Rheumatic fever is one type of collagen diseases of children between 5 to 14 years and adult up to age of 18 years by the infection of beta haemolytic streptococci and is characterised by fever, fleeting joint pains, carditis, chorea, erythema margintum and rheumatic nodules. It is an acute, subacute and chronic systemic disease involving the connective tissue throughout the body characterised by fleeting polyarthritis and a great tendency to carditis which is usually a sequela to pharyngeal infection. It is sometimes called juvenile rheumatism.
ii) Climate: people in the temperate climates mainly affects by this disease and comparatively less common in tropics.
iii) Family history: rheumatic fever may run in families, which is often due to poor hygienic conditions.
iv) Social condition: poverty is one of the reasons of this disease and usually affects persons of the lower income group.
v) Condition of sanitation: the people living in the overcrowding, low sanitary condition and dampness are often suffered by rheumatic fever.
vi) Infection of upper respiratory tract: upper respiratory infection commonly tonsillitis or pharyngitis one to 3 weeks before the attack of the disease is usually preceded by.
vii) Age group: rheumatic fever is common in lower age group that is 5 to 15 years and it is layer before four years and after 50 years of age.
viii) Sex: it is equal in both sexes.
i) Polyarthritis – usually migratory and mild in children.
ii) Carditis – about 75% incidence of carditis are found in an initial attack of rheumatic fever. Murmurs, pericardial rub, tachycardia, galloprhythm and heart failure may be present.
iii) Subcutaneous nodules – it occur every bony prominences and signify.
iv) Fever – temperatures remains usually highly which is usually of remittent or intermittent in character. But some degree of fever is always present so long persists. The fever is not associated with chill and rigor and hyper pyrexia may occur occasionally as a complication of rheumatic fever.
v) Arthritis – in 70% of the cases it is sane and deals characteristically fleeting or migratory Polyarthritis. Big joints are commonly affected such as knees, ankles, elbows, wrists, shoulder and hip joints. Small joints may be affected but it is rare. The affected joints become red, hot, painful, swollen and tender, so that all movements of joints are restricted.
vi) Sweating – sweating is moderate in amount, acrid or offensive in odour.
vii) Some other symptoms include sore throat, epistaxis, abdominal pain, skin rashes, anorexia, constipation, weakness.
viii) Carditis – during the course of acute rheumatic fever the heart may be relatively unaffected or the child may be developing endocarditis, myocarditis, pericarditis or pancarditis. Recovery may be complete or the patient may develop valvular lesions. The most constantly affected valve is the mitral valve, followed by the aortic valve and then the tricuspid valve.
ix) Radiological Finding – X-ray shows pear-shaped heart and sometimes pericardial effusions.
x) E.C.G.—E.C.G. reveals depresses ST segments in standard leads with subsequent inversion of T waves. In acute rheumatic fever ECG may be normal, in mild cases an amount of heart block exists, but complete heart block is rare.
ii) Pulmonary –Bronchopneumonia and pleurisy.
iii) Nervous-hyperpyrexia and delirium.
iv) Cutaneous-Purpura and Erythemia.
i) High fever, restlessness, loss of appetite, high coloured urine, affected parts are red and inflamed. The patient is irritable, anxious and restless; tosses about and knows he is going to die. Great thirst and very sensitive and there is shooting and tearing pain in the joints aggravated at night: – Aconite is the remedy.
ii) Joints paying and backache with rheumatic fever. Joint is swollen, red and hot. Sharp, stitching or cutting type pains worse by least motion, touch or pressure. Feels better by lying down on painful side: – use Bryonia.
iii) Intercostal rheumatism of extremities, pains are worse during rest, first motion, cold wet and rainy weather, at night and getting wet, better by change of position, motion, movement of the affected part: – Rhus Tox is useful.
iv) High fever, tendency to cerebral irritation; dry hot skin, thirst and throbbing carotids. Joint swelling, red and shiny with tearing, shooting pains, the pains comes and goes quickly: – Belladonna works great.
v) Bruised feelings as is lying on something hard. The joint is hard, swollen and red. With soreness and bruised feelings with great fear of being touched. There is numbness of the joint. Paying and stiffness following hurt or fall: – Give Arnica.
But those are not all. There have many remedies to control the rheumatic fever but the medicines should be used as per totality of symptoms and experienced homoeopathic physician can suggest the best medicine for a specific patient. With homeopathic also need treatment with magnetic therapy for early recovery and to avoid complication.