A treatise on the diseases of infancy and childhood . pneu-monitis, rendering the prognosis more unfavorable. In rare instances the acute symptoms of rheu-matism abate, but the joints remain stiff and moreor less swollen, and painful when moved. Theacute has lapsed into a subacute or chronic rheu-matism. Such a case, represented in the accom-panying figure, was brought to the childrens classin the Outdoor Department at Bellevue Hospital,in February, 1871. E. EL, a female, 3J yearsold, had intermittent fever from the age of nineto fifteen months. From this time she remainedwell till the age of
A treatise on the diseases of infancy and childhood . pneu-monitis, rendering the prognosis more unfavorable. In rare instances the acute symptoms of rheu-matism abate, but the joints remain stiff and moreor less swollen, and painful when moved. Theacute has lapsed into a subacute or chronic rheu-matism. Such a case, represented in the accom-panying figure, was brought to the childrens classin the Outdoor Department at Bellevue Hospital,in February, 1871. E. EL, a female, 3J yearsold, had intermittent fever from the age of nineto fifteen months. From this time she remainedwell till the age of two years, when she was takenwith acute rheumatism, commencing in her anklesand extending to other joints. The knee and hipjoints on both sides have only partially recoveredtheir mobility, and both legs and both thighs arepermanently flexed, so that the gait is slow and unsteady. It is im-possible to straighten either limb without causing great pain, andattempts to straighten the thigh produce the arch in the back verysimilar to that in coxalgia. 26. 402 ACUTE RHEUMATISM. Diagnosis .—This is not difficult in ordinary cases, if a proper exam-ination be made. In the commencement, if the affection of the jointsbe slight, rheumatism might be mistaken for remittent, typhoid, one ofthe eruptive fevers, or meningitis ; but, on careful examination, tender-ness of one or more of the articulations will be observed, and probablysome swelling. This tenderness is readily distinguished from the hyper-esthesia which is common in the first stage of the essential fevers, andwhich is observed when pressure is made upon the chest or abdomen aswell as upon the limbs, and is more marked between the joints than inthem. Any doubt which may at first exist, whether the patient maynot have one of those diseases, is soon dispelled, since their clinicalhistory presents notable differences from that of rheumatism. I have known scrofulous arthritis, or scrofulous ostitis near the joint,present so close a
Size: 993px × 2518px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, bookidtreat, booksubjectchildren
