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Rheumatism in its broadest sense is one of the oldest diseases
known to affect mankind. It attacks people of all ages and is
responsible for more prolonged absences from work or school than
any other disease. Resultant heart damage or joint deformity are
often so tragically disabling that early diagnosis, prompt treatment
and well directed after-care are vitally important.
It is only too clear that rheumatic diseases constitute a major
medical, social and economic problem for the nation. For example,
general practitioners consider that 10% of all their work is concerned
with this group of diseases and official statistics show that
more than 27 million working days per year are lost as a result of
rheumatic disabilities.
The incidence of all rheumatic conditions rises steadily with age
from 29% in males and 25% in females between the ages of 15
and 24 years to a peak of 76% and 87% respectively between the
ages of 55 and 64 years. As one would expect loss of working
time rises correspondingly and, in the latter group, some 47% of
men and 40% of women give a history of incapacity due to
rheumatism of which 20% state they have lost at least 3 months'
work from this particular cause.
Basically, rheumatic diseases are considered to be of two types,
namely, those where the disease is essentially the result of inflammatory
conditions such as rheumatoid arthritis and ankylosing
spondylitis and those in which the essential ingredient is degeneration
as exemplified in osteoarthritis and intervertebral disc disease.
Although random countrywide surveys have revealed that over
7 million individuals believe that they suffer from some form of
rheumatic complaint it is evident that the majority of these people
can suffer only the relatively milder forms. Nevertheless, almost
½ million men and 1 million women suffer from the serious and
potentially crippling effects of rheumatoid arthritis. Of all arthritis
this, in its severe form, is the most feared for, with its generalised
systemic illness, it taxes the emotional as well as the physical
strength. Victims are aware that their disease could be prolonged
and, because recrudescence may occur at any time in quiescent
joints, they fear the future perhaps even more than they resent the
present. Family complications and threats to economic stability
merely serve to exacerbate the problem. Studies have shown that
prognosis is best in those whose onset is acute and who receive
hospital treatment promptly.
The pathogenesis of rheumatoid arthritis and related diseases
remains obscure. Nevertheless, increasing attention given by
research teams to this problem in recent years seems, at long last,
likely to yield results. There is evidence to support the view that