Rheumatism: Its Nature; Its Pathology And Its Successful Treatment

Abstract

"A PERUSAL of the literature which bears on the question of the treatment of acute rheumatism (rheumatic fever) is a task from which few would rise with any definite idea as to how that disease is best treated. Purgatives, diaphoretics, sedatives, alkalies and alkaline salts, colchicum, aconite, quinine, guaiacum, lemon juice, sulphur, mercury, veratria, tincture of muriate of iron, etc., would each be found to have in turn attracted the favorable notice of one or more of those who have directed attention to the subject. Of all these different remedies not one stands out prominently, as that to which we can with confidence look for good results. We have, indeed, no remedy for acute rheumatism-a malady which not unfrequently proves fatal, which is always accompanied by great pain, and is a fruitful source of heart disease. “Under these circumstances I need make no apology for bringing under the notice of the profession a remedy which, so far as my observations have gone, has given better results than any which I have hitherto tried-and I have tried all the usual remedies over and over again. '' In the course of an investigation into the causation and pathology of acute febrile ailments, which has for some time engaged my attention, I was led to give some consideration to intermittent and to rheumatic fever. The more I studied these ailments, the more was I struck with the points of analogy which existed between them. On a detailed consideration of these I shall not now enter. Suffice it to say that they were sufficiently marked to lead me to regard rheumatic fever as being, in its pathology, more closely allied to intermittent fever than to any other disease, an opinion which further reflection and extended experience have served only to strengthen." Such are the opening sentences of the paper in which, in March, 1876, I introduced salicin to the notice of the profession, as a remedy in acute rheumatism. In this volume the miasmatic theory of rheumatism, there referred to, is expounded ; and an explanation offered of the manner in which the salicyl compounds produce the marked anti-rheumatic effects which they are now all but universally acknowledged to possess. The plates representing the early changes noted on the surface of the endocardium in cases of rheumatic endocarditis, are taken from Dr. Green's " Introduction to Pathology and Morbid Anatomy." For permission to use them I have to thank Dr. Green and his publisher.