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Three men wearing orthopedic apparatus. Etching and engraving by Paul Sandby, 1783. Wellcome Library image L0019751

How was arthritis pain treated in the 18th century? One option was the mustard plaster, which operates on the principle that heat generated by the plaster increases blood flow, which will reduce inflammation. Frankincense supposedly inhibits the production of molecules that cause inflammation and break down cartilage tissue, which leads to joint pain, at least in knees. This level of scientific knowledge wasn’t available to the 18th century physick, but frankincense is an edible aromatic resin with a long history of use in treating ailments including arthritis. At least you (or your breath) would smell good.

The primary ailment treated of was gout, and the remedies above are mostly directed at inflammatory arthritis, the kind where joints grow red and swollen. Think of wealthy, overweight men drinking port with swollen feet propped up on footstools: that’s gout.

Models showing progressive arthritis in a knee, followed by joint replacement.

Then there’s osteoarthritis, or degenerative joint disease, once included in the catchall and obsolete term, rheumatism. This is a different matter, where changing your diet and icing the joint generally won’t bring much relief. When your cartilage is gone, your bones rub together. Osteophystes or bone spurs form is response to damage or inflammation, and cause both pain and noise.
In the pre-joint replacement era, treating this kind of arthritis was treating chronic pain. (In this era, that’s still the case: absent a TJR or resurfacing, all that’s treated is pain. Once the joint is replaced, there’s nothing left to hurt. It’s a neat little trick.)

Providence Gazette and Country Journal, June 16, 1764. V II, Issue 87, page 3

Providence Gazette and Country Journal, June 16, 1764. V II, Issue 87, page 3

In pre-Revolution Boston and Rhode Island, there were various cures advertised promising far more benefit than they were likely to deliver. Phillip Bourne, from Greenwich Hospital in England, promises to “undertake curing any Persons who are afflicted with the Gout and Rheumatic Pains, with the greatest Facility and Safety imaginable.” The caveat about “especially such as have not been visited with those Disorders for more than Seven Years” is particularly nice, since the longer pain persists, the harder it is to treat. He knew his limits, I suppose, if only of his patience, or the amount of time he could safely ‘practice’ in any location.

Boston Gazette, February 14, 1774.

Boston Gazette, February 14, 1774.

Edes and Gill sold Keyser’s Famous Pills, “So well known all over Europe,” and promising much, like Cures for Scorbutic Eruptions, Leprosies, White Swellings, Stiff Joints, Gout and Rheumatic Disorders, etc.” I don’t know about you, but I think I’d prefer to have my scurvy treatments separate from my arthritis treatments.

Ultimately, the best option was probably a crutch or cane, though braces were devised and are still used, along with crutches and canes. All that prevents their use or efficacy is the vanity of the user.