Osteo Arthritis (Arthritis Deformans).
- RUDDOCK.E.H,
DEFINITION. A chronic disease of the joints, characterized by changes in the synovial membranes and ligaments, and often by atrophic or hypertrophic changes in the bones. This disease was long called Rheumatic Gout, but is distinct from both Rheumatism and Gout. It affects women more than men, and is generally a disease of middle life. It appears often at least, if not always, to be due to poisoning from some chronic suppuration. The effect of gonorrhoea in causing joint troubles us well known, and diseases like pyorrhoea alveolaris ( a disease of the gums and teeth, with constant suppuration), or chronic pelvic inflammation, leucorrhoeas, etc., are responsible for some manifestations of osteo arthritis. Exposure to damp and cold. worry and care, overwork and under feeding are all predisposing cause.
SYMPTOMS. The disease may come on acutely with fever and implication of several joints. Even cardiac complications are observed, and in children enlargement of lymph glands and sleep (Still's disease). This form is difficult to distinguish from Rheumatic fever. The immediate treatment should be the same as for that disease, and the later condition of the joints makes the diagnosis clear.
In the more usual chronic form, the joints are generally attacked symmetrically. Pain on movement and slight selling appear. The joints of the hands are frequently first attacked and later other joints. Progress is very variable with intermissions, but gradually the shape of the joint is altered, the ligaments thicken and the muscles retract; bony growths form round the joint and lock it, and in time the joints become fixed nd useless. If the vertebral joints are attacked the patient becomes an absolute. The finger joints acquire a spindle form, which is very characteristic.
TREATMENT. The disease is obstinate and very difficult to cure. If actual tissue changes have taken place arrest of symptoms is all that can be looked for. Vigorous local measures, massage, hot air baths, should be used in the chronic forms, and other remedial measures mentioned under Rheumatism. A search should be made for any source of pus, and the trouble dealt with. Vaccine treatment is helpful sometimes and good possibilities lie in phylacogen treatment, where the remedies are made from the products of bacterial growth without the actual germs. See Chronic Intestinal Infections.'
The drug treatment of both the acute and chronic forms depends on the symptoms. In the acute form, Acon., Bry., Puls., etc., will probably find a place; when the disease is chronic, however, although Rhus., Rhodo., Mercurius, etc., are often valuable for relief of local symptoms and especially Caulophyllum in women, the best prescription are those founded on the general and constitutional symptoms rather than on the local ones. Sulphur is particularly valuable often, and Silicea. Drugs chosen on general grounds are best given in infrequent doses of high potencies.
DEFINITION. A chronic disease of the joints, characterized by changes in the synovial membranes and ligaments, and often by atrophic or hypertrophic changes in the bones. This disease was long called Rheumatic Gout, but is distinct from both Rheumatism and Gout. It affects women more than men, and is generally a disease of middle life. It appears often at least, if not always, to be due to poisoning from some chronic suppuration. The effect of gonorrhoea in causing joint troubles us well known, and diseases like pyorrhoea alveolaris ( a disease of the gums and teeth, with constant suppuration), or chronic pelvic inflammation, leucorrhoeas, etc., are responsible for some manifestations of osteo arthritis. Exposure to damp and cold. worry and care, overwork and under feeding are all predisposing cause.
SYMPTOMS. The disease may come on acutely with fever and implication of several joints. Even cardiac complications are observed, and in children enlargement of lymph glands and sleep (Still's disease). This form is difficult to distinguish from Rheumatic fever. The immediate treatment should be the same as for that disease, and the later condition of the joints makes the diagnosis clear.
In the more usual chronic form, the joints are generally attacked symmetrically. Pain on movement and slight selling appear. The joints of the hands are frequently first attacked and later other joints. Progress is very variable with intermissions, but gradually the shape of the joint is altered, the ligaments thicken and the muscles retract; bony growths form round the joint and lock it, and in time the joints become fixed nd useless. If the vertebral joints are attacked the patient becomes an absolute. The finger joints acquire a spindle form, which is very characteristic.
TREATMENT. The disease is obstinate and very difficult to cure. If actual tissue changes have taken place arrest of symptoms is all that can be looked for. Vigorous local measures, massage, hot air baths, should be used in the chronic forms, and other remedial measures mentioned under Rheumatism. A search should be made for any source of pus, and the trouble dealt with. Vaccine treatment is helpful sometimes and good possibilities lie in phylacogen treatment, where the remedies are made from the products of bacterial growth without the actual germs. See Chronic Intestinal Infections.'
The drug treatment of both the acute and chronic forms depends on the symptoms. In the acute form, Acon., Bry., Puls., etc., will probably find a place; when the disease is chronic, however, although Rhus., Rhodo., Mercurius, etc., are often valuable for relief of local symptoms and especially Caulophyllum in women, the best prescription are those founded on the general and constitutional symptoms rather than on the local ones. Sulphur is particularly valuable often, and Silicea. Drugs chosen on general grounds are best given in infrequent doses of high potencies.
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