Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Arthritis is an inflammation of the joints and may be of many different types, the four commonest being osteoarthritis, rheumatoid arthritis, infectious or toxic arthritis, and gout. Certain forms of arthritis are associated with a decrease in skin temperature and blood flow to the extremities.‍

Osteoarthritis is caused by an overuse of the joints. There is some question in the minds of certain authorities whether an agent of infection such as a virus might also be involved in some cases of osteoarthritis. The involvement in this form of arthritis is usually limited to the overworked joint. Pain is usually worse in the early morning, but quickly improves upon movement and warming-up activities of the person.‍

Rheumatoid arthritis is of unknown cause; possibly a virus, possibly an immune reaction or a degenerative process following the ingestion of a preformed toxin. Toxic or infectious arthritides are caused by germs such as the one that causes gonorrhea, or by toxins that are capable of attacking the joint directly. An infection, such as those around the teeth, chronic infections on the skin, or a chronic colon infection can sometimes cause arthritis. "Lyme arthritis" is an interesting disease recently described in certain northern states, and now definitely shown to be associated with a tick bite. Whether the arthritis is caused by an infectious agent or some toxin injected by the tick is not yet known. Fortunately, the disease seems to be self limited.‍

Gout is a form of arthritis due to the presence of uric acid crystals in or around the joints or in the soft tissues. Purines are the culprit in elevating the uric acid. Foods of animal origin and food yeasts - baker's yeast and brewer's yeast, all cause the uric acid to rise. It is generally felt that eating too many rich foods, especially those high in purines, in persons who are genetically predisposed is the cause of this form of arthritis. Hot, swollen, tender joints are characteristic.‍

Infectious or toxic arthritis is caused by certain germs such as the gonococcus, which can attack joints directly. Other germs apparently cause arthritis even if the infection is elsewhere in the body, such as around the teeth, on the skin, or in the colon. Sometimes a wrong diet or a viral upper respiratory infection can cause the joints to ache.

The way to combat arthritis is to combat the cause as far as is possible. From early childhood, one should protect the joints so that when the natural aging of joints occurs at about the age of 50, they will not respond by overgrowth of bone cartilage, degeneration, and inflammation of soft tissue. One should become accustomed early in life to sensing pain in the joints so that any activity which causes pain, such as carrying a heavy weight for a long time or keeping a joint in an abnormal position for a prolonged period can be avoided.

Since the exact cause of rheumatoid arthritis is unknown, it is necessary to institute a general treatment program that eliminates all the suspected causes in order to try to avoid rheumatoid arthritis. Because certain painful psychological factors turn up repeatedly in the lives of individuals who develop rheumatoid arthritis, it should be an objective of life to handle psychological and emotional factors as definitively as possible. Marital distress should especially be carefully handled, as marital conflict is found in many cases of rheumatoid arthritis. Whenever deep and unresolved psychological pain is found in individuals with rheumatoid arthritis, counseling is indicated by an understanding and experienced person, a minister or other skillful person, on a repeating basis until the conflict is resolved.

A certain number of persons with rheumatoid types of arthritis or rheumatic pains seem to respond to a diet entirely free of foods in the nightshade family. This includes tomatoes, potatoes, eggplant, and peppers. The diet must be strictly followed for 3 months without a single exception, not even a sprinkle of paprika, in order to adequately test if the individual is sensitive to the toxic alkaloids found in the nightshades. Other allergic toxic or infectious agents may be similarly eliminated from the environment of the individual who is sensitive.

Gout can be successfully treated by a pronounced change in lifestyle. The person must begin a program of regularity, going to bed on time, getting up on time, eating meals on time, and getting exercise on time. During an acute flare-up, the diet must be of the simplest variety, including only fruits, vegetables, and whole grains for the first six to twelve weeks, until the gout is under control. At that time, nuts may be added. If overweight or hypertension is a part of the disease, it must be corrected. Gradually, return to a full, regular diet, but with restrictions against high purine food, substances containing methylxanthine (coffee, tea, colas, and chocolates), and all rich foods.

