On the treatment of acute rheumatism : with special references to the use of the salicylates / by Donald W.C. Hood.

  • Hood, Donald William Charles.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of acute rheumatism : with special references to the use of the salicylates / by Donald W.C. Hood. 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.

    48/74 (page 44)
    In a third division I will place those patients suffering from ordinary acute or sub-acute rheumatism, but with strongly-marked neurotic tendencies, patients with a nervous equilibrium easily disturbed. Whether such unstable equilibrium be due to con- genita] peculiarity, or to effect of alcoholic excess upon the organism, it cannot be doubted but that individuals addicted to alcohol pass through acute rheumatic attacks with great danger, and that such a damaged state of nervous system is a factor which demands much care ivhen treating such cases. Granting that acute rheumatism is presented to us under the conditions or in* form as alluded to above, we should inquire whether these several conditions or forms are to be treated from the same standpoint. In other words, is the patient suffering, from acute sthenic rheumatism to be treated in the same manner as the ill-conditioned anaemic girl, who, after weeks of ill-defined illness, is seized with an acute rheumatic attack ? Is the young man who, from his history, we are fully aware, has led an intemperate life—is he, simply because his illness is that-known as acute rheumatism, to be treated in the same manner ? Such cases, from the very first, are as much wanting in nerve power as those of the degenerate type are wanting in rich red blood. It is with patients suffering from acute sthenic rheumatism of ordinary pronounced type that we find salicylates exerting their most powerful effect for good. It is in. this class we find such rapid defervescence with loss of pain, but disappointing as it is without concomitant lessened liability to cardiac complication. I do not think the same good does follow the use of the remedy in cases of more degenerate type, and I have met with several cases where the use of the remedy has- been followed by much prostration and general weakness. I should add that in some of these cases the remedy had been continued for a lengthened period and the patient much debilitated by its prolonged use. Acute rheumatism occurring among weakened anasmic im- poverished subjects, with a temperature hovering at or about 100°, with urine frequently clear, or if turbid with pale lithates, with perspiration which has not the characteristic sour odour, is bene- fited by a treatment based upon more tonic principles, and the use of salicylates, if given at all, should be for the purpose of relieving the pain, for which a dose or two is often amply sufficient.