The Treatment of Acute Infectious Diseases (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER III ACUTE RHEUMATIC FEVER Theories of Rheumatism. It is not my purpose to discuss the numerous theories advanced to account for the phenomena of acute rheumatic fever. I will merely state that it is the consensus of opinion at the present time that the disease is an acute infection. Numerous observers have claimed to have isolated the specific organism, among the most insistent of whom are Poynton and Payne. Etiology. The classification of this "specific" organism has not as yet been fairly settled; indeed, the identity of the "specific" organisms is much in question. Some believe, moreover, that different organisms can produce the same clinical complex called Rheumatic Fever and one observer, Rosenow, maintains the transmutation of members of the streptococcus group into several forms, each inducing some differences in the clinical picture. This will be touched upon again when discussing vaccine therapy. To Poynton's view has been lent the weight of the authority of Osler's new Modem Medicine, to the pages of which he contributes the article on rheumatism, and in which the various views of the etiology of this disorder are set forth in some detail. Age. About one-half of all cases of rheumatism occur between the ages of fifteen and twenty-five years; about one-quarter in the next decade, that is, between twenty-five and thirty-five years. My own impression, based on considerable contact with children, is that the figures set for childhood are too low, as the disease is peculiarly insidious at this age, and deviates strikingly from the type as established in the adult. The serious complications are quite as common, even more common than in the adult. Of the cases occurring in childhood, 70 per cent. fall between the ages of ten and fifteen years. I cannot re...