Prof. B M Hegde
Vice-Chancellor
Manipal Academy of Higher Education
Manipal – 576 119

Anthropologists believe that nearly five million years ago in Africa the first ape man lived. Michael Cremo, an archeologist in USA, has scientific data to show human footprints in the rock layer in Africa, dating back to four hundred thousand years, corresponding to Bhramha’s creation, of ancient Indian belief. Prof. David Weatherall, in his beautiful book “ The Science of Medicine and its Quiet Art” believes that we have existed here for nine hundred thousand years in more than fifty thousand generations. Roy Porter, a medical historian of repute at the Wellcom Institute for the History of Science, in his beautiful book “ A Medical History of Humanity” estimates that Homo sapiens emerged around one hundred fifty thousand year B.C.

Archaeology and palaeo-pathology give us a vague picture of our ancestors, who were often mal-formed with arthritis, possibly rheumatoid, and lamed by injuries having had to live in the forests among dangerous predators. They had broken limbs healed irregularly and had a very short life span. From the dangers for our hunter-gatherer forefathers to the present day killers like AIDS and ebola; from the clear convictions of the Hippocratic oath to the muddy ethical dilemmas of today’s medi–business, rheumatoid arthritis possibly did exist. Egyptian Mummys tell us a lot more about skeletal evidences of rheumatoid arthritis.

Things changed dramatically around the 1930’s when, for the first time, cortisone was isolated in the Mayo Clinic, Rochester, Minnesota. Cortisone’s greatest benefit at that time seemed to be the spectacular success in treating rheumatoid arthritis. Lord Horder (1871 – 1955) claimed that “if the word miraculous may ever be used in referring to the effects of a remedy, it could surely be excused here”. Patients with the disease, long bed-ridden, were able to get up and walk. Euphoria was short lived. Ugly skin disorders, heart disease, stomach ulcers, susceptibility to infections and obesity quickly rought awareness to doctors that hormonal treatment could disturb the body’s internal balance.

Much water has flown under the bridge from the time of pain killers to steroids and on to anti-inflammatory drugs and Gold. Even cytotoxic drugs have held their own from time to time in this disease. Surgery and physiotherapy have added their share to relieve human suffering in this case.

Thought to be a disease due to the wrath of Gods we went over to the ever present threat of germs as the cause of rheumatoid arthritis. We have now come to believe that it is an autoimmune disease. I am sure history will bring in newer ideas as we go along. Lately interest has shifted to our genes. The latest craze in the field of medi-business is gene mapping. All kinds of permutations and combinations have been suggested as the perpratators of rheumatoid arthritis.

Recently, a more interesting suggestion has come. While every other American black person of East African origin suffers from autoimmune disease of some sort or the other, very few of them suffer from such maladies in their natural habitat in Africa. Curiously, it is postulated that in Africa there are so many germs for the immune system to contend with, whereas in the cleaner environments of American life the one hundred fifty odd genes situated in the long arm of the fourteenth chromosome find themselves jobless! It is thought possible that they, habitually, produce antibodies and the latter, in the absence of invading germs, mis-identify the tissues of their own body cells, resulting in autoimmune diseases of various types with rheumatoid arthritis topping the list. Curious are the ways of the world. Doesn’t mankind pay a price for their own ignorance?

Many were the physicians who studied the intricacies of this enigma. Dr George Dock taught at the University of Michigan around 1900. He is said to have taught his students that this joint disease might even involve the heart and many other structure of the body.

While the story moves on there is now a general awareness that modern scientific medicine has not proved successful against lethal diseases like cancer, many types of arthritis led by rheumatoid arthritis, and other severe maladies. This has led to the resurgence of a wide range of Alternative Therapies like osteopathy, acupuncture, aroma therapy, homeopathy, Alexander technique, massage, shiatsu, iridology, chiropractic, herbalism, meditation, reflexology, kinesiology and hypnosis among the western population. The popularity of these methods could be gauzed from the fact that one in five doctors in the UK now refers his patients to one of these systems. Shockingly, in one year four hundred twenty five million consultations in America were made to these doctors. Most of them were for arthritis.

India has a rich heritage of our ancient system of Ayurveda, which is now slowly being recognised as the mother of most medical systems in the world. Between Ayurveda, Sidha and Unani, we have a large number of remedies for rheumatoid arthritis. The final secret of this disease is hidden deep inside the womb of the future. Physicians all over the world have been contemplating deeply on the mysteries of this peculiar malady which even in the twenty first century cripples a sizeable section of populace.

Suggested Reading :
(i) David Weatherall – The Science of Medicine and its Quiet Art. 1997 – Oxford Press
(ii) Roy Porter. 1995 – A Medical History of Humanity – The Greatest Benefit to Mankind – Wellcom Institute.