The diseases enumerated in the nomenclature of disease, under the second section or division of General Diseases, are dis tinguished from those of the first division by their longer per sistence, their possible recurrence in the same person, and their constitutional and hereditary character.
These types of disease are defined in the nomenclature of the Royal College as :— "Diseases for the most part which are apt to invade different parts of the same body simultaneously or in succession. They are sometimes spoken of as constitutional diseases, and they often manifest a tendency to transmission by inheritance." The diseases may be described in the following order.
A specific disease, attended with fever and characterized by inflammation of the fibrous tissues surrounding the joints, but without tendency to the formation of matter. Many joints may be affected in the course of an attack at the same time or in suc cession.
Acute rheumatism is attended with a free secretion of acid fluid from the skin, the acid being of the kind known as lactic. In my experimental researches I have shown that this acid has the power of producing the symptoms of the disease. Rheu matic disease of the heart is a common result of acute rheumatic fever. The affection is hereditary.
Varieties of Rheumatism.
Subacute Rheumatism.A less acute form of the disease, but attended usually with some fever and much pain.
Gonorrhoeal Rheumatism. A specific form of acute rheuma tism, often very severe, and attended with severe febrile disturb ance and with pain and swelling in the joints. A disease con nected with and probably dependent on the specific disease which precedes its occurrence.
Synovial Rheumatism. Rheumatism of the joints with ac cumulation of serous or watery fluid in the synovial sacs or in vesting membranous pouches of the joints in which the lubricat ing synovial fluid is secreted. The disease is attended with much local swelling of the joints and pain, but with less inflammation and fever than occurs in acute rheumatism.
Muscular Rheumatism. A form of rheumatism affecting the sheaths, or fibrous coverings of muscles, and giving rise to pain, increased greatly by motion, throughout the muscular. structures. There are two sub-varieties of muscular rheumatism : Lumbago, or rheumatism of the muscles of the back.
Stiff neck, or rheumatism of the muscles of the neck.
Chronic Rheumatism. Rheumatism in which the pain is con tinued chiefly in joints, and attended with " stiffness and swelling of the various affected joints," and with little or no fever.