What is meant by the term “rheumatism”? The men of medicine have not yet definitely decided just what constitutes rheumatism – just where rheumatism begins and where it leaves off – just when the condition is rheumatism and when it is not. Modern health-seekers, as well as physicians, tend toward distinguishing other ailments from specific rheumatism. Among these disorders are arthritis in various forms, neuralgia and neuritis.
Among the true rheumatisms are acute rheumatic fever and chronic rheumatism, the latter being now quite frequently called polyarthritis because several or many joints may be involved at once; the chronic types also include rheumatoid arthritis or arthritis deformans. But these two names are really descriptive of different conditions – the former meaning a chronic rheumatism of a severe degree, but with little or no deformity yet developed, the latter meaning a more severe chronic degree with deformity.
Since the acute form is not frequent, and the symptoms so severe as to make the victim temporarily bedfast, this form will not be considered in this article.
The chronic form may result from the acute, or from what sometimes is called a sub-acute form, similar to the acute but less severe; but in most cases it comes on insidiously in people who have never had either the acute or sub-acute form. For more regarding reverse osmosis membrane – https://blip.fm – visit the web-site. The chronic form is considered to be a disease of middle life and old age and occurs about equally in men and women. By some it is considered to be hereditary, but it is most likely that the “heredity” consists of the same family habits of diet and hygiene, also the same climate. It is a disease of the temporate zone, where there are more frequent sudden and marked changes in temperature and climatic conditions, with considerable dampness, and it develops most frequently in those who are exposed to sudden temperature changes in their occupation, also to cold and damp. The manual laborer often is affected but is not the most usual sufferer, however, at least not so frequently as those who are under a mental strain and who are not nourished properly, especially when the hygiene is defective. Hence, it develops more frequently in the poor – though it is no respecter of class. Injuries may be responsible, such as blows and strains, also straining use of the joints. An injury to a joint may have been almost forgotten until that joint becomes the seat of rheumatic pains.
Of course, a species of bacteria is suspected to exist, as it is considered by the medical man as an infection; but as yet the germ has been successful in evading research.
Chronic rheumatism may be muscular or articular (of the joints) and, contrary to a common impression that the disease develops only in middle life and later, especially the muscular form may be found in early life. And “growing pains” are also a type of joint or bone rheumatism, and certainly they are not common in the mature man or woman. Both muscles or joints may be affected in some cases. Whether the muscular form is a true rheumatism or a false or pseudo-rheumatism, as some wish to call it, it comes on with similar conditions as does articular rheumatism – after exposure to cold and wet and fatigue; but a high degree of toxemia must be present in either case. Pain is the main symptom, aggravated by movements of the affected muscles and usually by pressure. Lumbago and wry-neck arc present in this form.
In the articular form the main symptoms are swelling and heat of the affected joints, with an interference of joint movements. The joints usually feel distinctly hot. Sometimes the disturbance is confined to smaller joints, sometimes to large joints, but both large and small joints may be affected at the same time. Acute reactions occur from time to time, but each succeeding attack is milder than the preceding one, so far as pain is concerned, yet each leaves the joint more and more crippled, until it eventually becomes greatly disabled and the size and shape are markedly altered. The joints that are most usually implicated are those of the extremities, though those of the spine and also of the jaw are not infrequently attacked, and in fact no joint is immune. The heart usually is not affected, as it is so frequently as a result of the acute inflammatory form, but there usually is anemia.
There may be a hypertrophic or an atrophic form – in the former the joints being greatly enlarged, and in the latter the surrounding tissues being so affected and atrophied that the joints appear enlarged.
In all diseases prevention is worth a ton of cure, but this is perhaps especially true in case of rheumatism. An exposure to inclement weather is a frequent starting or exciting cause, this should be avoided as much as possible, also marked physical, mental and nervous fatigue. The body should be well nourished with an alkalinizing diet that will prevent fermentation and putrefaction and toxemia. The body should be well protected against chill and damp, but not by an excess of clothing; it should be universally protected and the resistance built up by an open air life, cool or cold baths and plenty of sleep, rest and relaxation; besides exercises to maintain normal circulation and skin and general functional activity.
Any focus of infection should be avoided, or if rheumatism develops such a focus if discovered should receive attention, as it is more than likely that it will interfere with progress under the most satisfactory treatments.When acute painful reactions develop, the patient should be put to bed until relieved. Except in the anemic and undernourished, who require more nourishment, I believe all patients should adopt the fruit juice diet for several days, or the absolute fast, with the daily enema or colonic irrigation. Following this, and for the under-nourished, the milk diet may be used successfully in some cases, but by no means in all cases.
Some will do much better on a diet of raw salad vegetables, cooked green vegetables and fruits. It cannot be positively determined beforehand what diet will be most apt to effect a favorable change, but if necessary various diets may be given trial. Starches and sugars and proteins usually are partly responsible for the condition and therefore should be kept out of the diet until a considerable improvement has been made. However, fats frequently are necessary, and cod liver oil is excellent in these cases.
In addition to rest (which sometimes is better secured by splints to the joints) local treatment should include hot applications. Hot-packs, wet with a saturated solution of Epsom salts or common table salt are excellent, also the hot-water bottle over dry flannel, or alternate hot and cold applications, though sometimes the ice-bag over a wet cloth is more agreeable, particularly in the acute exacerbations.When the acute or severe pain has subsided, the joint may be moved in various directions and other local manipulation are sometimes excellent in these cases. As soon as possible, however, active motions of the joints should be started. Treatment in some institution that provides all these treatments plus a suitable diet and drinking water, and also special heating appliances, is to be recommended for those who can take advantage of it. Water in large amounts should be taken regularly unless the milk diet is taken, but distilled water should be used for the most part when procurable.
“Baking” the joint in dry air is an excellent treatment, and by an electric heating pad, by hot sand-bags or hot-water bottles, wet cloths covered by dry flannel, or an infrared or incandescent bulb, locally applied, will be excellent; but after such treatment (continued until the local part perspires well) there should be cold applications followed by careful drying and wrapping of the part sufficiently to maintain warmth. The part may be wrapped in cotton wool, or cotton or wool.
The skin should be kept active by an abundance of friction, also by cool or by hot and fairly cold baths if the reaction is good. Hot baths with massage are of great value, but the massage should continue after the bath until the skin is dry and the parts about the joint a glowing pink. As soon as safe, general active exercises should be taken, and to the point of perspiration if possible. In the muscular forms of rheumatism, local hot packs or fomentations or alternate long hot and short cold applications should be used, also massage when bearable, and perhaps natural or artificial sun-baths.
These measures with the correct diet and perhaps some or, if necessary, all of the health-building factors mentioned usually will take care of the other pains frequently misinterpreted as rheumatism. When one attack has been successfully overcome from then one should observe every prophylactic or preventative measure possible – and strictly – if a worse attack is to be avoided.