This is a book (mainly about fibrositis treatment, and other rheumatic diseases) first published in 1954 by Copeman and Mason titled Rheumatism: Fibrositis, Lumbago, Sciatica, “Slipped Disc”, Gout, Spondylitis. The book’s aim is to inform people about common rheumatic illnesses in an understandable manner.

I will focus in the chapter Fibrositis, since back mice were also named “fibrositis of the back”.

It is a good review from all types of remedies that humanity had to deal with in the pain treatment. Some of the old remedies are still in use.

About the authors:

William S.C. Copeman
Richard Michael Mason (1917-1977)

Notes about chapter II, FIBROSITIS from the book:

RHEUMATISM : Fibrositis, Arthritis, Lumbago, Sciatica, “Slipped Disc”, Gout, Spondylitis

By W.S.C. Copeman and R.M. Mason

First published in London in 1954

Copeman and Mason’s introduction: The word rheumatism

The word rheumatism was in the early days thought by the learned to be the result of a “peccant humour” or “rheum” which flowed through the body from the brain downwards, stirring up in the course of its travels pains in the organs it crossed, and swelling of joints into which it flowed and it seemed more related to the accute rheumatism or rheumatic fever episode.

But under the term chronic rheumatism they grouped rheumatoid arthritis, osteorathritis, arthritis of the spine (spondylitis), non-articular rheumatism (fibrositis), etc.

NOTES ABOUT BOOK’S Chapter II: Fibrositis

These pains have been recognized both by sufferers and doctors for many hundreds of years, although the uncertainty of their real CAUSE and proper treatment always made the latter a little shy of them.

They were generally called “myalgia” -which in Greek only means muscle pain-. At the beginning of the century, Sir William Gowers (1904), who was a prominent doctor and the father of Sir Ernest Gowers, conceived the theory that these pains were caused by a MYSTERIOUS INFLAMMATION of the white fibers that spread to the other soft tissues of the body. Then he gave it the name of “fibrositis”.

This term achieved great popularity since it appeared to explain at last the origin of this MYSTERIOUS BUT PAINFUL MALADY.

It is now known that this theory was not the correct one, but “SINCE IT IS EASIER TO INTRODUCE A NICE SOUNDING NAME THAN TO GET RID OF IT ONCE IT HAS TAKEN ON, THE TERM REMAINS IN USE”.

This often leads a certain type of doctor to get up at the medical meetings and declare: “This disease DOES NOT EXIST!” Maybe meaning that the term is wrong, they generally get a brief headline in the daily press, but the sufferers’ pains seem to remain.

It would be better to name the condition as “pain of unknown origin”, as some purists suggest.

The truth is that fibrositis is not a pedigree disease. The pains that are included under this heading are a mixed lot. Shakespeare referred to them as “this foul rheumatic breed”. This breed, apart from being PAINFUL, is a great handicap to the industry because of absenteeism. So a serious research should be undertaken on fibrositis but, since it lacked glamour, it has been overlooked.

Copeman states:

“Since fibrositis lacks glamour it has been overlooked”.

However, they learnt certain things about it: there seemed to be quite a lot of causes.

Causes that were related to fibrositis by the 50’s

FOCAL SEPSIS cause: the cause that led to the removal of many teeth and tonsils

Copeman explains that after the discovery of the microbes a few years before and their relation to most of the acute illnesses, it was thought that “small collections of germs” might lie dormant in various parts of the body, giving rise to no pain or other symptoms but, nevertheless, disseminating their poisons (or toxins as they are called technically) at intervals into the blood stream.

This had the name of “theory of the focal sepsis”.

This theory led to the removal of a large number of teeth and tonsils.

Copeman and Mason thought that this still could account in some cases, but that was not the “only cause” of fibrositis.

They recommend to remove infection focuses that are demonstrated, but not to remove the teeth, just in case.

