Licence: Public Domain Mark
Credit: A system of medicine / edited by J. Russell Reynolds. 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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![returns of the navy show a considerably larger proportionate number of attacks than those of the army—the number per thousand annual mean strength attacked in the Mediterranean fleet being 63*9, in the West Indies and North American station 69, and 'in the South American Station 72-3. Chomel remarks that Kheumatism is seldom met with near either the equator or the poles, but that it becomes more frequent as we proceed from these regions, and that it is more especially rife in the temperate zones. In England the occurrence of rheumatic fever appears to be much more common in the eastern than in the western counties; this is usually accounted for by the exposure of the former portion of the country to the cold north-east winds. As far as seasons are concerned, it may be stated that no part of the year is exempt. Haygarth's tables give the following results in 150 cases:—The disease began in January in 21; Tebruary, 11; March, 9; April, 18; May, 11; June, 11; July, 14; August, 5; September, 8; October, 13; ]November, 13; December, 16. It will be found, however, that in different years the relative number for each month is liable to considerable variation. Pathology op Eheumatism.-—The name Eheumatism implies that the disease has been considered to be dependent upon some altered con- dition of the blood, and the ancients, confusing Kheumatism with gout, necessarily regarded it as having the same humoral origin. One set of pathologists look upon Eheumatism simply as an inflam- mation of certain fibrous and serous membranes. This was the view held by CuUen, who remarks that, although some have attributed the disease to the existence of a peculiar acrimony in the system, it was without reason. Sir C. Scudamore held the same views as CuUen, and makes the following remark:— It may be stated, that the predisposition to Eheumatism consists in a deficiency of healthy tone in texture's con- nected with joints and muscles, and in nerves, so as to be affected in this peculiar manner by the influence of variable temperature. If we lose sight of the humoral term Eheumatism, we shall come to the simple fact, that, in a condition of susceptibility, cold, or sudden reduction of temperature, makes a particular impression on the vessels and nerves near the surface, and produces a painful affection of certain textures, which is attended with more or less inflammation, the phenomena of which are so far of a peculiar nature, that we either consider the disease specific, inasmuch as the symptoms differ in their constituent character from those produced by other inflammations, or we may view the effect in the light of common inflammation, modified on the one hand, by the nature of the exciting cause—the external one, cold,—and, on the other hand, by the particular species of tex- tures which become affected. With slight modifications, quite unnecessary to detail, this view](https://iiif.wellcomecollection.org/image/b2198010x_0001_0921.jp2/full/800%2C/0/default.jpg)
