Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    906/976 (page 886)
    and this in many instances lias arisen from influences which have been years in operation ; it cannot, therefore, he even reasonably hoped that an affection occurring under such circumstances can he rapidly cured: it is often a great achievement to arrest its further progress. It the disease is far advanced, and the joints severely injured, it is impossible to restore the articulations to their former state, even if the constitutional tendency to the disease is thoroughly arrested ; still, under such circumstances, it sometimes happens that patients, who for years have been unable to move, will regain their power of locomotion, a result caused by the formation of a kind of false joint in some of the more important articulations. When the disease is less advanced, when the affected joints are few in number, and their mobility but partially interfered with: when at the same time there is freedom from any disease which must of necessity keep up the impaired state of health; lastly, when the progress of the affection has not been rapid; then a more favourable view may be taken of the case, and a recovery more or less complete may be hoped for. When the disease is at its commencement, or at least when but little damage has ensued, and at the same time the affection shows little tendency to assume an acute character, then a complete recovery may be anticipated, if proper measures be adopted; if, however, the patient is in any way weakened, or treated as if he were suffering from a sthenic malady, then the probability of the disease becoming deeply engrafted into the system, and causing serious mischief, is greatly increased. The accurate diagnosis and proper treatment of cases of Rlieuma- toid Arthritis exercise a very important influence upon its prognosis. ■ Treatment of Rheumatoid Arthritis.—The treatment of Rheuma- toid Arthritis is a subject of the highest importance, more especially in the earlier stages of the disease, when as yet the joints are not seriously or irremediably injured. From what has been stated under the “ Causes” and “ Pathology ’ of Rheumatoid Arthritis, it will be naturally inferred that a prolonged sustaining plan of treatment is imperatively called for, and that all depleting measures must tend most materially to increase the rapidity and severity of the disease. I have witnessed a great number of cases in which depletion has been persevered in for a time, and with the effect of producing lamentable results, as the joints became per- fectly disorganised; and in many of these it is probable an opposite treatment would have been attended with different results. We must remember that, during the more acute inflammatory ,^ stages, the disease must not be treated in the manner recommended to be adopted in gout. Colchicum is always worse than useless, an I the patient should be well sustained throiighout the whole of the I treatment; neither are the alkalies, so serviceable in rheumatism, o any permanent value in Rheumatoid Arthritis.