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Rheumatism

Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. The study of, and therapeutic interventions in, such disorders is called rheumatology. more...

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The term "rheumatism" is still used in colloquial speech and historical contexts, but is no longer frequently used in medical or technical literature; it would be fair to say that there is no longer any recognized disorder called, simply, "rheumatism". The traditional term covers such a range of different problems that to ascribe symptoms to "rheumatism" is not to say very much: arthritis and rheumatism between them cover at least 200 different conditions.

A vast number of traditional herbal remedies were recommended for "rheumatism". Modern medicine, both conventional and complementary, recognises that the different rheumatic disorders have different causes (and several of them have multiple causes) and require different kinds of treatment. Most sources dealing with rheumatism tend to focus on arthritis. However "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism" can cause just as much discomfort and difficulty.

The major rheumatic disorders currently recognised include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Rheumatic heart disease (Rheumatic fever)
  • Shoulder pain
  • Neck pain
  • Back pain
  • Fibromyalgia
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Systemic lupus erythematosus
  • Polymyalgia rheumatica
  • Tenosynovitis
  • Capsulitis
  • Bursitis
  • Rheumatic fever.

Although these disorders probably have little in common in terms of their epidemiology, they do share two characteristics: they cause chronic (though often intermittent) pain, and they are difficult to treat. They are also, collectively, very common. The very long list of supposed herbal remedies for rheumatism no doubt reflects the intractable nature of the problems it involves, and so, perhaps, does the fact that are no fewer than six patron saints for sufferers from rheumatism: Saint Alphonsus Maria de Liguori, Saint Colman, Saint James the Greater, Saint Killian, Saint Servatus, and Saint Totnan.

Initial therapy of the major rheumatological diseases is with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), members of which are ibuprofen and diclofenac. Often, stronger analgesics are required.

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Hunger: An Unnatural History
From Natural History, 10/1/05 by Laurence A. Marschall

Hunger: An Unnatural History by Sharman Apt Russell Basic Books, 2005; $23.95

At the risk of oversimplifying, you can think about the body as if it were a car. Ordinarily, about 2,000 calories a day are needed to keep it running, and most of us top the tank off frequently, so that regular meals provide most of those calories. In a pinch, there's a large reserve, about 160,000 calories, stored primarily in fat and muscle tissues: enough to keep a person puttering around, in principle, for about eighty days.

Most everyone has experienced hunger at one time or another. But I would venture that most readers of this magazine know the feeling as little more than a temporary inconvenience. We in the West eat, by and large, whenever we need to, and often when we don't.

Nature writer Sharman Apt Russell explores the subject of hunger far beyond such common experience. What happens, she asks, and what does it feel like, when the body is deprived of food for a day, a week, a month? What happens when food is scarce? It should come as no surprise that there is plenty of historical light to shed on the subject, and even some science: wars and famines, as well as fasting rituals, characterized human experience for far longer than have the relative peace and plenty of the recent past.

On the bright side, some people have actually experienced hunger as an "uplifting" experience. In 1877, for instance, a middle-aged physician named Henry Tanner, depressed and ailing, decided to commit suicide by not eating. After ten days, at which time the medical science of his day had predicted inexorable death, Tanner was still feeling fine--so much so that he continued to refuse food for another month. He emerged from his fast a changed man, free of asthma, rheumatism, and self-destructive thoughts, and he embarked on a new career as a lecturer, touting the restorative power of fasting.

Tanner was neither the first nor the last to recommend this extreme form of self-restraint: religious faiths have long promoted regular fasting as a way to purge the soul of worldly distractions, and there seems to be a "health guru" in every generation whose idea of the good life is to restrict meals to merest subsistence. The scientific evidence regarding the benefits of fasting, however, is spotty. Aside from a few well-known studies with mice, whose calorie-restricted diets led to significantly longer lives, persuasive medical evidence that food deprivation promotes health is hard to come by.

But alas, there is no shortage of scientific evidence on the harmful effects of hunger. In one section of her book, Russell recounts the story of the remarkable study of "hunger disease" that Jewish doctors carried on in the besieged Warsaw Ghetto, in 1942. In spite of their own desperate conditions, the physicians meticulously recorded the physiology of starving patients at two hospitals. Their manuscript, at once horrifying and edifying in its systematic detail, is a document that records both unspeakable cruelty and the power of the mind to withstand it. Of course, most of the participants, including the authors, did not survive the war. But as one doctor wrote in the introduction to the manuscript, before he was shipped off to Treblinka, the work of these physicians "could give the henchman the answer.... I shall not wholly die."

Not every chapter in Russell's book is that grim, but all of them are thought provoking. She writes of anthropological studies of societies hit by famine; of conscientious objectors during the Second World War who voluntarily starved themselves in order to help nutritionists develop a strategy for reviving the starving masses in postwar Europe; and of anorexic middle-class teenagers in the West who experience a form of psychological gratification by starving themselves to death.

Although Russell flies across this landscape perhaps too quickly to provide more than a glimpse of today's major hunger issues, she writes with immediacy and authority. Readers whose appetites are whetted can find food for further thought in the ample references at the end of the book.

COPYRIGHT 2005 Natural History Magazine, Inc.
COPYRIGHT 2005 Gale Group

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