Many persons with any kind of arthritis will obtain pain relief and limbering of the joints by the use of heat. One should beware of machines, fad diets, and unproven remedies. For painful hands, one may wear stretch nylon gloves at night. The weight must be reduced to slightly below average weight for height and age. Proper clothing that will eliminate the possibility of even the slightest chilling of the extremities, neck, or ears must be provided. Good posture, deep breathing, and the avoidance of fumes, contact with odors of rotting leaves and hydrocarbons are essential. Avoid the use of certain chemicals: tobacco, alcohol, all drugs and pharmaceuticals, nutritional supplements, and even deodorants. Be regular in all life's habits, doing the same thing at the same time each day. Cultivate a sunny disposition, entirely eliminating anger, excitement, anxiety; and practicing kindliness, mildness, joy, patience, and quietness.

‍GENERAL INSTRUCTIONS:‍

Although arthritis is difficult to treat, the crippling effects can be retarded and the pain can be controlled by the use of certain physical and dietary programs. It is essential to follow the programs to the letter, as that very thing which might be considered unimportant may be the key to success. Resolve to be strict with yourself in following each of the suggestions until your program is liberalized by your physician.‍

Lifestyle

• ‍‍Work up a sweat each day for twenty minutes to two hours with exercise, heat, or sunshine. Keep the head cool at all times. Take a sunbath daily. Beware of machines, fad diets, unproven remedies.
• Wear stretch nylon gloves on painful hands at night. An electric blanket is a great help to many.
• Reduce weight to slightly below average weight for height and age, as extra flesh requires maintenance.
• Prevent, by proper warm clothing, the slightest chilling of the extremities, neck, or ears. Cool skin is abnormal.Have good posture. Practice deep breathing with each breath. The digestion is improved and the circulation quickened.
• Use heat, fasting, mustard plasters, herb teas, gentle massage without jarring, and other natural methods of pain relief over the joints instead of drugs. A paraffin bath and the charcoal poultice have been of great relief to many.
• Avoid the use of tobacco, alcohol, all drugs, pharmaceuticals, nutritional supplements, lotions, deodorants, and cosmetics. Use soap sparingly and no lard base soap. Use dish detergent sparingly in washing dishes and rinse off thoroughly.
• Do not breathe any kind of fumes or anything having an unpleasant odor including rotting leaves or gasoline.
• Avoid tissue injuries of all kinds such as crushing, thermal, and other burns, etc. There is evidence that tissue injury causes antibodies to form that may injure joints. (Lancet, May 6, 1972, p. 1019)
• Avoid dogs, cats, birds, and all sick animals, as rheumatoid patients have been found to be more likely to have a history of exposure to pets than persons not having rheumatoid arthritis.

‍Dietary Matters:

• ‍‍Take small bites, one-third the usual size.
• Put the fork down between bites.
• Chew until food is a cream before swallowing (very important).
• Not a morsel of food or beverages between meals except water.
• Sip a supper of 4-5 ounces of fruit juice, or skip supper.
• Eat 2-4 apricots and 3-6 olives daily.
• Use a serving of cherries daily for gout.
• Do not eat fruits and vegetables at the same meal; do not use liquid foods except when skipping the regular meal.
• Use no more than three dishes at one meal.
• Fast one or two days a week if weight permits, as fasting often gives much relief.Use a high fiber diet. Especially effective are unpolished grains and the fruits high in pectin. Have a green drink twice weekly, made with parsley, lettuce, celery, or other greens and carrot juice.
• Alfalfa tea is helpful to some: 1 cup per day.
• Correct constipation and gas.
• Regularity in all things is essential.
• The nightshade group of foods cause about 10% of people to have arthritis. These foods include tomatoes, potatoes, eggplant, and peppers. Even a small taste will spoil the diet. Maintain strict abstinence for two months as a trial.
• Milk is a carrier of a germ that may cause arthritis. It would be wise to omit dairy products from the diet, as 75% of rheumatoid patients grow the germ in their throat, and have antibodies to it in their blood. (Acta Medica Scandinavica, 192:231-239, September, 1972) ‍

Arthritis Routine (Days 1 and 2):

