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
On the other hand, while the disease cannot be regarded as curable
under the employment of drugs, very much can frequently be done,
especially in the polyarticular form, to relieve the suffering and to
retard, if not arrest, the progress of the disease, and even to restore
sometimes very considerably the functions of the joints. Neither of
these forms of rheumatoid arthritis can be said to be dangerous to
life, and they often exist ten or twenty years and more without
seriously injuring the general health. Heberden's nodosities are
incurable, but they are little more than deformities.
TREATMENT.--The treatment of rheumatoid arthritis is, as a rule,
disappointing, and perhaps no affection requires more perseverence and
self-reliance on the part of the physician or more hopeful resolution
on that of the patient. Our first duty is to make an exhaustive search
as to the probable cause of the disease, as its removal is an important
step in the treatment of the affection, although such search is
frequently futile, and many of the alleged causes may, after all, be
mere antecedents or coincidences. However, inasmuch as the pathology of
the disease is very obscure, any abnormal condition of organ or
function that may be discovered should receive strict and prompt
attention, lest it should, either through disturbed innervation or
malassimilation or impaired nutrition or defective excretion, be the
predisposing or exciting cause of the disease. In women the most
careful inquiry should be made into the state of the ovario-uterine
organs and functions, and the least departure from their norm should be
at once treated. Deficient, excessive, or painful menstruation,
leucorrhoea, ovarian irritations, or pain, even displacements of the
uterus or ovary, should be corrected as soon as possible. Repeated
pregnancy and prolonged lactation, recurring mental anxiety and
physical fatigue, defects of diet, want of food, of sunlight, and of
good air, residence in damp dwellings, occupations involving exposure
to cold and wet, are conditions supplying important indications which
too often are {97} beyond the control of the physician, although they
peremptorily require his attention. The general form is often met with
in anæmic persons and in those of impaired health and vigor, and
probably very rarely occurs under opposite circumstances; and there is
a consensus of opinion that a lowering system of treatment is
contraindicated in rheumatoid arthritis.
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