A practical treatise on the diseases of children / By James Milman Coley.

  • Coley, James Milman.
Date:
1846
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / By James Milman Coley. Source: Wellcome Collection.

    421/492 (page 401)
    GOUT. 40] GOUT. This, like the preceding, is a disease of the fibrous structure ; but it differs from rheumatism by selecting the smaller articulations for its attack, and by a dark, pink, efflorescence on the surface. Lhe seat of articular gout is the ligamentous or white fibre connect: ing the affected joint, and the external redness indicates the locality of the deeper seated inflammation. This characteristic discoloration is a little elevated, limited in extent, and so exquisitely tender to the touch, that the least pressure even from the superincumbent sheet is sufficient to excite severe pain, which is increased by the excited and irritable state of the patient. At the beginning of the attack, a febrile state of the system prevails, and the urine is deficient and high coloured, and deposits a pink, amorphous sedi- ment, which adheres to the vessel in which it is deposited. The patient complains of constant pain, accompanied with loss of sleep and appetite. The duration of the first attack is short, seldom extending beyond two or three days; but the disease possesses the same migratory character as rheumatism. Hence, when it suddenly recedes, it is liable to attack other fibrous structures, as, the heart, pericardium, or the dura matral covering of the brain. This disease is both hereditary and acquired, in the adult: but in children it is always connected with a congenital organization, predisposing to its invasion, which only requires for its excitement the application of cold or external injury. L'reatment.—The same internal remedies as those I have recommended for rheumatism will be found equally efficacious in the treatment of gout. Cabbage leaves will also afford more local relief, than any other external application. When these cannot be procured or are objected to by the patient, a spirit lotion, as recommended by Sir C. Scudamore, will be a pleasant substitute. This lotion consists of one part rectified spirit, and three parts water. By this treatment, the external disease will be removed in a few days. In some cases puly. ipec. comp. with potassio-tartrate of antimony, may be given with advantage at bedtime, to allay pain. ‘The carbonate and sulphate of magnesia, and the colchicum must however be continued twice a-day for the space of a week or ten days after the local disease has retired. The disease of the internal organs produced by the Immigra- tion of gout, are, in children, always of an inflammatory nature, and must therefore be treated by the same means as primary inflammations, without regard to the name of the original affection. Much injury has been inflicted by that system of therapeutics, Z