Improvement from gold therapy is not immediate but comes about very slowly. The patient and physician should be forewarned that as many as 8 to 14 weeks may pass before any benefit is noted, and that months of treatment may be required before improvement is sufficient to decrease disability. With effective therapy, signs of inflammation gradually decrease, pain abates, and function improves. Not all patients benefit, and whether beneficial results occur can be determined only by clinical trial. There is no advance method of determining whether treatment will be effective. Gold therapy suppresses rheumatoid inflammation and checks the progress of the disease. It should not be used alone, but shoud be part of a well-planned program of treatment carefully adjusted to the needs of the individual. This therapy will include steroidal and nonsteroidal anti-inflammatory agents (including aspirin), which should not be reduced or abandoned until definite improvement from gold can be determined. With the possible exception of palindromic and juvenile forms, RA is the only rheumatic disease benefited by intramuscular gold therapy. The treatment should never be used for other forms of rheumatism.