Although a patient who has suffered long from chronic rheumatism, whose joints have become much enlarged and almost immobile, and whose muscles consequently have greatly atrophied, presents to the careless observer almost precisely the same appearance as one suffering from rheumatoid arthritis, the two maladies are distinct, and require very different dietetic and medicinal treatment. Those who are suffering from rheumatoid arthritis should be fed as generously as possible. Digestion and appetite being usually good during the earlier stages of the disease, they should be allowed to eat heartily of all simple foods. Later, when the appetite diminishes, although digestion may remain good, foods should be crowded upon them, especially such foods as contribute to maintain a good degree of flesh. Farinaceous, cereal foods, fats, and oils are particularly to be commended. When it is well tolerated, cod-liver oil is of considerable value to such patients.

When, as happens sooner or later in most cases, digestion is disturbed because of lack of exercise, and because of generous feeding, foods must be carefully adapted to the capacity of the digestive organs. In these cases, as in cases of chronic rheumatism, water should be given freely.

As much exercise, either passive or active, as the patient can take without great pain and discomfort should be prescribed. Every endeavor should be made to maintain the strength of the muscles that are inclined to atrophy.

If at all possible, these patients should be treated in climates where they are not exposed to dampness, and where they will have a maximum amount of sunshine. Certain spas, especially those possessing thermal and sulphurous waters, have acquired considerable reputation as resorts for patients with rheumatoid arthritis.