Medicine.

Date:
[1919?]
Catalogue details

Licence: In copyright

Credit: Medicine. Source: Wellcome Collection.

    54/454 (page 48)
    43 RHEUMATIC FEVER (ACUTE RHEUMATISM). What is Rheumatic Fever 1 A specific infectious disease, characterised by poly¬ arthritis, and a tendency to inflammatory affections of the pericardium and endocardium. What are its Causes 1 The specific organism has not been certainly identified, though the micrococcus rheumaticus, a short Gram-positive streptococcus found in the inflamed synovial membranes and in the cardiac lesions, is claimed by Poynton and Paine as the cause of the disease. Rheumatic fever is commonest in spring, and in damp climates; it attacks both sexes, and by preference young adults; it may be provoked by exposure to cold or damp ; and one attack predisposes to a second. What are the Morbid Changes 1 Inflammatory affection of the synovial membranes and ligaments, the effused fluid being turbid and containing albumin, but never becoming purulent; in many cases pericardial, endocardial, or myocarditic changes of the ordinary inflammatory type, but with a special tendency to affect the valvular endocardium ; and in some inflamma¬ tion of other serous membranes, such as the pleura. Describe the Chief Symptoms. The attack, which is often preceded by tonsillitis, mav begin either abruptly or after a few days’ malaise. One of the larger joints is usually first affected (knee, ankle, or wrist), and becomes swollen, red, hot, and intensely painful. Fluid effusion can be recognised by palpation. The inflammation spreads to other joints, or flits from one to another, the first affected improving as the second is attacked. The smaller joints may be implicated later.