Therapeutics of the gouty diathesis : from a lecture delivered in the Polyclinic Evening Lecture Course, March 12, 1889 / by Solomon Solis-Cohen.

  • Solis-Cohen, Solomon, 1857-1948.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Therapeutics of the gouty diathesis : from a lecture delivered in the Polyclinic Evening Lecture Course, March 12, 1889 / by Solomon Solis-Cohen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the inability to concentrate attention upon his work, the throbbings, the pains here, there, and elsewhere, the dis- turbance of the heart rhythm, the condition he terms li torpidity of liver,” for which the patient seeks relief— that condition, in a word, which tortures the patient with dread of impending mental failure, and which by physi- cians is so often carelessly mistermed “ neurasthenia ”— is to be ascribed not alone to the overloading of the cir- culation with uric acid, but also to direct and indirect impoverishment of the blood, from faulty assimilation due to failure of digestion. Too great a demand is made upon the digestive apparatus, and the energies that should be directed to other work are called upon to pre- pare an amount of food far beyond that necessary for purposes of force-production or tissue-building. The work is not done properly; and, as a consequence, the system suffers both from lack of the products of perfect digestion and from overplus of the products of imperfect digestion. Therefore, we must diminish the absolute quantity of food consumed, and must so regulate its quality as to produce the greatest amount of force with the least possible expenditure. We must, in addition, cut off those elements which, if undigested, are liable to undergo acid fermentation, thus increasing uric acid production. It is a mistake, I think, except in the worst cases, to interdict meat completely. We can allow one kind of meat at one meal, daily; giving the preference to “white meats,” but not abso- lutely excluding butchers’ meat. We must insist upon proper cooking—that is, broiling, roasting, or boiling; not too “well done” in the former methods, and not “done to rags” in the latter. Fish can often take the place of meat with advantage. Bread must not be used in excess, and gluten bread, or that made from the whole wheat and retaining the phosphates, is preferable to our ordinary white bread. Pastries and sweets are to be for-