Tuesday, October 25, 2016

Rheumatoid Arthritis

Leonora Curtin was told plants like gumweed, sunflowers, and prickly poppy were used to treat rheumatism in northern New Mexico in the 1940s. None have been analyzed by scientists and none are reported as cures for joint pain by any group of Native Americans in the United States.

In fact, when you look at the list of antirheumatic plants compiled by Dan Moerman, you discover at least 225 have been used externally and 120 used internally. At the genus level where he created his index, just over a third were reported by more than one band. The most commonly mentioned were artemisia, discussed last week; stinging nettles, which were introduced from Europe, and yarrow.

The other common herbal plants in Moerman’s index were evergreens in the spruce, pine, juniper, and hemlock genera. Curtin found locals ground dried piñon pitch and rubbed the powder on rheumatic joints. Pinus edulis sap is widely used by natives in New Mexico, but mainly as a band-aid to seal sores from exposure to the air.

Local native groups who mentioned externally applied cures for arthritis or rheumatism were the Isleta and the Zuñi. Those who took medicines internally were the Jémez and the Navajo. Keres speakers and the Hopi did both.

Since so few plants were known by more than one band, I wondered if rheumatoid arthritis was in fact an introduced disease that had been met with a variety of responses. Instead, researchers believe it was a New World malady taken to Europe. Bruce Rothschild discovered bone lesions on remains from 35 pre-Columbian sites, but said they weren’t reported in Europe until 1785. He believed what had been attributed to rheumatoid arthritis before was actually spondylarthritis.

Since he first published his findings, others have reviewed evidence from bones, paintings, and literature. A group in Guadalajara noted the first distinction between rheumatoid arthritis and gout was made in México in 1578. In the early 1600s, Thierry Appelboom said Peter Paul Rubens and other Flemish painters were depicting deformed hands. He suggested the disease had been imported through the port of Antwerp that then was under Spanish rule.

Today, rheumatoid arthritis is not equally distributed among all groups of Native Americans. The highest incidence is among the Mille Lacs Chippewa of central Minnesota and the Pima of Arizona. It also has a significant presence among the Tlingit of southeastern Alaska and the Yakima of cental Washington.

Medical specialists agree that it is an immune system problem with an unknown precursor. They’ve identified the genetic factor that controls its appearance. However, they’ve found that the allele only defines who can, not who will, develop the disease.

Some researchers suspected processed sugar, flour, caffeine, and tobacco were the activating culprits. The first two didn’t exist before the Spanish, and the other two probably were used in different forms. Many now think such dietary factors influence the progress of the disease once it has been launched, but don’t initiate it. So far, no one has been able to identify the virus or bacteria that converts "might have" to "do have," though they’ve eliminated several suspects.

This all leaves the question, could Miguel de Quintana have developed rheumatoid arthritis in Santa Cruz in the 1730s? The fact it spread to Europe meant there was some microbe or animal that migrated in bodies or cargoes or shipboard grime when Spanish sailors returned to European ports. He could have been afflicted in Santa Cruz, or he may have been affected when he still lived in Mexico City. That there’s no evidence of antirheumatic cures among the northern Tewa speaking pueblos means little more than no anthropologist asked the right question at the right time.

The few barbers who came north in the 1690s, or the common knowledge shared among the colonists from Mexico City, recognized the difference between gout, which was a blood condition, and rheumatism, which was a spleen problem. However, the fact I’ve found so little on-line about arthritis cures within the schema of the Four Humors suggests the best doctors in Europe didn’t then have ready treatments.

That means, if he had any medical care, and it’s hard to believe he didn’t try things to relieve his pain, they were still in the experimental stage of trying everything and seeing if anything worked. His diet may have helped, if he ate peppers, and may have contributed to his problems, if he ate sweets or smoked much tobacco. Probably nothing happened systematically enough to have produced positive or negative results.

Notes:
Aceves-Avila, F. J., F. Medina, and A Fraga. "The Antiquity of Rheumatoid Arthritis: a Reappraisal," Journal of Rheumatology 28:751-7:2001; based in Guadalajar.

Appelboom, T. "Rubens - One of the First Victims of an Epidemic of Rheumatoid Arthritis That Started in the 16th-17th Century?, Rheumatology 44:681-683:2005.

Curtin, Leonora Scott Muse. Healing Herbs of the Upper Rio Grande, 1947, republished 1997, with revisions by Michael Moore.

Ferucci, Elizabeth D., David W. Templin, and Anne P. Lanier. "Rheumatoid Arthritis in American Indians and Alaska Natives: a Review of the Literature," Seminars in Arthritis and Rheumatism 34:662-667:2004. She was primarily interested in the far northwest, and used the Arctic Health Literature Database and the American Indian and Alaska Native Health Bibliography. Those sources may not have covered this part of the country comprehensively.

Halberg, P. "The History of Rheumatoid Arthritis," Dansk Medicinhistorisk Arbog :173-93:1995.

Moerman, Dan. Native American Ethnobotany, 1998.

Ortiz y Pino III, José. The Herbs of Galisteo and Their Powers, 1971.

Rothschild, B.M. and R. J. Woods. "Does Rheumatoid Polyarthritis Come from the New World?," Revue du Rhumatisme et Des Maladies Osteo-Articulaires 57:271-4:1990.

Silman, Alan J. and Jacqueline E. Pearson. "Epidemiology and Genetics of Rheumatoid Arthritis," Arthritis Research 4:S265-72:2002.

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