Unlike much of Europe, study of rheumatic disease in the United States prior to and during World War II was limited. Rheumatologists were a rare breed and immunologists were scarcely in evidence. Soon after that war, however, the discovery of cortisone and of blood factors in rheumatoid arthritis and lupus spurred interest and research to its current level.

Arthritis & RheumatismVolume 17, Issue 6 p. 944-945 Current CommentFree to Read Acupuncture in rheumatic disease First published: November/December 1974 https://doi.org/10.1002/art.1780170604Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 Fernandez-Herlihy L: Osler acupuncture and lumbago. N Engl J Med 287: 314, 1973 PubMedWeb of Science®Google Scholar 2 Curran JA: Acupuncture in western medicine. Harvard Med Alumni Bull November/December, 1973, p 12 Google Scholar Citing Literature Volume17, Issue6November/December 1974Pages 944-945 ReferencesRelatedInformation

In this illustrative case, rheumatoid disease changed an active, self-supporting woman into a disabled, dependent and depressed person. When disease activity is continuous, early efforts to prevent severe deformity take on great urgency. It is also important to alleviate the psychosocial impact of the disease, which may well be more than even a highly motivated patient can handle alone.

In this case the psychosocial impact of arthritis was superimposed on an already precarious home environment. When the disease began, the patient was still a teen-ager and was pregnant. Three years later she was an abandoned wife, was unable fully to care for her baby or herself, and did not have enough money for food.

Selected illustrative cases are reported, followed by “instant consultations” with appropriate specialists. The psychologic and socioeconomic effects of arthritis are inseparable from the direct physical effects of the disease. Even in mild disease a good deal of motivation is necessary to successful management. The best source of this stimulation is the patient's personal physician.

1. Sixteen rabbits were subjected to fractures of the femur. Eight of these were under treatment with cortisone.

OF FUNDAMENTAL importance is knowledge of the mechanism of action of those adrenal hormones which act beneficially in disseminated lupus erythematosus and other diseases of tissues of mesenchymal origin. Two of the patients described in our clinical discussion1showed failure to form granulation tissue while being treated, and 1 had prompt healing when treatment with pituitary adrenocorticotropic hormone (ACTH) was discontinued. In other patients, with rheumatoid arthritis, similar observations have been made.2The question arose of whether ACTH and cortisone might not act by altering the host response to the disease, that is, by halting a connective tissue process which results in the various clinical entities of these diseases. Accordingly, an experimental evaluation of the effect of various steroids on the connective tissues is going on in our laboratories. Preliminary data3indicate that cortisone administered to rabbits exerts a profoundly inhibitory effect on

SINCE Hench and his co-workers 1 described the dramatic effect of cortisone and pituitary adrenocorticotropic hormone, or ACTH, on patients with rheumatoid arthritis, interest in the effect of these substances on the "mesenchymal diseases" has mounted. Independent reports by Boland and Headley in Los Angeles, 2 Thorn in Boston 3 and Ragan and co-workers in New York 4 amply confirmed that there are beneficial effects observed in rheumatoid patients. Only scattered reports from Hench, 1 Thorn, 3 Grace 5 and others 6 to the time of writing indicated beneficial results from this therapy in other members of the group of connective tissue disorders which includes rheumatic fever, scleroderma, dermatomyositis, periarteritis nodosa and disseminated lupus erythematosus. This report deals with 3 patients with disseminated lupus, erythematosus, observed on the medical service of the Presbyterian Hospital, who were treated with ACTH. Experimental work conducted in an effort to explain

Summary11 dehydro 17 hydroxycortico-sterone (Compound E of Kendall, cortisone) administered to rabbits in large doses caused a delay in the development of all elements of connective tissue. It is suggested that the action of cortisone and ACTH on the “mesenchymal diseases” is due, at least in part, to “inhibition of reactivity” of the connective tissue. It is furthermore suggested that the inhibition of the growth of granulation tissue in the rabbit may prove of value in assay of compounds active in the treatment of “mesenchymal diseases.”