Some clinical aspects of rheumatoid arthritis

In our department we have been placing a special emphasis on the treatment and study of rheumatoid arthritis, and during the last four years we have handled about 1,600 cases visiting our outpatient clinic and approximately 100 hospitalized cases. Our experiences with these patients are only what might be called an introductory phase in the study and treatment of rheumatoid arthritis when compared with those in Europe and America. In estimating the incidence of rheumatoid arthritis in Japan from various available data, although it would not reach the level of England and U.S.A., it will be about 100 cases per 100,000 population, matching more or less the incidence in the northern Europe. As regards sex and the predisposing age we find no great difference from those in Europe and America. One striking difference that we find is the fact that patients in our country have very little resistance against salicylic acid drug used in treatment. Therefore, it is unreasonable to expect a good anti-inflammatory action by administering a large dosage of 5-10g of such a drug as aspirin per day. It must be limited within a comparatively small dosage of 1.0 to 2.0 g or with concomitant administration of prednisolone and aspirin in the hope of utilizing its analgesic effect. Furthermore, it is not feasible to introduce the results of studies made in Europe and America on the salicylic drug and its prescription all of them showing the concentration in blood 35 mg%, which is on the borderline of intoxicating dosage. This is only one example, and with some more experiences we shall undoubtedly encounter many dissimilar points. Therefore, it is essential that rheumatology specific to Japan needs to be established.