• Live by the clock, especially during the first month, keeping all things on schedule as much as possible: meals, bedtime, arising, physical hygiene, study, work, prayers, etc.
• Begin a program of walking on the first day. Walk as far as is comfortable. Gradually work up to five miles per day. Take two baths daily in the purest water possible, without soap, dry brushing the skin before each shower, or bathe with a stiff brush.
• Take deep breathing exercises three times daily, breathing in as deeply as possible and holding to the count of twenty, breathing out as deeply as possible and holding out to the count of ten. Repeat this exercise twenty times, always in fresh air. MAINTAIN GOOD POSTURE, STANDING, SITTING, LYING.
• Take contrast baths (hot and cold) daily for pain relief and for healing, involving whole body or only the extremities as may be necessary. Repeat one to four times daily as indicated. Hot for 6 minutes, cold for 30 seconds.If city water is used for drinking, it should be distilled or boiled. To improve the flavor of boiled water, blend 1/2 minute after it has cooled to re-aerate.
• Do warm-up exercises for 20 minutes each day, using a good book such as the Air Force book on exercises, or any other exercise list.
• Cultivate a sunny disposition. Eliminate anger, excitement, anxiety, TV, movies. Practice kindness, mildness, joy, patience, and quietness.
• Use no drugs. Be cautious about the use of cosmetics, soaps, and sprays.Keep the colon entirely clear for the first two weeks with two enemas per day until water is returned entirely clear (about three quarts).
• Fast for two days at the beginning of the course. Drink about 10 glasses of water daily, or enough to keep the urine quite pale.

‍Day Three:

‍Breakfast of juice (freshly squeezed) 10-12 ounces
Dinner of fruit (unsweetened) 2-3 servings
Omit supper

‍Day Four:

‍Breakfast - Raw fruit 2 servings; Dry whole grain bread 1 serving
Dinner - Raw fruit or vegetables 2 servings; Bread 1 slice
Supper - Omit

‍Day Five:

‍Fruit meal (according to the meal planner on separate sheet)
Vegetable meal for second meal (according to meal planner)
Omit supper

‍Day Six:

‍See arthritic diet for maintenance diet beginning on this day.‍

INITIAL ARTHRITIC DIET

‍(Use for first four weeks. Be strict.)

‍Eliminate‍

• Vinegar
• Smoked foods
• Pickled foods
• Preserved foods
• Rich gravy refined starches
• Sauces, thickenings
• Coffee, tea, alcohol
• Soft drinks
• Refined foods: carbohydrates, proteins, fats, oils, vitamins, minerals
• Desserts, sweets, dates, honey, dried fruits
• Animal products
• Any gas-forming foods
• Combinations of fruits and vegetables
• Spices (Pepper, nutmeg, cloves, baking soda, baking powder)
• Scorched or overcooked foods
• Unripe or overripe fruits and vegetables
• Food having additives, conditioners, preservatives, etc.
• Canned and frozen juices
• Food having a fermenting or aging step in processing
• Nightshades (potatoes, tomatoes, pepper, eggplant, and tobacco). To be successful in eliminating nightshades from the diet one must be a "label reader." Some brands of yogurt contain potato starch, some herb teas contain hot pepper, paprika is found in some cheeses, and some baby foods contain potato and tomato products. The diet must be strictly followed; even a whisper of paprika may produce symptoms.‍

Use Sparingly

• ‍‍Salt
• Whole grains
• Sweet fruits
• Legumes‍

Use Freely

‍Bland fruits: olives, avocados
Low starch vegetables: asparagus, celery, broccoli, cucumber, greens of all kinds, sprouts, beet tops, endive, lettuce, mustard, okra, onions, pumpkin, small* beets, small carrots, small parsnips, small turnips, spinach, small string beans, Swiss chard, summer squash, turnip tops, zucchini
Low starch fruits: apples, apricots, berries, cantaloupe, cherries, grapes, grapefruit, melons, nectarines, oranges, papaya, pineapple, peaches, plums, watermelons (1" x 6" slice only)
*Small root vegetables and immature vegetables contain less starch.