Licence: Public Domain Mark
Credit: A manual of medical diagnosis / by A.W. Barclay. 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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![■ traced back, ■with very gyeat jirobability, to it. The condition of the t heart must therefore he tvatclied from day to day; we must also ho rprepared for the incur.sion of pleurisy; and bronchitis sometimes c becomes a serious and troublesome complication. § 2. Suh-acute Rheumatism.—When the febrile state iis less marked, when the iullamraation of the joints is Hess severe, and the ninnber afi’ected smaller, we have a fform of rhetimatism which lias been called snb-aente. lit may differ in no essential particular from acute irheumatism, except in intensity; in no one symptom, {probalily, so much as in the amount of tenderness ; tHiere is generally considerable swelling, and, in some iinstance.s, a good deal of redness; but the exquisite sseusibility of acute rheumatism is wanting. Some of tthe cases belonging to this class are of short duration, as iif they were abortive attacks of the acute form. Some ccontinue for a long period, and take on the characters Ikuown as rheumatic gout. Others, on the contrarjq pre- sseut this jieculiarity, that the disease is in great measure, vOr entirely, limited either to one joint or to a single (extremity. The symptoms connected with the local c disturbance may be toleralily severe, but it remains ffixed there, and the disease is commonly very obstinate aand much prolonged in its duration. Such cases ai’e 1 liable to be taken for simple inllammation of the joint, or synovitis. The be.st guide in determining their nature is to be found in the history of the case. I Rheumatism almost always apjiears in several joints before it becomes located in one ; and, on im|uiry, j)erhaps we learn that the jiatient has had previous attacks of rheumatism or gout. The history of simjile inflammation generally points to some accident or injviry, acting as the exciting cause, or it tells of syphilis, with nodes or lichenous eruption. The dia- . gnosis is necessarily iin])crfect, inasuiucli as both diseases have an inflammatory character ; and it is remarkable that, in persons of gouty or rheumatic habit, the in- flammation, set up by accident or injury, often assumes I a specilic type, just as we find inflammatory action](https://iiif.wellcomecollection.org/image/b24989812_0103.jp2/full/800%2C/0/default.jpg)
