_Rheumatoid Arthritis_, or chronic _Osteo-arthritis_, is generally
found in persons beyond middle age; but it is not rare in young
people, though with them it need not be the progressive disease which
it too often is in their elders. It is an obscure affection of the
cartilage covering the joint surfaces of the bones, and it eventually
involves the bones and the ligaments. A favourite joint for it is the
knee or hip, and when one large joint is thus affected the other
joints may escape. But when the hands or feet are implicated pretty
nearly all the small joints are apt to suffer. Whether the joint is
large or small, the cartilages wear away and new bone is developed
about the ends of the bones, so that the joint is large and
mis-shapen, the fingers being knotted and the hands deformed. When the
spine is affected it becomes bowed and stiff. This is the disease
which has crippled the old people in the workhouses and almshouses,
and with them it is steadily progressive. Its early signs are
stiffness and creaking or cracking in the joints, with discomfort and
pain after exercise, and with a little effusion into the capsule of
the joint. As regards _treatment_, medicines are of no great value.
Wet, cold and damp being bad for the patient, he should be, if
possible, got into a dry, bright, sunny place, and he should dress
warmly. Perhaps there is no better place for him in the winter than
Assuan. Cairo is not so suitable as it used to be before the dam was
made, when its climate was drier. For the spring and summer certain
British and Continental watering-places serve well. But if this luxury
cannot be afforded, the patient must make himself as happy as he can
with such hot douchings and massage as he can obtain, keeping himself
warm, and his joints covered by flannel bandages and rubbed with
stimulating liniments. In people advanced or advancing in years, the
disease, as a rule, gets slowly worse, sometimes very slowly, but
sometimes rapidly, especially when its makes its appearance in the
hip, shoulder or knee as the result of an injury. In young people,
however, its course may be cut short by attention being given to the
principles stated above.
_Charcot's Disease_ resembles osteo-arthritis in that it causes
destruction of a joint and greatly deforms it. The deformity, however,
comes on rapidly and without pain or tenderness. It is usually
associated with the symptoms of locomotor ataxy, and depends upon
disease of the nerves which preside over the nutrition of the joints.
It is incurable.
Public-domain text, read in full here on John Shaqi.
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