Did Father Cicero suffer from rheumatism?

Father Cicero Romao Batista is probably the most famous Ceará character of all time. An important protagonist of the Cariri region, situated in the south of Ceara State, in the late nineteenth century and the first third of the twentieth century, Father Cicero had great political and religious activity, as well as other less well-known achievements, for instance, his ecological teachings that led him to be awarded the title of "Patron of Forests", besides an enormous effort and personal sacrifice for the improvement of the conditions of human life. Inspired by reading his biography, we find that the "Padim Ciço" could have inflammatory spondyloarthropathy. In this article, we present the plausibility of this diagnostic hypothesis, seeking to emphasize that an attentive ear and clinical observation, albeit indirectly and without the privilege of a personal contact with the patient, are unparalleled tools for bringing forth a diagnosis.

Rheumatic diseases in the ancient Americas: the skeletal manifestations of treponematoses.

INTRODUCTION: The effect of rheumatic and infectious diseases on skeletal remains provides an important source of information for knowledge of contemporary medicine. Few pathologic conditions have attracted so much interest as treponematoses. One of these, syphilis, was the most feared venereal disease throughout the civilized world until the introduction of penicillin in the 20th century. OBJECTIVE: To describe paleopathological and ceramic illustrations of treponematoses in ancient Mexico. MATERIALS AND METHODS: Paleopathological and ceramic material examples from the National Institute of Anthropology and History of Mexico were reviewed. RESULTS: A unique paleopathologic site for treponemal diseases comprises the La Candelaria Cave skeletal collection from northern Mexico. The cave was used as a burial site and contained the bones of at least 83 adults and 33 subadults. Fifty-one percent of the recovered skulls possess erosions of the vault consistent with treponematoses. Some of these exhibit the impressive frontal bone lytic changes with irregular borders typical of caries sicca. In addition, periostosis of the long bones was found in up to 88% of the study sample, including 6 examples of saber-shin deformity of tibias. Radiocarbon dating (-C) of a bone retrieved from the cave ranges from 1100 to 1300 A.D. Additionally, a Pre-Hispanic ceramic figurine from the Mexican state of Nayarit depicting a lame man with multiple nodular skin lesions that suggest gummatous treponemal infection is described. CONCLUSIONS: These ancient specimens reinforce the notion that treponemal infection was present on the American Continent before European penetration of the New World. These very advanced paleopathologic lesions and ceramic representations demonstrate the degree to which these diseases wrought devastation before the antibiotic era. In ancient times, treponematoses were true rheumatic diseases that produced profound skeletal abnormalities marked by periosteal accretion and bone destruction.

[The "Hospital Real de San Josef de los Naturales" and the rheumatic conditions found in New Spain during the 16th century]. / L'"Hospital Real de San Josef de los Naturales" e le malattie reumatiche nella Nueva España (Messico) durante il XVI secolo.

The rheumatic conditions found in New Spain during the sixteenth century were not different from those seen in Mexico in present times. We present the humoral conceptions on which medical theory was based in those times, and the contributions made by Alonso López de Hinojosos during his practice in the Hospital Real de San Josef de los Naturales, in Mexico City. Among them were the clinical distinction between gout and rheumatoid arthritis more than one hundred years before Sydenham, and the identification of arthritis and ocular involvement associated with a contagious disease more than three hundred years before Reiter. We conclude that the analysis of ancient medical traditions is an interesting and fruitful enterprise.

[A medical history of Bernardo O'Higgins (1778-1842)]. / Historial médico de Bernardo O'Higgins Riquelme (1778-1842).

