110 American Journal of Med. Sciences, July, 1863.
111 Ib., vol. xii.
112 Medico-Chirurgical Transactions, vol. lii.
113 Guy's Hospital Reports, 2d Series, vol. xi.
Gull and Sutton have published the natural histories of 62 cases—viz. of 41 in their first series, of 8 more in their second, and of 13 more in their third. The average duration of the acute symptoms was, in the first series, 8.5 days, in the second, 9 days, and in the third, 10 days, giving an average of 9.1 days for the duration, after admission to hospital, of the acute symptoms of acute polyarticular rheumatism when there is no very severe cardiac disease. In their third paper, based upon 13 new cases and 12 of those published in their two previous communications, they conclude "that rheumatic fever uncomplicated with any very severe heart affection tends to run its course in nineteen days, calculating from the time the rheumatic symptoms first set in to their termination."114 Yet an analysis of the 23 of the 41 cases contained in their first series115 respecting which the duration of the rheumatic symptoms before admission and from admission to complete convalescence is given, shows that the period occupied from the setting in of the rheumatic symptoms to convalescence was in the 13 male subjects 25.8 days, and in the 10 female 42 days, or, including both sexes, the average duration was 32.8 days—i.e. 6.8 days longer than Flint's result.
114 Med.-Chir. Trans., lii. 82.
115 Guy's Hospital Reports, xi. 435.
As Gull and Sutton had especially pointed out the class that tends to assume acute characters and recover more quickly than any other, and the class that runs a protracted course and tends to relapse, it is somewhat remarkable that they did not tabulate the cases belonging to those classes separately, and show distinctly their differences in duration and modes of convalescence. This has been attempted by Southey,116 but, unfortunately, his conclusions, as will hereafter appear, have not been confirmed by other observers.
116 St. Bartholomew's Hospital Reports, xiv., and ib., xv.
Finally, in this connection, after carefully weighing ten subjects of acute articular rheumatism during their illness and until they had regained their usual weight, A. Roussel117 found that the time during convalescence occupied in regaining the weight previously lost was inversely proportional to the duration of the attack.