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RHEUMATIC GOUT. (Rheumatic Arthritis. Arthritis Deformans)

Categories: Constitutional Diseases

Cause. It
occurs most often from thirty to fifty-five, usually in women, generally

at or after the change of life, and most frequently in those who have not

had children. The involvement of the joints is most common in adult males.

Exciting cause may be: Exposure to cold and wet, improper food, unhygienic

surroundings, worry, blows and acute infections.

Conditions. Several joints are
sually involved symmetrically. At the

edge of the joints there is formation of new bone covered with cartilage,

causing the enlargement of the bone and often partial loss of motion in

that joint.

Symptoms. Several distinct types exist. 1. General progressive types

which may be acute or chronic.

Acute. This occurs usually in women from twenty to thirty and at the

change of life. It comes on like acute joint rheumatism, many joints being

affected, permanent enlargement appearing early, redness of the joints

rarely existing, the pain being very severe, some fever, feel very tired,

with anemia, loss of flesh and strength. The first and later attacks are

often associated with pregnancy, confinement or nursing.

Chronic Type. There is a gradual onset of pain or stiffness in one or

more joints, usually of the fingers, then of the corresponding joints of

the other side and then other joints. The swelling at first may be in the

soft parts of the joints with effusion in the joints and tenderness. The

pain varies from slight to severe. Periods of improvement and getting

worse alternate; the joints becoming enlarged and deformed, often nearly

stiff in partial bending on account of the thickened bone and soft

tissues. The muscles that move the joint dwindle and there may be changes

in the skin and nails of the parts affected due to the want of proper

nourishment. Disturbances of the stomach and anemia are common. The heart

is not affected. There may be only a few joints affected, or many, with

great deformity, before the disease reaches the period of inactivity.

2. Monarticular or one joint type. This usually occurs in males over

fifty; one joint or a few large joints may be affected, generally with

shrinking of the corresponding muscles. If it occurs in the hip it is

called Morbus Coxae Senilis,--Hip joint disease in the aged.

Recovery. The disease usually goes on with intervals of improvement and

often results in great crippling and disability. In some cases it becomes


General Treatment. The climate should be warm and dry. The patient should

avoid exposing himself; lead a general hygienic life, with as nourishing

food as his digestion will permit. The chief line of treatment should be

to improve the general health and relieve the pain. The stomach, bowels,

and kidneys should be kept working well. Nourishing food should be taken,

but its effect must be watched. Cod-liver oil to build up the system, iron

and arsenic may be of value. Sometimes iodide of potash is good. Early and

thorough treatment at Hot Springs offers the best hope of arresting its

progress, the Hot Springs in Bath County, Va., and in Arkansas. Much can

be done at home by hot air baths, hot baths, and compresses at night to

the tender joints.

Local. Massage carefully given is helpful. The hot air treatment is good.

Baking the joints is now frequently done.