RHEUMATIC FEVER (Articular Rheumatism)

Category: Constitutional Diseases

Causes. This may be acute or
chronic. It is an infectious disease characterized by inflammation of
several joints. The joints are held in place by ligaments and are inclosed
by a thin membrane. In this acute rheumatism these parts become congested
and inflamed, there is redness and swelling, heat and pain. Fluid is
passed into the joint sometimes and then the parts look watery
(oeclematous). The inflammation and swelling cause great pain in the
joint.

Predisposing. A damp climate, winter and spring, young adults and persons
who are exposed to damp, wet and cold.

Condition. There is congestion of the soft parts of the joints and
effusion into the joint cavities of a watery fluid. Endocarditis,
pericarditis, myocarditis, pleurisy and pneumonia may complicate it. The
first named, endocarditis, is very common and as the mitral valves become
inflamed it is likely to leave valvular trouble unless carefully watched
and treated at the time.

Symptoms. The invasion may be gradual, with a very tired feeling and
often tonsilitis; but it is usually sudden, with pains, soreness in one or
more joints and fever. The knees, ankles, elbows and wrists are much
affected, but it frequently goes through almost every joint in the body
and sometimes repeats the terrible dose. I know, for I had it twice. The
suffering, torture and pain sometimes are simply indescribable and almost
too hard to bear. The joints become hot, red, painful, swollen and tender
to touch and motion. It seems to hurt worse when anyone comes near, for
the patient is afraid of careless handling.

Fever. This runs from 102 to 104 and is modified by profuse perspiration
with bad odor and, generally, it does not afford any relief. The urine is
very acid, very thick and looks like thick, strong coffee. The symptoms
frequently disappear partially from one joint or joints as they begin in
other joints, attacking several in rapid succession, the fever varying and
changing with the degrees of joint involvement.

We may see the shoulder and hip, the elbow and wrist, knee and ankle,
etc., all affected at once: Heart complications are frequent and bear
close watching, for they are dangerous to life and the future health of
the patient. The patient becomes very anemic and this progresses rapidly.
When improvement does begin it is gradual; or the disease may become
chronic. Care must be taken not to be too active when improvement sets in
or you will cause a return by using the joints before they have become
thoroughly well. I did the same thing in my anxiety to get out, but would
never be as reckless again. Pain and stiffness of the joints often last
long after convalescence has set in. One who has had this disease once is
liable to another attack if he is not careful.

MOTHERS' REMEDIES. 1. Articular Rheumatism. A gentleman sends us the
following treatment for articular rheumatism and writes as follows: "I
send you the following treatment for articular rheumatism because I used
it myself and was cured in a very short time, in fact, about ten days. It
was a number of years ago in the early spring when my knee joints, ankles
and wrists began to pain me and continued to become worse for about a
week, at the end of which time both my knees were perfectly stiff. I sent
for my physician; he wrapped my knees with common baking soda; taking long
wide bandages he was enabled to have the baking soda a fourth of an inch
thick around the knee, raising the bandage as he laid the soda on; after
this was completed I had heavy wet hot cloths laid around my knee and
renewed every fifteen or twenty minutes for probably eight or ten hours.
In the meantime I was taking the salicylate of soda and the cathartic,
veronica water, as directed below. The following day I sat up with my legs
resting on a chair, straightened out, and hot flat irons at my knees. I
began this treatment on Saturday, and the following Thursday was able to
walk about and go out of town, and never had rheumatism since, but at two
or three different times I suspected it was coming on and used the
salicylate of soda and veronica water as a successful preventive; at least
the rheumatism did not materialize.

Veronica Water. Dose:--Glassful every two and one-half hours till bowels
are free, then one dose a day.

Also
Salicylate of Soda 1 ounce
Water 6 ounces

Large teaspoonful every two hours with a quinine pill every other dose."

