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Arthritis Deformans

disease, diseases, bones, times, name and rheumatism

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The defects and shortcomings of the system of classification of diseases, which is of necessity adopted, in default of a better, in the text-books of medicine of the present clay, is nowhere more manifest than in connection with those diseases in which joint affections play a conspicuous part. It is customary to group together, as diseases of the joints, a series of systemic maladies which have little in common with each other beyond the tendency to involve the articular structures. It is true that the diseases so included present superficial resem blances, and have indeed been at all clearly differentiated only in com paratively recent times. The first step that was made in this direc tion was the separation from gout of the disease which is now known as rheumatism, and it was not until many years later that there was recognized a third disorder which had previously had no distinct place in medical literature, but was confused now with gout and now with rheumatism, according to the views which prevailed at various times and in various places, as to the boundaries of the provinces of those two disorders.

Even at the present day there are many who hold that after all gout, rheumatism, and arthritis deformans are much the same thing; and the want of stability in the notions which still prevail is re flected in our nomenclature, for arthritis deformans enjoys the dis tinction of having been called by a larger number of different names than any other in the whole catalogue of diseases. In England it is most frequently spoken of as "chronic rheumatic arthritis," "osteo arthritis,'' or " rheumatoid arthritis." In France the name of "rhumatisme noueux" is perhaps most frequently employed ; while in America and in Germany that of arthritis deformans, which will be employed in the present article, has been widely adopted. This last name, originally suggested by Virchow, is preferable to most of the others which have been proposed, for it implies no theory and presupposes no relationship to other maladies, but merely records the most conspicuous feature of the disease ; however, it possesses the disadvantage which is not shared by osteo-arthritis, a name which is equally free from objection in the above respects, that it has a forbidding sound and a gloomy prognostic significance.

Although, as we have seen, our knowledge of arthritis deformans as a distinct disease has had such recent beginnings, the history of the disease itself can be traced back, in a fragmentary manner, it is true, to a very remote period of antiquity, much further indeed than that of any disorder which confines its ravages to the softer structures of the human body. Bones bearing the unmistakable stamp of this disease have been unearthed by Professor Petrie' in the course of his explorations in Egypt, and some of the bones so marked, which he has found, date back in all probability to the very dawn of Egyptian history, while others which have been described by Eve' were prob ably those of persons who lived not earlier than the Ptolomaic times.

Similar evidences have been met with by Delle Chiage, in bones found among the ruins of Pompeii, by Norman Moore' in the bones of a skeleton discovered in a Roman sarcophagus in London; and by in those from the graveyard of an ancient convent in Pomerania which was founded in the year 1356.

Nor were the characteristic features of arthritis deformans over looked by the older medical writers, as may be gathered by passages embodied in the works of Sydeuham, Musgrave,' de Sauvages,' Haller,' and others. Sydenham's' account is particularly worthy of notice. When speaking of the sequelLB of rheumatic fever he de scribes as an occasional legacy of that disease a condition of the joints which may persist for years or even throughout the life of the patient, characterized by distortion and deformity with nodular out growths of the finger-joints and other articulations, which tend to cripple the sufferer more or less completely, although his general health may remain little if at all impaired.

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