Environmental cause: THE DAMPNESS

Copeman states that there are causes that lay outside the body, in the environment of the sufferer. Of these, DAMP HOUSING is a prime offender.

This means that the moist can arise continuously in the walls from the foundations and that the atmosphere in the rooms is therefore perpetually moist, and generally colder than outside.

He says: “This state of affairs closes up the blood vessels of the skin and helps the development of rheumatism of all types”.

When there is DAMP CLOTHING, this acts in a similar way by chilling the skin.

Occupations which involve working in changing extremes of temperature, like baking or steel-melting also seem to act the same way, since fibrositis seems to occur more frequently in such people.

Sitting by an open window in the hot weather.

Anxiety cause

Its onset can also be correlated in some people with periods of mental stress or anxiety, which has led the Americans to coin the term of “psychogenic rheumatism” for this type.

The LOCALIZED forms of fibrositis with a specific name

Copeman makes it clear that the word “fibrositis” as it was used by then was a “portmanteau word”, which was used to cover rheumatic pains in the soft tissues anywhere in the body.

In addition to that, he says that there are “other words” that do exist to describe certain LOCALIZED pains, such as LUMBAGO (which describes a common pain in the lumbar region).

Lumbago: It can appear after some unusual strain on the back, after a muscular effort such as using a pick, or unexpectedly when jumping out of the bed. It usually stays for a time until the painful cramp of the muscles of the back subsides. (Copeman mentioned that it was recently discovered that a slight degree of slipping of the intervertebral disc could be often one of the causes of lumbago, he dealt with it in another chapter. That meant that the patient was recommended to REST FLAT IN BED on the back with a small cushion to maintain the arch of the lower part of the spine until the pain has almost passed. After that, “cative treatment” can be started).
Torticollis: This explains painful fibrositis of the neck, which is sufficiently severe to prevent movement. It generally affects one side more than the other, so the patient looks to one side.
Pleurodynia: A synonym for fibrositis of the muscles that lie between the ribs. Copeman mentions that one sufferer from this was Lenin during his exile. When pleurodynia occurs on the left side of the chest, the sufferer often thinks that he must be suffering from heart disease.
Bursitis: It means an inflammation occurring in one of the naturally occurring bursae, which are bags of tissue situated in places where pressure or friction between moving surfaces normally occurs. The most common sites are: shoulder joint, tip of elbow, behind the knee.
Neuritis: It means an inflammation of the nerve, and this condition occurs in certain circumstances, especially after a “toxic poisoning”. For example, taking too much certain medicine or drugs (chronic alcoholism, diabetes, arsenic). Some would be suffering from “fibrositis” instead of neuritis. A “slipped disc on the neck” can also cause a painful condition named “brachial neuritis” (in which pain runs down one or both arms from the neck).
Tennis elbow: This is caused by the “sprain” of the ligaments of the elbow joint. Although some get well in time, even without much treatment, others are sometimes extremely difficult to cure.

Fibrositis treatment around the 50s

Copeman warns: There is NO specific treatment that will cure ALL FORMS OF FIBROSITIS. Some medical advices are based on common sense and experience more than on medical science. And every case should be treated individually.

The “magic” cures from all over the world

Copeman warns that on those days people had the tendency (Personal note: Not very different from now) to believe in fantastic “cures”.

New potato: One of them was to carry a new potato or nutmeg in the pocket. He says the local rector highly recommended that until he got rheumatism himself.
The hair of an elephant’s tail that is worn round the wrist in most parts of Africa.
Rings made of copper and silver in the aristocracy of Persia. Or among lower social scale little linen bags containing dried camel dung are worn next to the skin.
In Italy and Spain small medallions depicting St Joseph. Or sprinkling flowers of sulfur in the socks.
In America they have “electric belts”.

Copeman and Mason’s “rational advices” to treat fibrositis-related maladies

Clothes

Avoiding damp clothes in winter and in summer. In summer, the clothes should allow the natural perspiration, so it is better to wear clothes that do not get wet.

