Sore throats are an inevitable part of childhood, no matter where in the world one lives. However for those children living in poor, under-resourced and marginalised societies of the world, this could mean a childhood either cut short by crippling heart failure or the need for open-heart surgery.
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Today rheumatic and musculoskeletal diseases affect more than 120 million people across Europe, but evidence shows that people have been suffering for many thousands of years. In this whistle-stop tour of rheumatology through the ages we look at how understanding and beliefs about the diseases developed.
Rheumatology is the branch of medicine dealing with the causes, pathology, diagnosis, and treatment of rheumatic disorders. In general, rheumatic disorders are those characterized by inflammation, degeneration, or metabolic derangement of the connective tissue structures of the body, especially the joints, joint capsules, tendons, bones, and muscles. There are over 150 different forms of rheumatic or musculoskeletal diseases. These conditions may be acute or chronic, and affect people of all ages and races.
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Rheumatic and musculoskeletal diseases in paleopathology
Palaeopathology is the study of the diseases of humans and other animals in prehistoric times, from examination of their bones or other remains.
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Definition of 'rheum'
The term ‘rheuma’ dates back to the 1st century a.d., when it had a similar meaning to the Hippocratic term Catarrhos. Both terms refer to substances which flow, and are derived from the term phlegm, which was one of the four primary humors. The first known use in English is from the late 14th century.
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Thomas Sydenham’s description of gout
Thomas Sydenham, 1624–89, was an English physician who has often been called ‘the English Hippocrates’. He established the value of clinical observation in the practice of medicine and based his treatment on practical experience rather than upon the theories of Galen. He suffered from gout, of which he left a classic description and wrote frequently about it.
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Famous suffers of gout
Kings Henry VII and VIII; Queen Anne and King George IV; many of the Bourbons, Medicis, and Hapsburgs. Others said to have been affected include William Cecil, Francis Bacon, William Harvey, Oliver Cromwell, John Milton, Isaac Newton, William Pitt, Samuel Johnson, John Wesley, Horatio Nelson, Charles Darwin, Benjamin Franklin, and Martin Luther. Indeed, it is said that it was the incapacity from gout affecting William Pitt which kept him away from the English Parliament when it passed the heavy colonial duty on tea which resulted in the Boston Tea Party and the loss to England of the American colonies.
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Augustin Jacob Landre-Beauvais
The first clinical description of rheumatoid arthritis is credited to Landre-Beauvais (1880). He described a series of women with a disease he considered to be a variant of gout. The patients were nine long-term residents of the Salpêtrière hospice in Paris. After reviewing the main features of ordinary or regular gout, Landré-Beauvais points out that the disease he calls “asthenic gout” exhibits several distinctive features, including predominance in women, a chronic course, involvement of many joints from the onset, and a decline in general health.
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First use of the term 'rheumatoid arthritis'
Sir Archibald Garrod first used the term ‘rheumatoid arthritis’ in the late 1850s, and he is Oxford English Dictionary’s first quotation for the term.
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Philip Hench, awarded a Nobel prize for his work in Rheumatology
Philip Showalter Hench 1896–1965, American physician won the Nobel prize in 1950 for his work developing the first steroid drug.
For many years Hench had been seeking a method of treating the crippling and painful complaint of rheumatoid arthritis. He suspected that it was not a conventional microbial infection since, among other features, it was relieved by pregnancy and jaundice. Hench therefore felt it was more likely to result from a biochemical disturbance that is transiently corrected by some incidental biological change. The search, he argued, must concentrate on something patients with jaundice had in common with pregnant women. At length he was led to suppose that the antirheumatic substance might be an adrenal hormone, since temporary remissions are often induced by procedures that stimulate the adrenal cortex. Thus in 1948 he was ready to try the newly prepared ‘compound E’, later known as cortisone, of Edward Kendall on 14 patients.
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Foreward to the first edition of the journal Annals of Physical Medicine
Lord TJ Horder, in his foreword to the first edition of the Journal of the Annals of Physical Medicine, now called Rheumatology
Image credits: Brown rust paper background by cesstrelle; Public Domain via Pixabay. Texture background by Zeana; Public Domain via Pixabay. “English Caricaturists, ‘The Gout'” by James Gillray, 1893; Public Domain via Wikimedia Commons. Background abstract texture green; Public Domain via Pixabay. Hans Holbein the Younger; Public Domain via Wikimedia Commons. Portrait of Anne of Great Britain by Michael Dahl; Public Domain via Wikimedia Commons. Giovanni di Medici by Bronzino; Public domain via Wikimedia Commons. Francis Bacon, Viscount St Alban; Public domain via Wikimedia Commons. Oliver Cromwell Gaspard de Crayer by Caspar de Crayer; Public domain via Wikimedia Commons. Samuel Johnson by Joshua Reynolds; Public domain via Wikimedia Commons. Jwesleysitting by Frank O. Salisbury, Public domain via Wikimedia Commons. Horatio Nelson by Lemuel Francis Abbott; Public domain via Wikimedia Commons. Charles Darwin; Public domain via Wikimedia Commons. Benjamin Franklin 1767 by David Martin. Public domain Wikimedia Commons. Martin Luther, 1528 by Lucas Cranach the Elder. Public domain via Wikimedia Commons. Renoir by Pierre-Auguste Renoir. Public domain via Wikimedia Commons. J.B. Arrieu Albertini, Public domain via Wikimedia Commons. James Coburn in Charade, Public domain via Wikimedia Commons. Lucy YankArmy cropped, Public domain via Wikimedia Commons. George IV of the United Kingdom by Thomas Lawrence. Public domain via Wikimedia Commons. Abstract ink painting on grunge paper texture dreamy texture via Shutterstock. An anatomical illustration from the 1909 American edition of Sobotta’s Atlas and Text-book of Human Anatomy. Public Domain via Wikimedia Commons. An anatomical illustration from the 1909 American edition of Sobotta’s Atlas and Text-book of Human Anatomy. Public Domain via Wikimedia Commons. Backdrop watercolour painting Public Domain via Pixabay. Colorful circles of light abstract background via Shutterstock.
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