CONSTITUTIONAL DISEASES. 

 RHEUMATISM. 



Definition. Past views. Causes : heredity, age, cold, damp, cold cli- 

 mates, seasons, exposure, buildings, cellars, night chills, weather vicissi- 

 tudes, valleys, wading, checked perspiration, lactic acid, metabolic products, 

 acid phosphate of soda, vegetable acids, neuropathic causation, infection, 

 microbes, injuries, over work. ' Lesions : in joints, synovia, serosa, articular 

 cartilage, fibro cartilage, articular lamella, bone, eburnation, ligaments, 

 joints affected in horse and ox, blood' changes, albumen, fibrine, blood 

 globules, pericardium, endocarditis, valvular disease, myocarditis, embo- 

 lisms in lungs, pleura, nervous lesions, digestive system. 



Definition. A constitutional, inflammatory affection, probably 

 toxic, tending to localization in the joints, muscles, tendons, 

 fascia, skin, heart and serous membranes and with a marked 

 disposition to shift from place to place. 



The word is derived from peojut. flow, and was origin- 

 ally employed to indicate that an acrid humor, generated in the 

 brain or elsewhere escaped mainly by the nose and eyes as a 

 catarrh. The idea naturally followed that the retention of this 

 humor caused inflammation in the joints, muscles, heart or else- 

 where. The connection of these various, conditions with exposure 

 to cold, led to the association of the name with the various in- 

 ternal inflammations in which chilling appeared to have been a 

 factor, until it was difiicult to limit it by any definite line. Finally 

 infectious diseases implicating the joints or muscles (influenza, 

 contagious pneumonia, omphalitis, gonorrhoeal rheumatism), and 

 diseases of metabolism (gout and possibly rheumatoid arthritis) 

 have added to the general confusion. 



General Causes. Heredity. This has been more definitely 

 traced in man than in the lower animals, the line of family 

 descent being more easily followed in man. Children of rheu- 

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