system as a whole but individual parts of it. If a cicatrising wound or a callous ulcer is slow and sluggish in its progress do we not stimulate 1 Clin. Lect. and Reports of Load. Hospital, ]864.$