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.

    420/506 (page 394)
    changes may prove complications, demanding treatment on general principles. Most often, we have to deal with some degree of tumidity, and more or less hepatalgia. The portal venous system may be engorged, and piles may result. Gastric catarrh is a necessary concomitant. Constipation may result, and the stools be paler than natural, and knotty in chai'acter. Attacks of this nature coiastitute a variety of visceral gout. The tendency for uric acid to be retained in the liver in persons of gouty habit must be borne in mind, and such retention cannot fail to be noxious in various ways. Headache, mental depression, irritability of temper, and lassitude, with loaded uratic urine, are but some of the symptomatic indications. Mercurial purgation and sodium salts, with colchicum, prove effectual in I'elieving these troubles, and alkalies with chloride of ammonium are also of value. Biliary Calculi.—The same line of treatment is proper when biliary calculi form, and threaten to pass. Restricted diet is of great importance, and farinaceous food is sometimes to be spar- ingly used in these cases. Fish, thin broths, and green vegetables are rather indicated than more concentrated liquid nourish- ment. Many mineral waters are of great value. Exercise is imperatively necessary, and biisk walking or riding are the best forms of it. Glyeosupia and Gouty Diabetes.—Glycosuria is one of the most marked symptoms of hepatic gout. I have alread}' discussed the causation and symptoms of this disorder at length. It is before all things important to recognize the arthritic element in these cases. The treatment is in the first instance regulated by such recognition. As in other forms of the malady, it is fortunate if the glycosuria be early detected. The amount of urine daily passed, and the degree of saccharine impregnation should be ascertained, as also the influence of digestion on the amount of sugar. The patient's weight should be taken weekly or monthly. At first, it will certainly be proper to employ re- stricted diet, and to watch its eSccts carefully. The glycosuria may, or may not, pass off completely, and if it disappear, the diet may be made more natural by degrees. Digestion must be kept at the highest standard. It will generally be found that the patient is conscious of better digestion when the special diet is not too strict, or too long persisted in. If there is a strong gouty tendency, fish and fowl, and avoidance of red meats may be beneficial; and whatever is bad for gout will in any case be bad for the glycos- uria. It is usually found in the earlier stages that the sugar is easily removed by dietetic measures alone.