HEALTH NOTES.

New Zealand Mail, Issue 1847, 31 July 1907, Page 11

HEALTH NOTES.

ABOUT RHEUMATISM. " (By Dr Andrew Wilson.) A word, first of all, regarding tlie conditions which, give rise to rheumatism. In accounting for the origin of any disease we have to take two things into consideration. There is first the exciting cause, that which directly causes the ailment; and there is, second, the predisposing cause, or that which favours and assists the “exciting” cause. The predisposing conditions give the exciting ones their chance to develop the disease. Without them, the exciting causes might lie fallow and remain in abeyance. Consider the case of rheumatism in view of these remarks. The ordinary mortal will tell you that rheumatism is duo to cold, dampneifs, and chill. But a little collection will show us that very many of us are exposed to cold and chill, and yet remain free from rheumatism. It is clear that there must be some special condition of body which, favoured by exposure to cold, gives rise to the disease. That condition is the “exciting cause” of rheumatism, the cold and damp being merely those which “predispose” certain people to attack.

We have a very fair knowledge, indeed, of the exact, or exciting,, cause of rheumatism. It consists in the overproduction, or at least the excess in the body, of an acid called lactic acid, chemically and olosely related, indeed, to the acid that is the cause of the souring of milk. Lactio acid is formed naturally in the body as a waste product. It is one of those substances developed as a result of our bodily wear and tear, and as such requires to be got rid of if the body is to remain in a healthy condition. This acid is largely produced in our frames as a result of muscular exertion, and the skin, it may be added, is the chief channel whereby it is got rid of from the system. Part of the lactic acid is, no doubt, otherwise, eliminated from the body, but the skin remains as the chief organ devoted to its removal. ® Now, if through a chill acting on the skin, checking its action,, or if through cold acting on other organs of the body, the lactio acid waste is not excreted, one may readily imagine the result. This waste matter will accumulate in the system, will act as an irritant quite as much as if it were a poison introduced into the body from without, and will accordingly set up diseased action. What lactic acid especially does is to attack the joints. It seems to have a preference for those structures, and so we £*id the essential feature of rheumatism at once developed, for in its essence it is a joint trouble, in so far as its seat of attack is concerned. But this is not all. The general bodily disturbance to which the excess" of lactic acid gives rise has also to be taken into account, and so we find other symptoms developed, each having a distinct significance of its own. Take*the course of an attack of rheumatic fever —that is what we otherwise call acute rheumatism—and you will easily note how the whole system is upset in this process of poisoning by lactic acid. The ailment begins with sore throat, chilliness, shivering, headache, and a general aching and soreness all over the body.; Pam begins m one or several of the which show tenderness and swelling. If one joint is at first affected the disease will pass to others. Then the pulse begins to auicken. and the temperature of the

body to rise. These, of course, are the signs of fever. Constipation exists, and the kidney secretion will be found high coloured, and diminished in amount. The temperature will rise as the disease progresses. It will .go up to 103 or 104 degrees, though it may fall a little now and then. If it runs up much above 104 degrees the case is to be regarded as of very serious nature.

To show the part the skin plays in the getting rid of lactic acid, it must be added that one characteristic sign of rheumatic fever consists in the strong acid-smelling, or sour-smelling sweat which is given off; but while in other fevers a copious skin action relieves the patient, this result is not seen in the ailment v. r e are considering. The course of the trouble, with its fever, pain in joints, swelling of joints, and general unset of the whole functions of the body, will run through a period of three or four weeks. But it is no uncommon thing to find patients suffer from relapses. They appear to be going on favourably, when “a bad turn,” as the saying is, appears, and then there is a return of the severe symptoms. But in any case of a favourable termination recovery is slow, and there must ensue a long interval before strengui is regained. The sufferer will aho be fortunate if he escapes without one or more of his joints demanding care and attention after he has recovered from the acute attack of this disease.

The list of rheumatic fever signs and symptoms, however, cannot be completed without a reference to the after-effects this disease is apt lo leave behind it. Unfortunately, heart-troubles are only too commonly found after an attack. Lung troubles are not unknown to follow it, -the eyes may even bo affected, and in some cases “e>t. Vitus’s Dance”— a disease characterised by jerking movements of the muscles —is an unwelcome legacy left by rhe mafic fever. On all grounds, then, a rneumatic attack is a ciiing to be dreaded, and of ali things to oe prevented, or at least efficiently and early- treated. Delay in treatment is proverbially dangerous here.