Studies of the Relationship Between Emotional Factors and Rheumatoid Arthritis: Ralph M. Patterson, James B. Craig, Raymond W. Waggoner, and Richard Freyberg. Amer. J. of Psychiatry, XCIX, 1943, pp. 775–781.

In 1930 Wright and Pemberton demonstrated that the initial skin temperature in arthritics was lower than that of the average subject and that it was less responsive to changes in the environmental temperature. The authors concluded that there must be a disturbance of capillary flow, presumably on a vasomotor basis, the arthritic individual being less labile in adaptation than the nonarthritic.

Mittelmann and Wolff were able to demonstrate a definite drop in skin temperature under experimentally induced emotional stress. In view of their findings and the above reported changes in capillary flow, it seemed advisable to consider the possibility of emotional stress action in arthritis through a disturbance in circulation. Skin temperature studies seemed to offer a means of approach to this problem.

Twenty-five rheumatoid arthritics and twenty-five control patients were subjected to studies of skin temperature changes under induced emotional stress. Suggestive but inconclusive differences were noted. Emotional stress was found to produce a drop in skin temperature indicative of changes in circulation. The importance of such a mechanism in the development of arthritis could not be conclusively evaluated but its influence appeared to be greater in producing exacerbations or in affecting the course of the illness.