2. Rheumatism, Cotton Excellent for Inflammatory. "Take a roll of cotton
batting and wrap the limb, or part of the body affected, as firmly and
tightly as possible, without tearing the cotton, let it remain
"twenty-four hours, then tighten it up by unwinding and rewrapping the
cotton as tight as possible, as on the first application, and so continue
every twenty-four hours until cured, which, in my case, was three days. I
had been troubled with rheumatism for a long time, and was unable to walk.
I tried everything, doctors and all, but nothing helped me. A lady from
Cincinnati, who was visiting at a neighbor's, called at my house one day
and learning what was the matter with me, advised me to put cotton on as
stated above. I had no faith in it, but I had tried everything else and
concluded I would try that, with the result that it cured me. Possibly if
a case should require a longer time for a cure than mine it might be
necessary, or be better, to replace the cotton with a fresh roll. The
rewrapping every twenty-four hours is intended to keep the cotton batting
firmly and tightly around the part affected as the swelling recedes."

Prevention. Wear flannel late and early. Keep from taking cold. Put off
wet things of every kind immediately upon getting home and dry your body
and put on dry well-aired clothes. Never sleep in a damp bed, under damp
unaired clothes. When you go away from home do not sleep in a room or bed
that has been unoccupied for any length of time, especially if there is no
furnace in the house. Do not sit down in wet damp clothes, stockings,
shoes, etc. Do not sit down anywhere to "cool off." It is inviting trouble
and sickness. Do not lie on the damp ground, do not sleep on the first
floor of an old damp house. Have plenty of sunlight and air in your
sleeping room. These directions apply to the chronic cases also. It does
not matter so much if one is wet or sweating as long as he keeps moving or
working. On wash day do not dry your clothes in the kitchen or sitting
room, or put them on your bed, unless they have been thoroughly dried,
aired and warmed before using. These little things mean much in real life.

PHYSICIANS' CAUTION for Articular Rheumatism. Go to bed and remain there
and do not get up too soon, for remember the parts are still tender when
they may not be painful.

Local Treatment. 1. There must be absolute rest. Remove the sheets from
the bed and wrap woolen cloths or blankets about the patient and protect
the inflamed joints from the weight of the coverings. Cover the joints
with gauze or absorbent cotton, after putting on the parts a thick coating
of ichthyol ointment.

2. Sometimes hot fomentations are helpful in relieving the suffering;
sometimes cold cloths are best.

3. The following is good. Apply with cloths wrung out of it:

Carbonate of Soda 6 drams
Tincture Arnica 10 ounces
Glycerin 2 ounces
Water 9 ounces

4. Oil of Wintergreen 1 ounce
Compound Soap Liniment 8 ounces

Mix.

Rub the affected parts with oil of wintergreen and then wrap the parts in
cotton wool and soak with the solution.

5. "A layer or two of gauze saturated with methyl-salicylate is wrapped
around the painful joints and covered with paraffin paper, or other
impervious dressing, held in place by a bandage. This is renewed once or
twice daily until the pain in all the joints is relieved."

6. Internal. Sodium salicylate or aspirin given until the pain and
temperature are relieved; usually five to ten grains of sodium salicylate
every three hours for an adult; or five grains of the aspirin every three
hours.

7. Dr. Hare recommends for the beginning in a strong, healthy individual,
ten drops of the tincture of aconite at once in a little water, and follow
it by a teaspoonful of a mixture containing fifteen drops of tincture of
aconite and two ounces of water everyone-half hour, until perspiration on
the skin betokens the circulatory depression through the action of the
drug. I use aconite in this disease very often, but not in such doses as
the first one. It seems to me that it is uselessly large. I use about
one-tenth of a drop at a dose everyone to two hours during the first
twenty-four hours.

Nursing. The nurse must have the patience of Job to attend a patient sick
with this disease; but you must remember the suffering is awful. The
patient may be very restless and the pillows may need rearranging every
few minutes. Also be careful how you handle the patient. It hurts terribly
to be even touched. A rough, hearty person has no business to care for
such a patient. I allow patients to say anything they wish, for this is a
painful disease. They may swear at me if they wish. I know how it is, for
I was there twice, the last time for six long weeks. Have patience and
courage and cheer your patient. Do not look cross or scold.

Diet. Milk mainly, broths, gruels, albumen water, oyster or clam broth,
milk toast, buttermilk, kumiss. Do not give solid food. Water, lemonade,
vichy or carbonated water.

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RHEUMATIC FEVER (Articular Rheumatism)