The Nature of Still's Disease

The following case of Still's disease is reported because of the unusually full pathological data that were available and because of the light these throw on the nature of the disease. Still's disease is defined clinically as a form of chronic arthritis with swelling of the lymph glands and spleen. The swellings of the joints and lymph glands are usually multiple and symmetrical. The disease generally starts before the second dentition (Still, 1897; Simonetti, 1930) but sometimes occurs in adults (Strauss, 1926; Micheli and Gamna, 1928). The onset is usually insidious but sometimes acute and often accompanied by fever. The course is chronic; intermissions of fever may be associated with regression of the swellings of the joints, glands and spleen but both fever and the other changes often recur (Still, 1897; Simonetti, 1930; Bini, 1935). To the three cardinal signs may be added, in order of frequency: anaemia, muscular atrophy, cachexia, pericarditis, pleurisy, exophthalmos (Bini, 1935) and exanthemata (Simonetti, 1930).