The various manifestations of the rheumatic state as exemplified in childhood and early life : lectures delivered before the Harveian Society of London / by W. B. Cheadle.

  • Cheadle, Walter B. (Walter Butler), 1835-1910.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: The various manifestations of the rheumatic state as exemplified in childhood and early life : lectures delivered before the Harveian Society of London / by W. B. Cheadle. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    forty-eight hours, and he describes the rheumatic sore-throat as something more than tonsillitis, in- volving the pharynx, soft palate, and uvula. In some cases which I have observed, the diffused character of the inflammatory redness and swelling was very marked; but I do not know that this is invariable ; further observation is needed on this point. It is probable that tonsillitis may occur as a solitary expression of the rheumatic state. In many cases it arises in rheumatic subjects quite apart from the articular manifestation. Of its concurrence with another rheumatic affection—viz. chorea—I have seen three examples quite recently, and in all these the chorea occurred in a child who had articu- lar rheumatism at another epoch. But of its con- nection with endocarditis or pericarditis apart from arthritis I have no certain knowledge.* Tonsillitis ' I have not traced the connection; but, curiously enough, as I was in the act of ^VTiting this ]X»rtion of my lecture 1 was asked by Mr. Kiallmark to see, in consultation with him, a little boy of six suffering from relapsing tonsillitis, in -whom he had discovered, to his dismaj’, a distinct apex murmur. The child had had previous attacks, and Mr. Kiallmark had judged them to be rheumatic. The boy has had no arthritis, and there is no distinct rheumatic family history. The tonsillitis rapidly got well under salicylate of soda, recurring three times when this medicine was omitted. The mur- mur is a soft one, audible over the tricuspid area, not at the apex. I am doubtful whether it is organic, but 1 shall be much interested to learn its future course.