Abstract
To the Editor.— The study by Appelboom et al (1981;245:483) on the antiquity of rheumatoid arthritis provides pictorial evidence for this disease in the 17th century, approximately 200 years earlier than is generally acknowledged. However, I think that they are in error concerning the lack of evidence for rheumatoid arthritis before this time. The paleopathological literature provides evidence that rheumatoid arthritis was present before the 17th century. 1 One case is that of an Egyptian mummy from the Fifth Dynasty (2750 to 2625 BC). 1,2 The hands were deformed by joint swellings, ulnar deviation of the fingers, hyperextension at the metacarpophalangeal joints, flexion at the interphalangeal joints, and involvement of the temporomandibular joints. American Indian skeletal material from Dickson Mounds, Ill, has disclosed a case of rheumatoid arthritis in an elderly man from the Mississippian period (700 to 1650 AD). 3 The Indian displayed flexed knees and some erosion of
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