COMMENTARY

Arthritis, Then and Now

Bret S. Stetka, MD; Nathan Wei, AB, MD

Disclosures

March 22, 2013

In This Article

Joint discomfort has been around for some time.

Described in ancient Egyptian medical texts,[1,2] arthritis -- particularly gout -- was one of the earliest diseases to be clinically recognized. Hippocrates (~460-357 BC) differentiated gout from other forms of arthritis, while an ayurvedic medicine text from 123 AD references a disease characterized by swollen, painful joints and occasional fever -- in all likelihood, rheumatoid arthritis (RA).[1,2]

Evidence from archeological remains extends back much further, well into prehistory; dinosaurs, Neanderthals, and early humans all appear to have suffered arthritic aches and pains. Early Greek scholars, Hippocrates included, and later medieval Europeans, ascribed joint maladies to "rheumatism," from "rheum," or the "flux" of congested humors; and often more specifically to "gutta" -- Latin for a "drop" of fluid and derivation of "gout." Bad humors were thought to literally drip into affected joints.

Eventually, the humor hypothesis gave way to more modern medicine. Arthritis subtypes were identified and characterized, and management moved beyond herbal folk remedies, culminating in our current understanding and approach to one of the oldest known human diseases.

Encouraged by recent progress in the pathophysiologic understanding and treatment of the major arthritides, we've compared the oldest known disease accounts and therapies with the clinical picture of arthritis circa 2013.

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