BRIEF NOTES ON THE NATURAL HISTORY OF RHEUMATOID ARTHRITIS.

The natural history of rheumatoid arthritis is the first stage in its scientific study. Existing knowledge of its long-term course is small, and a brief review is made of 250 consecutive unselected patients followed between 1939 and 1963 at the Postgraduate Medical School in London, England. During the course of this study, the clinical signs of digital arteritis were noticed. This appeared to be a systemic manifestation associated with the presence in the plasma of rheumatoid factor. It was a more generalized phenomenon than disease in the joints which is primarily a localized process. We need to know why one joint can remain unaffected and another joint shows active disease over a prolonged period of time.