PROGNOSIS - ARTHRITIS DEFORMANS.
Seeing, then, that arthritis deformans has no tendency to attack any vital organ, it is no matter for surprise that the disease is apt to persist for many years, sometimes rendering the patient a helpless cripple, and being terminated only by the supervention of some in tercurrent disorder, such as those alluded to above, or of others which are common iu later life, such as cancer. The disease, if left to itself, tends to progress with greater or less rapidity, but its prog ress may be spontaneously arrested at any time. Under appropriate treatment such arrest or even marked improvement is not infre quently observed, but when the disease is well established and serious deformities have been produced, little can usually be clone beyond relieving pain.
The prognosis is therefore better the earlier the patient comes under treatment.
The chances of improvement are greatest in the more acute cases, and in the younger subjects ; while in the chronic form seen in elderly people there is the consolation of knowing that if there is less pros pect of amelioration, the progress of the disease is much slower, and the chance of serious crippling is infinitely less.
A satisfactory prognosis can only be given after the ease has been watched for a time, and the rate at which it tends to progress, the degree to which it responds to treatment, and the amount of its ten dency to involve fresh joints has been noted. As regards the effect of treatment especially no notion can be formed from an initial exam ination of the patient. The prognosis as to life is favorable except when some intercurrent disease already exists, or when the patient exhibits a profound degree of anmmia ; but unless there has been an opportunity of watching the patient, the prognosis of the joint affec tion should be given with great caution, while it should always be borne in mind that by discouraging the sufferer unduly, we tend to produce a mental depression which itself favors the further develop ment of the disease.