Some considerations on the disease rheumatism

The term Rheumatism is one of great antiquity, going as far "back as the time of Hippocrates; and, as the name indicates, it was employed by the early authors to denote a flowing, or catarrh.From these early times, down to the present time, the term has been used to denote many and various conditions; indeed, there is probably no word in the whole, of medical nomenclature that has been so freely used and abused. The name of rheumatism, like that of gout, carries with it the impress of humoral pathology.It cannot but be admitted that the modern view defines the province of the disease with a clearness, such as never before was the case. This view dispels all that mustiness and vagueness which are part and parcel of such expressions as "constitutional", "diathesis". It does not permit the term "rheumatism" to symbolise all forms of arthritis, and all "cold" caused affections.A firmer mental grasp can be taken of this conception of the disease; it can be viewed as a composite whole. The conception of the disease in short, is more scientific.This conception is the result of further knowledge of the disease obtained by clinical and pathological study.This further knowledge combined with pathological and clinical knowledge of other diseases has resulted in the formation of the infective theory as to the etiology and pathology of rheumatism. No other theory gas yet been advanced which accounts so fully and completely for the phenomena of rheumatism. No other theory has yet been advanced which is so near to being proved.It was remarked above that many writers of text-books had placed rheumatism among the Infectious diseases, and that it marked an advance in the right direction. There is, however, still left something to be desired in the description of the disease. With many writers, acute rheumatic arthritis, or rheumatic fever, is still represented as being typically the rheumatic process. The rheumatism of childhood, or subacute rheumatism, does not get dealt with as it ought. It cannot be insisted too strongly that subacute rheumatism is as important, if not more important, than acute rheumatism.Some of the manifestations are mentioned chiefly as complications. Some show a lingering regard for pseudorheumatic affections. Even gout is described, either immediately before, or immediately after, rheumatism, by some writers.It must be remembered, however, that rheumatism is a disease of great antiquity; that it has long held a position firmly established in the medical mind, as well as the lay public mind; that traditions die hard; that allowance must be made for peculiar obstacles, beliefs, and prejudrices.If it be that rheumatism as a disease, is on the eve of being put in its proper place in Medicine, it can, truly, be said that the history of the progress of our knowledge of rheumatism affords one more instance of -"Science moves, but slowly slowly, Creeping on from point to point.