Stressful life events have long been supposed to act as a precipitating factor for rheumatoid arthritis (RA).1 In 1860 Fuller expressed the opinion that “...when the rheumatic poison is present in the system, any disturbing circumstance, even of temporary duration, such as overfatigue, anxiety, grief or anger, by rendering the system more susceptible of its influence, may prove the accidental or exciting cause of the disease...”.2 In modern terms, the rheumatic poison may reflect the underlying immunological process preceding RA.3 James has highlighted the stressful life events to support his contention that low androgen values are a contributory cause of RA.4

We have studied serum testosterone …