252 



CHRONIC ARTICULAR RHEUMATISM 



gives the following statistics of his cases. In the forms beginning acutely, 

 there were 53.4 per cent, of heart murmurs and 20 per cent, of valvular 

 disease ; in cases chronic from the outset only 13.5 per cent, of heart murmurs 

 and 4 per cent, of valvular disease. 



Chronic nephritis of benign character and showing but slight tendency to 

 uremia is not infrequently observed. 



Among other complications those affecting the eye, such as iritis, iridocy- 

 clitis and episcleritis, and the shin (various forms of erythema, eczema, urti- 

 caria and psoriasis) are to be mentioned. The occurrence of multiple sym- 

 metric lipomata has frequently been observed in connection with chronic 

 arthritis, as well as bronchial asthma, dyspepsia, hemorrhoids and numerous 

 nervous disturbances, and this gives rise to some confusion. These affections 

 are spoken of particularly by authors who look upon chronic arthritis as an 

 expression of a general constitutional anomaly. 



Lancereaux, in 1870, divided rheumatism into two classes, of which one, 

 " qui ne laisse jamais des traces sur son passage " corresponds to acute articular 

 rheumatism ; the other he said was : " pas une maladie, mais un syndrome, 



Fig. 6. 



-SuBCUT.iNEOUS NoDULES SiTUATED UPON THE DoRSAL TenDON ShEATHS IN A CaSE 



or Cheonic Exudative Polyabthritis in a Young Girl. 



une manifestation d'un etat constitutionel," " le branche d'un grande famille 

 pathologique," " herpetisme," a vasomotor trophic neurosis, expressing itself 

 m dynamic (migraine, epistaxis, neuralgias) and material disturbances in the 

 skm and of the tissues deficient in blood-vessels. In this group is also included 

 the^ teiad of diabetes, obesity, and gout. Bouchard gives a similar definition 

 of " arthntisme " ; both authors emphasize its conspicuous family and hered- 