Weather

Avoiding damp weather is the best. Ideal climate: a nice porous soil that drain easily after rain, 500 feet altitude, protected from the winds, not many trees around so they keep moist, house centrally heated.

Commercialized medicines for fibrositis treatment around the 50’s

The best is aspirin, taking it at the first sign of an attack in doses of 10 grains (2 tablets) every 4 hours for three days.

Some people find that aspirin DOES NOT suit them, causing indigestion or constipation. They can then take calcium-aspirin that can be dissolved in water and very seldom gives rise to such troubles. If constipation remains, then they can take a small dose of “salts” in the morning.

In the eldery sufferer iodine may help. Since its effect produces an action on the thyroid gland, it is important to get medical advice regarding suitable dosage.

Copeman & Mason state that most of the sold “rheumatic medicines” contain aspirin and/or iodine, and some reinforcing agents as phenacetin or caffeine (A.P.C pills). (Personal note: the use of phenacetin was forbidden in some countries and it gradually changed for paracetamol.)

Some other preparations contain stronger drugs that can be dangerous.(Personal note: The tincture of idoine is still used, but mainly for its sterilizing effect topically).

Liniments and Ointments for fibrositis treatment

—Liniments (or embrocation) are created as a lotion to create friction and counterirritation.

—Ointments are more greasy preparations.

Liniments:

It seems instinctive in the human race to “rub a pain”.

-Charles Dickens, who was a sufferer, recommended “wintergreen oil” and since then it has been used.

It may contain some salicylate and its disadvantage is that it smells rather strongly. Now there are preparations with capsicum (which is a counterirritant) and with iodine.

Ointments:

-There are other grease preparations that are worldwide known like ointments. In Russia, bear’s grease; in India, pelican’s fat; in England, adder’s fat.

–Lanoline creams that are non-greasy are more common lately. The latest well-advertised idea is a small amount of adrenalin added to lanoline cream, but a study from the Empire Rheumatism Council suggested that it was just a good lubricant before the massage.

–Embrocations seemed to be out of fashion except for the treatment of horses. (Personal note: Royal embrocation from Elliman’s was used first for animals; later, being the same compound, Universal embrocation was used for humans. The brand did a strong advertisement campaign).

But counter-irritants (terpentine, capsium) as good as anything, but they may not be too well rubbed in, particularly in large areas such as the back.

The value of ointments and balms is enhanced if the skin is warmed by heat sufficiently so it becomes pink. It should be done twice a day -morning and evening.

Rubbing with fingertips well pressed in and moved in a circular fashion. The rubbing should be concentrated at the points of maximum tenderness or “trigger points”. The treatment should be applied in the trigger point and not in the area that, by referred pain, it appears to be sometimes.

Plasters with counter-irritants for fibrositis treatment

The fibrositis nodule

At the “trigger points”, a small hard nodule may often be felt, and pressure on this will increase the pain in the whole area affected. In this “fibrositic nodule” the treatment must be concentrated, however painful this is at first. It is important to maintain the treated part warm.

Massage techniques and heat application

There are various types of massage, the most generally employed are called “firm effleurage” and “pétrissage”. Better to combine with heat like infrared rays or radiant heat. The people that tend to have the attacks at the same period of year can receive anticipating treatments.

Also people can use small infrared apparatus at home and, once the skin is pink, apply the ointment by firmly rubbing in for 5 to 10 minutes.
If there is no electricity, then the person can get a very hot bath for 5 to 10 minutes. Then the person will lie and perspire between blankets for half an hour, before drying and getting the ointment or balm rubbed in.
In some countries, through a paper that protects the skin, they use an iron to “iron out the pain”, as they say. Another method is water bottles or bags of hot sand heated in the oven.
Turkish vapor baths have been known to be of value in the treatment of fibrositis, there are also “sweat boxes”.

