On the classification and nomenclature of chronic "rheumatic" joint diseases

Each rational classification consolidates the knowledge and understanding of the studied phenomena achieved at the time of its compilation. Being the formulation of this understanding, the classification, in turn, becomes the starting point for further progress. That is why from time to time it is necessary to revise the nomenclature and classification of the studied phenomena in order to raise them to the level of new knowledge, in order to pour the accumulated new observations into them. In clinical medicine, the classifications of painful forms cannot, of course, have the accuracy and certainty that they have, for example, in the mathematical sciences. Insufficient knowledge of etiological factors, their multiplicity and interference, the abundance of transitional and combined forms, compensatory adaptations that equalize functional disorders-all this makes every step on the path of classification extremely difficult. However, if there is no data for making more or less complete classifications, it is often necessary to make working classifications that are obviously only temporary. These difficulties of classification especially increase when we are dealing with such vaguely differentiated painful phenomena as joint diseases. Here, an unimaginable "confusion" (Umber) prevails among practitioners. Practical doctors drown their inability to understand the intricate forms of disease in vague diagnoses of "rheumatism", "gout". Meanwhile, the great social significance that "rheumatic" joint diseases acquire-social diseases par excellence-requires more careful differentiation and consideration of joint diseases, and the latter are possible only when building a more or less rational classification.