7 Wonders 0f the World
International Journal of Rheumatic Diseases 2008; 11: 91– 96
Blackwell Publishing Asia
SPECIAL ARTICLE
Seven wonders in the world of rheumatology
Seven wonders in the world of rheumatology: a short story of romance, reminiscences and renaissance
Prakash PISPATI
Jaslok, Breach Candy and Saifee Hospitals, Mumbai, India
Abstract
Genesis and evolution of contemporary rheumatology is many centuries old. The lessons of medical history, its triumphs and failures, its twists and turns, have all facilitated today’s science. Even in the ancient era some rheumatic diseases have been described with vivid accuracy. Among these are gout, spinal afflictions, osteoporosis and rheumatoid arthritis, as we recognize them today. Ancient systems of medicine such as Ayurveda in India led to the introduction of gold salts. Invention of the microscope paved the way to the birth of microbiology, unfolding infective, and later inflammatory diseases, cellular pathology and immunology. Progress in therapeutics was slow and physicians and rheumatologists had to borrow drugs from other medical disciplines, for example antimalarials and cytotoxics. The Nobel Prize-winning discovery and development of cortisone was a major landmark in medicine, while also treating rheumatoid arthritis. Thanks to the advent of molecular medicine, rapid strides have been accomplished, and we now have new agents of biotechnology research. Orthopedics with computer-assisted and robotic surgeries, are becoming almost fail-safe for specific indications. The nature of chronic rheumatic diseases, necessitating long-term treatments, have led to the popularity of alternative medicines. Seven significant episodes are essayed herein. Rheumatology is on the threshold of exciting medical progress, enabling the majority of rheumatic patients to enjoy enhanced quality of life. Key words: alternative medicines, Ayurveda, rheumatic diseases
INTRODUCTION
Since time immemorial, man’s quest for happiness and health
Blackwell Publishing Asia
SPECIAL ARTICLE
Seven wonders in the world of rheumatology
Seven wonders in the world of rheumatology: a short story of romance, reminiscences and renaissance
Prakash PISPATI
Jaslok, Breach Candy and Saifee Hospitals, Mumbai, India
Abstract
Genesis and evolution of contemporary rheumatology is many centuries old. The lessons of medical history, its triumphs and failures, its twists and turns, have all facilitated today’s science. Even in the ancient era some rheumatic diseases have been described with vivid accuracy. Among these are gout, spinal afflictions, osteoporosis and rheumatoid arthritis, as we recognize them today. Ancient systems of medicine such as Ayurveda in India led to the introduction of gold salts. Invention of the microscope paved the way to the birth of microbiology, unfolding infective, and later inflammatory diseases, cellular pathology and immunology. Progress in therapeutics was slow and physicians and rheumatologists had to borrow drugs from other medical disciplines, for example antimalarials and cytotoxics. The Nobel Prize-winning discovery and development of cortisone was a major landmark in medicine, while also treating rheumatoid arthritis. Thanks to the advent of molecular medicine, rapid strides have been accomplished, and we now have new agents of biotechnology research. Orthopedics with computer-assisted and robotic surgeries, are becoming almost fail-safe for specific indications. The nature of chronic rheumatic diseases, necessitating long-term treatments, have led to the popularity of alternative medicines. Seven significant episodes are essayed herein. Rheumatology is on the threshold of exciting medical progress, enabling the majority of rheumatic patients to enjoy enhanced quality of life. Key words: alternative medicines, Ayurveda, rheumatic diseases
INTRODUCTION
Since time immemorial, man’s quest for happiness and health
References: 1 Dequeker J, Luyten FP (2008) The history of osteoarthritisosteoarthrosis. Ann Rheum Dis 67, 5–9. 2 Pispati P (2008) The paradox of infection and inflammation: Friends or foes? The dilemma of biological usage in high endemic tuberculous areas. Editorial/Joint Bone Spine 75, 108–11. 3 Harris EN, Gharavi AE, Boey ML, et al. (1983) Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet ii, 1211–4. 4 Ruiz-Irastorza G, Khamashta MA, Hughes GRV (2002) Hughes syndrome crosses boundaries. Autoimmun Rev 1, 43–8. 5 Wienblatt ME, et al. (1985) Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl Med 112, 818–22. 6 Perrot SC (2004) Cannabis: the analgesic and antiinflammatory medication of the future? Joint Bone Spine 71, 7–8. 7 Hench PS, Kendall EC, Slocum CH, et al (1949) The effect of a hormone of the adrenal cortex (17-hydroxy-11dehydrocorticosterone: Compound E) and the pituitary adrenocorticotropic hormone on rheumatoid arthritis. Preliminary report. Proceedings of the Staff Meeting of the Mayo Clinic 24, 181–97. 8 Feldmann M, Maini RN (2003) TNF defined as a therapeutic target for rheumatoid arthritis and other autoimmune diseases. Nat Med 9, 1245–433. 9 Schultz O, Sittinger M, Haeupl T, Burmester GR (2000) Emerging strategies of bone and joint repair. Arthritis Res 2, 433–6. 10 Miller MC. (2004) We all need a dose of the doctor. Newsweek Oct. 4, 50. 11 Brune K, Hinz B (2004) The discovery and development of antiinflammatory drugs. Arthritis Rheum 50, 2391–9. EPILOGUE Practicing rheumatology, which has never been attractive, save for the diehard, has won the grudging respect of doctors and patients alike. The wonderland of rheumatology has many brilliant accomplishments that one can be proud of, and the challenge to explore and conquer makes it a gratifying discipline. Relieving pain and mobilizing the crippled is becoming realistic. Classical research will yield better, logical therapeutics. Historical events have lessons for us to enhance observational powers and look for serendipity which may unexpectedly provide therapeutic advances. After all, Pasteur did say that ‘chance favours the prepared mind’. Yet, mere errors, as in the case of Fleming for penicillin and Röntgen for X-rays cannot be relied upon as the only way toward discoveries: ‘Errors are fine but only some time (s). Not everyone heading for India discovers America’11 The world of rheumatology is a wonderful treasure trove of inspiring discoveries and inventions. Indeed a wonderful science, rheumatology is the promise of the future whose time has come. Let us prepare for a spectacular take off, the count down has begun. 96 International Journal of Rheumatic Diseases 2008; 11: 91– 96