RHEUMATISM. 
723 
mal principle has been found in the blood during- an attack of 
acute rheumatism. 
The pathology of acute rheumatism is still obscure, (of 
course a germ is an easy answer) and in the present article it 
will be sufficient to enumerate the principal theories upon the 
subject. 
1. —Prout, Todd and Richardson say : Lactic acid accum¬ 
ulates in the body, and the symptoms are directly referable to 
the action of this poison upon the system. 
2. —Canstall and Seitz say : Chill of the peripheral parts 
of the body, especially of the skin and joints, causes disturb¬ 
ance of the corresponding parts of the central nervous sys¬ 
tem, and this gives rise to pain and vaso-motor or trophic 
changes of the same peripheral parts, and to fever. 
3. — Senator says : Chill causes accumulation of lactic acid ; 
this acts on the central nervous ‘ system, and the disordered 
nervous centers react upon the joints, etc. 
-4.—Fuller says: Chill disturbs the nervous system; this 
disturbs nutrition generally ; lactic or some other acid is re¬ 
tained and acts as a poison. 
5. —Hueter says : Chills are attended with the entrance of 
micrococci into the system and endocarditis is the result; the 
joints symptoms are secondary and embolic, as in pyaemic 
arthritis. 
6. —Sailsbury says : The disease is due to the presence in 
the blood of a vegetable organism of a definite character 
(Zymotosis translucens). 
7. —Maclagan says: Rheumatism is due to the presence in 
the system of a poison which is of the nature of a miasm ; en¬ 
tering from without, this miasm is generically allied to , but 
specifically distinct from the miasm of malarial fever. 
Without attempting to criticise all these theories, we may 
conclude that the true pathology of rheumatism cannot pos¬ 
sibly be settled until the esssential nature of fever is 
thoroughly understood, which cannot be until the physiolo¬ 
gists explain why the temperature in health remains at a 
given point. 
My opinion is, that an acid of some kind is formed or re- 
