Arthritis Agatha M. Thrash, M.D.

Preventive Medicine Arthritis is an inflammation of the joints and may be of many different types, the four commonest being osteoarthritis, rheumatoid arthritis, infectious or toxic arthritis, and gout. Certain forms of arthritis are associated with a decrease in skin temperature and blood flow to the extremities. Osteoarthritis is caused by an overuse of the joints. There is some question in the minds of certain authorities whether an agent of infection such as a virus might also be involved in some cases of osteoarthritis. The involvement in this form of arthritis is usually limited to the overworked joint. Pain is usually worse in the early morning, but quickly improves upon movement and warming-up activities of the person. Rheumatoid arthritis is of unknown cause; possibly a virus, possibly an immune reaction or a degenerative process following the ingestion of a preformed toxin. Toxic or infectious arthritides are caused by germs such as the one that causes gonorrhea, or by toxins that are capable of attacking the joint directly. An infection, such as those around the teeth, chronic infections on the skin, or a chronic colon infection can sometimes cause arthritis. "Lyme arthritis" is an interesting disease recently described in certain northern states, and now definitely shown to be associated with a tick bite. Whether the arthritis is caused by an infectious agent or some toxin injected by the tick is not yet known. Fortunately, the disease seems to be self limited. Gout is a form of arthritis due to the presence of uric acid crystals in or around the joints or in the soft tissues. Purines are the culprit in elevating the uric acid. Foods of animal origin and food yeasts baker's yeast and brewer's yeast, all cause the uric acid to rise. It is generally felt that eating too many rich foods, especially those high in purines, in persons who are genetically predisposed is the cause of this form of arthritis. Hot, swollen, tender joints are characteristic. The way to combat arthritis is to combat the cause as far as is possible. From early childhood, one should protect the joints so that when the natural aging of joints occurs at about the age of 50, they will not respond by overgrowth of bone cartilage, degeneration, and inflammation of soft tissue. One should become accustomed early in life to sensing pain in the joints so that any activity which causes pain, such as carrying a heavy weight for a long time or keeping a joint in an abnormal position for a prolonged period can be avoided. Since the exact cause of rheumatoid arthritis is unknown, it is necessary to institute a general treatment program that eliminates all the suspected causes in order to try to avoid rheumatoid arthritis. Since certain painful psychological factors turn up repeatedly in the lives of individuals who develop rheumatoid arthritis, it should be an objective of life to handle psychological and emotional factors as definitively as possible. Marital distress should especially be carefully handled, as marital conflict is found in many cases of rheumatoid arthritis. Whenever deep and unresolved psychological pain is found in individuals with rheumatoid arthritis, counseling is indicated by an understanding and experienced person, a minister or other skillful person, on a repeating basis until the conflict is resolved. A certain number of persons with rheumatoid types of arthritis or rheumatic pains seem to respond to a diet entirely free of foods in the nightshade family. This includes tomatoes, potatoes, eggplant, and peppers. The diet must be strictly followed for 3 months without a single exception, not even a sprinkle

of paprika, in order to adequately test if the individual is sensitive to the toxic alkaloids found in the nightshades. Other allergic toxic or infectious agents may be similarly eliminated from the environment of the individual who is sensitive. Gout can be successfully treated by a pronounced change in lifestyle. The person must begin a program of regularity, going to bed on time, getting up on time, eating meals on time, and getting exercise on time. During an acute flare-up, the diet must be of the simplest variety, including only fruits, vegetables, and whole grains for the first six to twelve weeks, until the gout is under control. At that time, nuts may be added. If overweight or hypertension is a part of the disease, it must be corrected. Gradually, return to a full, regular diet, but with restrictions against high purine food, substances containing methylxanthine (coffee, tea, colas, and chocolates), and all rich foods. Many persons with any kind of arthritis will obtain pain relief and limbering of the joints by the use of heat. One should beware of machines, fad diets, and unproven remedies. For painful hands, one may wear stretch nylon gloves at night. The weight must be reduced to slightly below average weight for height and age. Proper clothing that will eliminate the possibility of even the slightest chilling of the extremities, neck, or ears must be provided. Good posture, deep breathing, and the avoidance of fumes, contact with odors of rotting leaves and hydrocarbons are essential. Avoid the use of certain chemicals: tobacco, alcohol, all drugs and pharmaceuticals, nutritional supplements, and even deodorants. Be regular in all life's habits, doing the same thing at the same time each day. Cultivate a sunny disposition, entirely eliminating anger, excitement, anxiety; and practicing kindliness, mildness, joy, patience, and quietness. For more information contact: Uchee PiGout is a form of arthritis due to the presence of uric acid crystals in or around the joints or in the