Halberg P
Dan Medicinhist Arbog. 1995:173-93.
The paper is a brief survey of the manner by which rheumatoid arthritis appears in modern clinical practice. The symmetric joint involvement, the location of synvial inflammatory changes in the joints of the hands, and the erosive bone lesions are stressed. The past and present nomenclature of chronic arthritis as well as the differential diagnostic possibilities, especially gout, are discussed. Rheumatoid arthritis may be of recent origin in Europe. The first reliable description of the disease was published in the year 1800. The medical and nonmedical literature, the visual arts, and the paleopathological examinations of skeletal findings from ancient and mediaeval times have failed to disclose certain evidence of the existance of the disease in The Old World before 1800, but bone changes found in skeletal material excavated in a district in America may indicate the existance of the disease here two or three thousand years ago. Since rheumatoid arthritis seems to have a hereditary as well as an environmental etiology the disease may have been brought from The New World to the Old World after the time of Columbus.
本文是对类风湿性关节炎在现代临床实践中表现方式的简要概述。强调了对称性关节受累、手部关节滑膜炎症变化的部位以及侵蚀性骨病变。讨论了慢性关节炎的过去和现在的命名法以及鉴别诊断的可能性,特别是痛风。类风湿性关节炎在欧洲可能是近期才出现的。对该疾病的首次可靠描述发表于1800年。医学和非医学文献、视觉艺术以及对古代和中世纪骨骼发现的古病理学检查均未能揭示1800年以前旧世界存在该疾病的确切证据,但在美国一个地区挖掘出的骨骼材料中发现的骨骼变化可能表明该疾病在两三千年前就在这里存在。由于类风湿性关节炎似乎具有遗传和环境病因,该疾病可能是在哥伦布时代之后从新世界带到旧世界的。