Bernardo O'Higgins was a very apprehensive individual regarding his health and ailments. This fact is clearly reflected in his letters, that provide valuable anamnestic data. During his youth, while living is Spain, he suffered of yellow fever and later in Chile, he probably had an acute phase of a rheumatic fever. Since his adolescence, he was affected by a chronic hlepharo-conjunctivitis. During the Chilean independence revolution, he suffered several battle wounds. The most severe was a shot that affected both his right arm and elbow (1818). While living in Peru (1823-1842) he suffered of dysentery and malaria. The latter was an endemic disease in the valleys of Peru. Being previously asymptomatic, he started experiencing extensional dyspnea, angor pectoris and syncopal episodes in 1840. At that time, physicians diagnosed a hypertrophic cardiomyopathy. Analyzing his symptoms and taking into account their short term evolution, the author concludes that they were a consequence of either an aortic stenosis or coronary insufficiency. These led him to a heart failure that was his immediate cause of death in 1842.

Paleopathology in osseous remains from the 16th century. A survey of rheumatic diseases.

OBJECTIVE: To describe the rheumatic conditions found in skeletal remains of Amerindian ancestry disinterred from a 16th century Mexican cemetery. METHODS: A physical anthropologist and 2 rheumatologists surveyed the recovered skeletal remains. RESULTS: We examined the skeletal remains of 443 subjects. We found 19 cases of Pott's disease, 17 of osteoarthrosis in various anatomical locations, 2 spondyloarthropathies, probably ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis, one probable septic arthritis in the stemoclavicular joint, and 2 compression fractures of the spine. We found no cases of gout or rheumatoid arthritis. CONCLUSION: This is the first report on the presence of rheumatic conditions in colonial Mexico. Studying the remains of these populations can provide useful information about the origin and evolution of different rheumatic conditions.

Las enfermedades reumáticas en el México colonial / Rheumatic diseases in colonial Mexico

Las obras médicas publicadas en la Nueva España entre los siglos XVI y XVIII no han sido tomadas en cuenta hasta ahora en la búsqueda de descripciones de la artritis reumatoide y de otras enfermedades reumáticas previas a las descripciones hechas por Sydenham. Revisamos la mayoría de las obras médicas publicadas en la Nueva España desde la llegada de los españoles hasta el siglo XVIII y dividimos a las enfermedades descritas con manifestaciones articulares en cuatro grupos de acuerdo con sus manifestaciones clínicas principales: dolor sin inflamación en una región anatómica, dolor sin inflamación en varias articulaciones e inflamación en las articulaciones, y manifestaciones articulares relacionadas con procesos contagiosos. Encontramos que cien años antes que Sydenham, se diferenciaba entre la gota y la artritis reumatoide por su forma de evolución, y presentamos la más antigua descripción conocida de las artritis reactivas

[Rheumatic diseases in colonial Mexico]. / Las enfermedades reumáticas en el México colonial.

The medical texts published in New Spain between the XVI and XVIII century have not been searched until now for evidence of the existence of rheumatoid arthritis and other rheumatic diseases before the descriptions made by Sydenham. We surveyed most of the medical books written and published in New Spain from the arrival of the Spaniards to the XVIII century, and we divided the diseases with articular manifestations into four groups, according to their main clinical characteristics: pain without swelling in anatomical region; pain without swelling in several joints; pain and swelling in joints, and joint complaints associated with contagious diseases. We found that a difference was established between gout and rheumatoid arthritis one hundred years before Sydenham, according to the different evolutions of both diseases, and we present one of the oldest descriptions of reactive arthritis.

A história da reumatologia pediátrica / The history of pediatric rheumatology

A primeira parte do texto refere-se ao nascimeto da Reumatologia Pediátrica no mundo desde as primeiras publicaçöes, definiçöes de objetivos, campo de açäo e evoluçäo. Posteriormente, aborda-se a especialidade no Brasil desde sua criaçäo até o momento atual, perseguindo objetivos comuns: assistência, ensino e pesquisa

A história da reumatologia pediátrica / The history of pediatric rheumatology

A primeira parte do texto refere-se ao nascimento da Reumatologia Pediátrica no mundo desde as primeiras publicaçöes, definiçöes de objetivos, campo de açäo e evoluçäo. Posteriormente, aborda-se a especialidade no Brasil desde sua criaçäo até o momento atual, perseguindo objetivos comuns: assistência, ensino e pesquisa (AU)