Max Hirsch (1875-1941): His forgotten fate and his contributions to the founding of modern rheumatology.

Objective: To elucidate the connections between balneology and rheumatology in the founding period of the discipline of rheumatology, and describe the contributions of Max Hirsch, MD in the formation of professional rheumatology societies.

Material And Methods: Historical documents from the medical history collection of Vogelsang-Gommern, Germany, and original personal documents of the Hirsch family and information from the medical and historical period literature were used in developing this report.

Results: The first efforts at organizing rheumatology as a recognized clinical and academic discipline took place in the 1920s.

[Fibrositis--100 years and still no wiser?].

The past centennium has witnessed scientific progress in the elucidation of the mechanisms involved in the formal pathogenesis of so-called muscular pathogenesis of so-called muscular rheumatism (recently fibromyalgia), but the aetiology of this widespread syndrome and the pathways to its appropriate treatment are still not known. Careful diagnosis based on consideration of numerous conditions relevant for differential diagnosis, patient education and shared decision-making are prerequisites to the efficacy of a complex treatment and rehabilitation plan which should comprise a reasonable combination of physio-, psycho-, and pharmacotherapeutic measures. Medication should be sparingly prescribed and the patient advised that in the end these drugs have a symptomatic effect only.

Topical treatment of chronic low back pain with a capsicum plaster.

The efficacy and tolerance of a capsicum plaster in non-specific low back pain was investigated in a double-blind, randomised, placebo-controlled multicentre parallel group study. A total of 320 patients were randomly assigned to two groups of n=160 subjects treated by the active or the placebo plaster. The main outcome measures used were a compound pain subscore of the Arhus low back rating scale (continuous variable), and a response criterion of a reduction in pain subscore=30% from baseline to final assessment (secondary, non-continuous variable).