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The Peripheral Circulation in Chronic Rheumatism

机译:慢性风湿病的外周循环

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摘要

A series of cases of rheumatoid arthritis, osteo-arthritis, gout and fibrositis have been investigated by means of the sedimentation rate, Arneth count, saline absorption test, glucose tolerance test, and direct observation of the capillaries, in order to correlate any abnormality of the peripheral circulation with the type and activity of the disease.The sedimentation rate test, in which a wide bore tube was used, was of great value as an estimation of activity in the rheumatoid arthritic cases, but a small group showed a normal reading. In the gouty subjects it was usually low but was liable to vary greatly within a short time. In the osteo-arthritic and fibrositic groups it was normal.The Arneth count did not parallel the sedimentation rate; it was usually normal in the gouty subjects but showed abnormalities in the rheumatoid arthritics and sometimes in the osteo-arthritics (a shift usually to the left, but sometimes to the right).The saline absorption test was valueless except in cases of gross circulatory disturbance.The glucose tolerance test, although producing some abnormal curves, in both the osteo-arthritic and the rheumatoid arthritic groups gave normal curves, taking an average of a large number of cases.Observation of the capillaries—notes being taken of their number, shape, &c., with a drawing eyepiece and photographs—showed a wide variation in normal individuals. This was so remarkable that the only clear-cut findings were a slight increase in tortuosity in the osteo-arthritic group—probably due to the increase in the average age of this group—and an increase in the visibility of the full-length of the capillary loop and of the basal meshwork in the rheumatoid arthritics, probably due to trophic thinning of the epidermis.
机译:通过沉积率,Arneth计数,盐吸收试验,葡萄糖耐量试验和直接观察毛细血管,研究了类风湿性关节炎,骨关节炎,痛风和纤维化的一系列病例,以便将其任何异常关联起来。沉积速率试验(使用宽口径管)对于类风湿关节炎病例的活动评估具有重要价值,但一小组显示正常。在痛风性受试者中,其通常较低,但易于在短时间内变化很大。在骨关节炎和纤维变性组中,这是正常的。在痛风患者中通常是正常的,但在类风湿性关节炎,有时在骨关节炎中表现出异常(通常向左移动,但有时向右移动)。盐水吸收试验没有任何价值,除非出现严重的循环障碍。葡萄糖耐量试验虽然在骨关节炎组和类风湿性关节炎组中均会产生一些异常曲线,但它们均呈现正常曲线,平均大量病例出现。观察毛细血管,注意其数目,形状。 ,&c。,带有绘图目镜和照片-显示了正常人的巨大差异。这是如此显着,以至于唯一明确的发现是骨关节炎组的曲折度略有增加(可能是由于该组平均年龄的增加)以及整个骨骼的可见度增加了。类风湿关节炎的毛细血管loop和基底网,可能是由于表皮营养性变薄所致。

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