Osteoarthritis

Stiffness and pain in the joints was for centuries seen as a mark of mortality, one of the natural shocks of old age: just look at Leonardo da Vinci or Thomas Rowlandson's caricatures of old people, with their crooked digits and knobbly joints. Since the 16th century, anatomists have been familiar with the basic structure of joints—bones capped with cartilage, connected by ligaments, and lubricated by synovial fluid—and the name they gave to the principal disorder of these joints is a classic example of plain English put into learned Greek: arthritis, literally joint inflammation. This simple term reflects a fairly straightforward clinical history, but it also evokes one of the hardest questions in medicine: how to deal with the intractable, quotidian misery of chronic pain? SyphilisFor early modern physicians syphilis was “the great imitator”, a disease that mystified with the sheer range of its symptoms and the length of time it might take to show itself. Syphilis was first recorded in Europe in the mid-1490s, and the coincidence with Christopher Columbus' first voyage to the New World led contemporary physicians (along with more recent archaeologists and historians) to conclude that his sailors had brought the disease back with them. Full-Text PDF The historian will see you now: introducing Case Histories“I hope that Lord Grey and you are well”, wrote the Regency wit and clergyman Sydney Smith to his confidante Lady Mary Grey in February, 1836, “no easy thing, seeing that there are about fifteen hundred diseases to which man is subject”. Last year the editors of the Lancet journals announced the launch of The Lancet Clinic, a major online initiative which draws together an overview Seminar with the best current research from across the Lancet journals on 135 of the most globally important diseases. Full-Text PDF GoutAs he tried to evoke the agonies of his gout-stricken patients in the first century CE, the Greek physician Aretaeus of Cappadocia did not mince his words: “No other pain is more severe than this, not iron screws, nor cords, nor the wound of a dagger, nor burning fire.” Like osteoarthritis, like dental caries, gout is one of many chronic diseases that, in the words of the historians Roy Porter and George Rousseau, “are not in themselves fatal, but incurable, typically debilitating, sometimes crippling and inordinately painful”. Full-Text PDF