It is one of the compensations of work in a fever¡
hospital, that, although dealing with a comparatively
limited number of diseases, in addition to various
conditions which may be beset by an infectious disease,
the scope of our observations in the field of medicine
is considerably widened by the incidence of the complications
which are a more or less constant feature
of the exanthems and the other infectious fevers.
Scarlet fever provides a rich selection of such complications
and of these none is more interesting than
Scarlatinal rheumatism or arthritis. This complication
has an interest for its own sake in view of the
marked attention paid at the present day to the generals
question of rheumatism, and the prevention of heart
disease associated therewith.
From another point of view even the most modern
and complete text -books show a certain amount of
divergency of opinion in regard to certain clinical
points that could be fairly easily cleared up by a
little careful observation, and certain gaps in know -
ledge, especially from the statistical standpoint,
that could be filled in after a little consideration
of the abundant records available in the Edinburgh
City Hospital. The writer also originally set out
with the intention of completing the work by making
some bacteriological researches into the condition,
but this was prevented by various circumstances, the
main difficulty being that it was almost impossible
to carry out this part of the work when not actually
resident in the hospital.
Most modern fever experts have adopted the term
"arthritis" in place of the old "rheumatism's and
although this may have something to commend it from a
scientific point of view, in so far as the modern
term denotes a certain condition in certain tissues,
the old term had its conveniences, for it could be
held to include associated inflammations in tendon
sheaths and muscular tissues as well as in joints -
so obviously manifestations of the same process that
the new habit of separating them into arthritis, tondo-synovitis, and myositis, seems clumsy by comparison.
Reference to this point is rendered necessary by the
fact that in all statistical considerations the use
of the term arthritis is held to include these other
manifestations as well
