Stronger Drugs For Rheumatism

Most patients far more often get satisfactory results from the drugs they have when they have some idea of how they work, or what their purpose is, than when they blindly follow the directions 'Take one, three times a day' and so on.

On whether the medicines taken by friends and relations would help the patient: this is a very difficult question when no one seems to know either what the medicine in questions is or what is really wrong with the people who are having to take it.

If you know more about your own kind of rheumatism and more about the drugs that can be used, you will be better able to use your own drugs to good advantage and to help other sufferers without raising their hopes with stories about 'wonder drugs. The most tragic of the 'wonder drugs' stories was that of cortisone, prednisone and other steroids.

Steroids

Cortisone first appeared about 1948 as 'compound E'.  It was one of many 'steroids' isolated from the adrenals, which are glands resting on the kidneys and which produce many hormones regulating the functions of the body. It was found to have a dramatic effect in suppressing inflammation. The next logical step was to use it on the inflammation that is an essential part of active rheumatoid arthritis. It was was superbly successful in controlling this and produced rosy prospects of cure of this previously incurable disease. Quite soon, though, it was realized by the doctors that cortisone had other effects, in particular those already known to occur in diseases in which the adrenal glands are too active. These effects were unpleasant or downright dangerous and the relief obtained from disease had to be very carefully weighed against the troubles caused by the treatment: at times the question was almost that of a 'short life and a gay one' or a long life and a sad one. Before this was worked out, however, stories had circulated about cortisone being a wonderful 'cure for arthritis'. Those with joints already deformed expected them to straighten and work like new: there were many sad stories of sufferers spending their savings to have access to one of the few places where cortisone was being used, only to find, when they had spent their money, that cortisone was not as marvelous as the stories about it.

Cortisone has been supplanted in the treatment of arthritis be sager compounds, chiefly prednisone, and the cost has come down to about 3d. a day but the dangers still exist and need to be watched for by doctors, who know not only what the dangers are but also what to do about them if they arise. The best guide to the doctor is in the intelligent patient. In fact, steroid, which include cortisone and prednisone, suppress inflammation. If the pain of your rheumatism is caused by inflammation it can be helped by steroids. If however, it is caused by worn surface rubbing each other with only a few patches of inflammation, then the prospects of success are poor. If you know from your past experience that your bouts of rheumatism only last a month at a time you will surely not ask for treatment that may have lifelong disadvantages.

At present steroids are used 3 ways for rheumatism:

1. Injection into inflamed areas

2. In tablets in a short sharp course, starting with large doses and working rapidly down to nothing to tide someone over a bad spell.

3. In tables in small doses given over a long period.

The last is the most difficult because it needs constant and intelligent observation to avoid the dangers.

Another way of treating someone with steroids is to inject ACTH (Adreno-Cortico-Trophic Hormone) made from an animal. This adds its effect to that of the person's own ACTH in making the adrenal glands produce steroids.

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