ses=

_Causes of Rheumatic Fever--Relief of Pain in the
Joints--Lumbago--Stiff Neck--Gout--Symptoms and Cure of Scurvy._

=RHEUMATIC FEVER; INFLAMMATORY RHEUMATISM; ACUTE RHEUMATISM.=--This
variety of rheumatism is quite distinct from the other forms, being in
all probability due to some special germ. It occurs in temperate
climates during the fall, winter, and spring--less often in summer.
Persons more frequently suffer between the ages of ten and forty
years. It is rare in infants; their pain and swelling of the limbs can
be attributed more often to scurvy (p. 180), or to surgical disease
with abscess of joint or bone. Exposure to cold and damp, in persons
insufficiently fed, fatigued, or overworked, is the most common
exciting cause.

=Symptoms.=--Rheumatic fever may begin with tonsilitis, or other sore
throat, with fever and pains in the joints. The joints rapidly become
very painful, hot, red, swollen, and tender, the larger joints, as the
knees, wrists, ankles, and elbows, being attacked in turn, the
inflammation skipping from one joint to another. The muscles near the
joints may be also somewhat swollen and tender. With the fever, which
may be high (the temperature ranging from 102 deg. to 104 deg. F.), there are
rapid pulse, copious sweating, and often the development of various
rashes and minute blisters on the skin. There is also loss of
appetite, and the bowels are constipated. The urine is usually very
dark-colored. Altogether, victims of the disease are truly pitiable,
for they suffer agony, and are unable to move without increasing it.
The weakness and prostration are marked. Small, hard lumps, from the
size of a shot to that of a pea, sometimes appear on the skin of the
fingers, hands, wrists, knees, and elbows. These are not tender; they
last for weeks and months. They are seen more often in children, and
are most characteristic of rheumatic fever, but do not show themselves
till late in the disease.

Complications of rheumatic fever are many. In about half the cases the
heart becomes involved, and more or less permanent crippling of the
heart persists in after life. Unconsciousness and convulsions may
develop--more often when the fever runs high.

Lung trouble and pleurisy are not infrequent. Chorea or St. Vitus's
dance follows inflammatory rheumatism, in children, in some instances.
Repeated attacks at intervals, varying from one to four or five years,
are rather the rule--more particularly in