disease known
popularly as rheumatic fever, and technically as acute rheumatism or
acute articular rheumatism. In fact, the commonest division is to
separate the "rheumatisms" into two great groups: acute, covering the
"fever" form, and chronic, containing all the others. From a purely
scientific point of view, this classification has rather an undesirable
degree of resemblance to General Grant's famous division of all music
into two tunes: one of which was Old Hundred, and the other wasn't. But
for practical purposes it has certain merits and may pass.

Every one has seen, or known, or had, the acute articular form of
rheumatism, and when once seen there is no difficulty in recognizing it
again. It is one of the most striking and most abominable of
disease-pictures, beginning with high fever and headache, then
tenderness, quickly increasing to extreme sensitiveness in one or more
of the larger joints, followed by drenching sweats of penetrating acid
odor. The joint attacked becomes red, swollen, and glossy, so tender
that merely pointing a finger at it will send a twinge of agony through
the entire body, and the patient lies rigid and cramped for fear of the
agony caused by the slightest movement. The tongue becomes coated and
foul, the blood-cells are rapidly broken down, and the victim becomes
ashy pale. He is worn out with pain and fever, yet afraid to fall asleep
for fear of unconsciously moving the inflamed joint and waking in
tortures; and altogether is about as acutely uncomfortable and
completely miserable as any human being can well be made in so short a
time.

Fortunately, as with its twin brother, the grip, the bark of rheumatism
is far worse than its bite; and a striking feature of the disease is its
low fatality, especially when contrasted with the fury of its onslaught
and the profoundness of the prostration which it produces. Though it
will torture its victim almost to the limits of his endurance for days
and even weeks at a stretch, it seldom kills directly. Its chief danger
lies in the legacies which it bequeaths. Though, like nearly all fevers,
it is self-limited, tends to run its course and subside when the body
has manufactured an antitoxin in sufficient amounts, it is unique in
another respect, and that is in the extraordinary variability of the
length of its "course." This may range anywhere from ten days to as many
weeks, the "average expectation of life" being about six weeks. The
agonizing in