The antiquity of rheumatoid arthritis: A reappraisal

Objective. To demonstrate the existence of rheumatoid arthritis (RA) before the 19th century. Methods. Survey of primary and secondary references on the history of rheumatic diseases. Results. Paleopathological evidence suggests the existence of RA in America since 8000 BC and in Europe since the 7th century. Descriptions and representations of a symmetric chronic polyarthritis producing characteristic deformities can be found in Rome since 100 BC and India since 500 BC. The first clinical distinction between RA and gout was published in Mexico in 1578. Different historical conditions contributed to lack of recognition of RA by official medicine before 1800. The recognition of RA as a distinct entity in the 19th century was influenced by socioeconomic circumstances. Conclusion, RA is not a recent disease. Historical investigation can provide useful clues on its pathogeny.