ACUTE RHEUMATISM. 239 



struditres or textures, as the coverings of muscles and 

 tendons, and certain structures entering into the formation of 

 joints ; these local manifestations shoiuing a disjjosition to 

 shift their situations to other textures or organs of a similar 

 nature hut remote situation. 



General Characters and Intimate Nature of the Disease. — That 

 rheumatism is more correctly considered as a general rather than 

 a local disease, seems tolerably evident when we recollect such 

 prevailing features as — 1. The regularity with which systemic 

 disturbance accompanies its appearance. 2. The considerable 

 tissue-changes, as alteration in the composition of the blood, 

 and occasionally in the urine, previous to the development of 

 the local phenomena. 3. The fact that certain animals are, 

 from a peculiar inherent diathesis, liable to develop the disease, 

 apart from any apparent cause. 



Although a wonderfully common disease amongst men, its 

 existence in our patients has often been doubted, and even 

 now is denied by some. There appears to be, however, suf- 

 ficient evidence to convince any but such as are determined 

 not to be satisfied with any proof, that all our domestic animals 

 are subject, with varying susceptibility, to rheumatic disease. 



The inbred morbific agent in the development of rheumatism 

 is, in the exhibition of the local inflammations and phenomena, 

 not confined to any one organ or texture, although markedly 

 disposed to invade the white fibrous tissues — those chiefly met 

 with as investing and covering membranes of the muscles, 

 the component parts of tendons, ligaments, their sheaths, and 

 the fibro-serous visceral membranes. It is one of those diseases 

 which are considerably influenced in their appearance, extent 

 of distribution, and severity of attack, by meteorological and 

 telluric agencies ; in this way may we account for its existence 

 or prevalence in certain districts and not in others. 



Very various and rather contradictory statements have from 

 time to time been made, both by observers of the phenomena 

 of the disease and by those who have attempted to study its 

 pathology by experimental investigation ; so that even at the 

 present the true nature and modes of action of that which we 

 have good reason to believe exists as the main factor in its 

 production, viz. a specific inbred morbific agent, are points upon 

 which pathologists are not agreed. At one time, and by many, 



