248 RHEUMATISM. 



process will shortly renew its supremacy, and proceed witli 

 fresh vigour until the articulation is completely altered. 



Although aged horses do suffer from this acute articular 

 rheumatism, it seems more prevalent amongst animals before 

 they reach maturity ; when occurring in the aged it is often as 

 an accompaniment or a sequel of the specific fever 'Dis- 

 temper,' and in such the tendons and their fibrous sheaths are 

 as apt to be involved as the joints themselves. 



Course and Complications. — We cannot from observation of 

 the earlier symptoms of rheumatism predict the probabihty 

 as to time of recovery ; it is not like some continued fevers 

 where the crisis is reached in a determinate number of days, 

 which as a rule is closely adhered to. In acute rheumatism 

 the fever may reach its height, and defervescence be established, 

 at the end of the first week ; the greater number of cases, 

 however, are prolonged considerably beyond this period. 



With the subsidence of the fever the local inflammations 

 may seem much relieved ; they generally, however, continue 

 stationary in the exhibition of their varied symptoms for a 

 considerable time after the general symptoms of illness have 

 disappeared. 



There is in the development of the difterent symptoms, the 

 constitutional and local, some considerable difference as to 

 time and sequence of individual appearance. W^hile, in what- 

 ever way these two classes of symptoms show themselves, 

 there does not, from the relative precedence as to time in 

 their occurrence, seem to be any rule established either as to 

 their subsidence, disappearance or probability of a severe or 

 slight attack, or yet of the chance of ultimate recovery or of 

 a fatal issue. 



In the instances of metastasis of the local symptoms there 

 cannot be said to be any indications or warnings given by 

 which we may become aware that any change is to occur, 

 Avhile when the change is being accomplished there is no cer- 

 tainty that the local phenomena will continue to develop and 

 remain in the situation to Avhich the action has been removed. 



The cardiac complications, which are neither offshoots nor 

 developments, so to speak, of the systemic disorder, nor of the 

 local inflammatory processes, and are only related to these 

 probably in so far as they arc the development or results of 



