THE GREAT CONTROVERSY: TRIALS DEALING WITH RHEUMATOID ARTHRITIS
Rheumatoid arthritis is a disease in which the joints become painful, swollen and warm, due to internal inflammation. There are characteristic changes in the level of certain factors in the blood that help to confirm die diagnosis. Contradictory results from different trials are often due to a failure to diagnose rheumatoid arthritis properly. This disease should not be .confused with other forms of joint pain, which are more transient and do not produce the same sort of changes in the blood, or damage to the joint – it is well known that joint pains of this type can be due to allergic reactions to food. What is at issue is whether foods can ever be a factor in true rheumatoid arthritis. In the two studies described here, all the patients involved were diagnosed as cases of rheumatoid arthritis by a standard set of tests.
Dr Gail Darlington, a consultant rheumatologist at Epsom District Hospital in Surrey, carried out one such trial, with the help of Dr John Mansfield, a private practitioner with many years’ experience of elimination diets. Dr Norman Ramsey, an experienced medical physicist, helped with the assessment of changes in the patients’ symptoms.
This was a reasonably large-scale study with 53 rheumatoid arthritis patients involved, and 44 actually completing the trial. They all underwent a two week ‘wash-out’ period, when the medicines they had been taking were withdrawn, and they all received paracetamol instead, plus a dummy tablet that they were told was a ‘new drug’. This sort of treatment is known as a placebo. Placebos play an important part in scientific trials.
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