A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
The partial form presents some peculiarities of causation--thus: it
occurs chiefly in advanced life (senile arthritis), much less
frequently in middle life, very exceptionally in the very young. Men
are much more liable to it than women. It is chiefly this variety which
follows injuries, blows, dislocations, pressure, etc., and the disease
may then be limited to the injured joint and be monoarticular, or it
may extend and become polyarticular, or rarely, as in Ord's case, even
general. This monoarticular form appears to be sometimes induced by
other local irritations of the articular structures than those
following traumatic influences; and as foreign growths in joints and
gouty irritation may respectively induce the lesions indicative of
rheumatoid arthritis, so, it is probable, may simple chronic
rheumatism; and this may be the true relationship existing between
these several affections. It is doubtful at present whether purely
local irritation or injury of a joint can originate the alterations
belonging to rheumatoid arthritis--that is, in the absence of all
predisposition to that disease or of the arthritic diathesis. Cold and
dampness are generally admitted to be causes of the partial form, but
the evidence on this point is not altogether satisfactory. It may be
that chronic articular rheumatism is induced by the prolonged operation
of damp cold, and that the prolonged rheumatic irritation, aggravated
by constant use of the joint and by occasional violence, ultimately
superinduces the profounder alterations characteristic of arthritis
deformans. It appears highly probable that if the predisposition exist,
any long-abiding irritation of a joint, whether the result of violence
or disease, may ultimately originate the alterations of the cartilages
and bones which obtain in rheumatoid arthritis.
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