Strapping

-In cases of lumbago, when they have got rid of the pain but the stiffness remains, it is useful to use it in the back with adhesive plaster (elsatoplast, which stretches) and to keep this for 1 or 2 weeks. It can also be done with “belladonna” plaster.

Novocaine injections as fibrositis treatment

Copeman and Mason warn that the pain of fibrositis, which appears to be affecting a large area of the body, can often be found by CAREFUL EXAMINATION to have its origin in one or two quite small localized “trigger points”. At these points a small nodule can often be felt, and pressure with the finger at such point will reproduce or exacerbate the pain felt throughout the whole area. IF THESE POINTS are accurately defined and injected with a solution of saline with locale anaesthetic such as PROCAINE, they can put out of action for a time and, in some cases, be destroyed permanently with a consequent pain relief.

If the injection misses the EXACT CENTER OF THE TRIGGER POINT, “even a fraction of a millimeter”, the relief will not occur or will be very transient.

That’s why a close collaboration between sufferer and doctor is necessary.

Sometimes these spots seem to occur in “crops”, further ones occurring after the successful injection of the previous lot. Then the injections have to continue until all have been dealt with.

Tennis elbow can also be sometimes relieved by injections. It can be by painful bursa or periostitis at the attachment of the forearm group of muscles (by movements of continuous strain).

Deep friction manipulation after injection may speed up the recovery that may take many months.

There are other remedies that have been related and appear from time to time:

-The idea that beekeepers do not suffer with rheumatism is very old country lore, but it is difficult to prove. So some people get injections of bee-venom.

Fibrositis at the “change of life” (and panniculitis): Copeman’s mentions a special type of fibrositis at the menopausal zone

(Personal note: This entity seems to me to be what now is called fibromyalgia)

Women who are in what is known as the “menopausal zone”, or who are five years either side, tend to suffer with a rather special form of “fibrositis” which is sometimes known as panniculitis.

It is usually associated with an increase in weight and so of the layers of fat that lie between the skin and the muscles. In this form of rheumatism, the pain arises probably in the fat. This fat tends to accumulate more in certain parts: knees or behind knees, outer sides of thighs, ALONG the crest of the pelvic bones, the outer parts of the arms and shoulders, and the base of the neck known as the “buffalo hump” by American doctors.

It was discovered during the last war that the “nodules” which are often particularly large and numerous in this special condition consist of TENSE “BUBBLES” of this extra fat, which it had popped through the weakened sheet of the fibrous tissue. These nodules are called “fatty hernias”. If the fat lobules swell for any reason, they find it difficult to get back through this fibrous layer. The neck of the hernia may be then constricted, causing pain and a tense nodular swelling that can be generally felt at the site of the pain.

The condition, especially on the knees, may be confused with arthritis.

The most important treatment aim is to reduce weight.

After that, some massage would help. Also some “diuretic” substance such as urea to take after meals. Also a small dose of thyroid extract. And if there are sleeping problems, also some milder barbiturates.

Other related pathological entities:

The slipped disc

Copeman makes fun and says that a few years ago a “slipped disc” would mean to the average person that a minor mishap had occurred on the gramophone turntable. Nevertheless, by then, in the 50s, it just meant an extremely painful illness. Once the doctor has to tell the patient that he has a slipped disc, the first question from the patient is “What happened before you doctors invented the discs?” Then the doctors explained that it was just called by then backache or lumbago.

Sciatica happens when the slipped disc presses upon the roots of the nerves. The attacks in young people usually can cure with time. When it affects the cervical zone, it is called “brachial neuritis”.

Osteoarthritis

It may develop in the vertebrae as a degenerative condition at the edges; it can be detected by means of X-rays.

Published in Novembre 2018 by Marta Cañis Parera

Reference

The book Rheumatism: Fibrositis, arthritis, lumbago, sciatica, “slipped disc”, gout and spondylitis. By W.S.C. Copeman and R.M. Mason. Duckworth’s Modern health Series Gerald Duckworth &CO. LTD. 1954