Henry Baird Favill, AB, MD, LL.D., 1860-1916, a ... - University Library

MEDICINE AND PUBLIC HEALTH 131
Delivered, Chicago Society of Internal Medicine, April 27, 1899.
Printed, Journal of the American Medical Association, February 11, 1900.
TREATMENT OF ACUTE RHEUMATISM
THE
task of discussing the treatment of acute articular
rheumatism, as a cHmax to this exhaustive discourse,
is inevitably rather thankless. Decided convictions
as to the successful and satisfactory therapy, I have not.
Too many times has experience contradicted and reversed
previous conclusions to permit me to hold dogmatically to
lines of procedure at all inflexible. Too thoroughly ground in
upon me are the doubts and disappointments of clinicians,
to allow me to harbor the hope of authoritative routine.
What I have to offer is a tentative and provisional
interpretation of accumulated experience, which seeks to
harmonize obvious conflicts in the line of advance of
investigations in this field. The history of the subject is
full of interest. The frequency of occurrence and ease of
diagnosis have made this an inviting field for therapeutic
measures. The consequences have, as usual in such circumstances,
been more or less disastrous. The number of plans
and agents which have traversed the scale from favor to
disfavor must create the impression that treatment has been
in the past unsatisfactory. That such is the fact, the therapeutic
nihilism of many close observers abundantly evinces.
The subject, however, is not for such reasons barren.
Without undertaking to deal with the detail of development
of this subject, I wish to refer to the various points
of view heretofore held, and to comment on the tendencies
of treatment following such outlook.
With noticeable uniformity the more or less imperfect
groupings of symptoms which have been called rheumatism
have been attributed to altered conditions of the blood.
The conception of constitutional character is quite likely
most natural; in view of the clinic behavior of the disease,