ARTICULAR RHEUMATISM 215 



the blood either through the throat (in man the tonsils) or 

 in cattle through the puerperal uterine mucosa. The post- 

 mortem lesions are those of a serous and serofibrinous 

 arthritis which in chronic cases develops into an arthritis 

 chronica deformans. 



Symptoms. — ^Articular rheumatism is rare in animals as 

 compared with man. Cattle are frequently attacked, horses 

 rarely. The most important symptoms are found in the 

 joints, tendon sheaths, and the heart. The joint symptoms 

 usually begin suddenly with a painful, hot swelling of 

 one or more joints accompanied by severe lameness or ina- 

 bility to stand. The joints most commonly affected are the 

 stifle, fetlock, hock and front knee. One peculiarity of the 

 arthritis is the tendency to shift suddenly from one joint to 

 another and the occurrence of relapses. The tendon sheaths 

 in the neighborhood of the affected joints are frequently 

 involved particularly the sheaths of the perforans and per- 

 foratus, a painful, hot, fluctuating swelling appearing along 

 the course of the tendons. Endocarditis is a common com- 

 plication and is therefore very characteristic of this form of 

 rheumatism. Through an ulcerous endocarditis death may 

 occur suddenly. Usually, however, it appears as a verrucous 

 endocarditis leading to valvular disease of the heart. The 

 temperature is elevated, appetite and rumination suppressed, 

 which, together with the fever and pain, lead to rapid 

 emaciation. Rare complications are metastatic pleuritis, 

 peritonitis and pericarditis. 



Diagnosis. — Articular rheumatism may be confused with 

 any other arthritis. Most commonly it is mistaken for trau- 

 matic arthritis. However, in these cases, unless suppurative, 

 there is no fever and no general disturbance. Tubercular 

 arthritis, which is more common, affects only one joint and 

 is usually associated with tuberculosis of other organs. In 

 adults osteomalacia and in young animals rachitis should be 

 thought of. Here, however, other symptoms of these dis- 

 eases are also present, the process is less acute, does not shift 

 and usually several animals are similarly attacked in a herd. 



Course. — ^While some cases heal in two or three weeks there 

 is always a tendency to relapse. The course in articular 



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