On the failure of salicyl-compounds in the treatment of acute rheumatism accompanied with inflammation of the genito-urinary mucous membranes : a paper read before the Medico-Chirurgical Society on the 6th of July 1881 with some additional observations on the character and nature of the disease / by Thomas R. Fraser.

Date:: 1885

Credit: On the failure of salicyl-compounds in the treatment of acute rheumatism accompanied with inflammation of the genito-urinary mucous membranes : a paper read before the Medico-Chirurgical Society on the 6th of July 1881 with some additional observations on the character and nature of the disease / by Thomas R. Fraser. Source: Wellcome Collection.

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

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$clay. It altogether failed in producing any amelioration in the symptoms, excepting that the average temperature, which was only slightly above the normal, was reduced a few tenths of a degree. The urethritis was greatly improved in a short time, and it by-and-by disappeared under local applications. The persisting joint affection, however, prevented the patient from leaving the Infirmary until the 24th of July. Several other cases of a subacute and chronic type have recently been under my care, but they have not been described in this paper, as salicyl-compounds were not used in their treatment. The cases that have been described show, among other points, that salicyl-compounds may be administered in large doses, and for long periods of time, without causing any injury. Inconvenient effects were, no doubt, observed in some of the case3, and it was even necessary to suspend further administration because of them. A considerable experience has now convinced me, however, that salicyl-compounds are fairly well tolerated unless their elimination be interfered with.1 This interference is most frequently produced by disease of the kidneys, and wherever albuminuria is present, extreme salicylism, including in the case of nervous females much irritability and excitement, may be anticipated if a liberal administration of these compounds be adopted. (See Cases II. and IV.) The cases further show that salicyl-compounds are therapeutically inefficient in rheumatism, whether acute or sub-acute, when it is associated with a discharge from the genito - urinary mucous surface. Such an association constitutes the disease usually designated gonorrhceal or blennorrhagic rheumatism, whose varieties and phenomena do not appear to have received in this country so much attention as elsewhere.2 To some extent this neglect may be explained by the comparative rarity of the disease. In 1912 cases of gonorrhoea, for example, Fournier3 met with only thirty-one complicated with rheumatism. To a greater extent it may possibly be explained by a general restriction of attention to the chronic forms, in which only one or a few joints are affected, and in which the conditions are devoid of much interest. 1 See on this subject, J. Deseille, loc. cit., p. 79 ; Blanchier, loc. cit.,]). 145 ; and Cadet, La TMrapeutique Contemporaire, 28th Sept. 1881, p. 614. 2 As contrasted with the numerous theses, the prolonged discussions in the Societe Medicale des Hopitaux (1866-67), and the elaborate papers in medical journals and cyclopaedias, which show the great attention that has been given to this subject in France, it is chiefly noticed in this country by brief descriptions in a few pages of general works on surgery and on venereal disease, and it has been treated with a similar neglect in Germany, where, according to Voelker, Lewin, and Talamon (1878), no monograph nor other important contribution to the literature of the subject lias been published. 3 Fournier, Nouveau Dictionnaire de Medecine et de Chirunjie,\o\. v., 1866.$

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