A treatise on gout / by Sir Dyce Duckworth.

  • Dyce Duckworth
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on gout / by Sir Dyce Duckworth. Source: Wellcome Collection.

    27/506 (page 3)
    rheumatic fever as an excretory fever. ^ Parkes ^ wrote : I define gout, after Garrod, as a febrile affection, with inflammation about joints, leading to a deposit of urate of soda. The essential elements in any case of gout relate, therefore, to peculiarity of diathesis, to diminished alkalescence of blood, owing to impregnation with uratic salts, and to the deposition of the latter, especially in the textures of joints. Sometimes the local mani- festations prevail more than the constitutional. Again, the latter may be alone prominent, without marked articular element in the case, as evinced in instances of incomplete or irregular gout. In some cases we meet with alternations of local and constitutional disturbance. The main conception of gout should have regard to its consti- tutional nature, and to the essential unity of the disorder, whether manifested in acute and regular, or in chronic and irregular fashion. In one sense the malady is always chronic, since we must regard any one having once given evidence of unequivocal gout as goutily disposed for his lifetime. Eespecting what is often called poor gout, or poor man's gout, it must be stated that many of such cases can be plainly referred to chronic rheumatic arthritis. Others are as plainly examples of true gout as can be demonstrated. They occur in persons of feeble constitution with faulty circulation and digestive incapacity, and who are prone to early textural decay. They are often quite temperate, but not always so. Women are sometimes the subjects of poor gout. It may, and often does, appear before the third or fourth decade; this is always a feature indicating gravity in any case, and is due to strong hereditariness. More than fifty years ago. Dr. Billing wrote : ^ Temperate persons have gout, because they have, whether hereditarily or not, a feeble nervous system and weak digestion. Abstemiousness will not cure such gout, which is called ' poor gout,' that which has come on in weak constitutions without excess. Some cases of this class are simply examples of incom- plete gout, and, by excess, they might eventuate in more sthenic and frank forms of the disease. I think I have made it plain that no brief or trite definition of this malady will suffice to explain its varied characters. A fitting conception of it now demands, with increasing knowledge, a com- prehensive survey of a very large field of pathological processes. • ^ Laycock, Medical Observation and Research, and edit., p. 124. Edinburgh, 1864. * The Composition of the Urine, i860, p. 292. ^ Principles of Medicine, p. 183.