Gout and goutiness : and their treatment / by William Ewart.

  • William Ewart
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Gout and goutiness : and their treatment / by William Ewart. Source: Wellcome Collection.

    29/612 (page 13)
    Our medical language betrays the impression that there is a constitutional background for the local events. We speak of the manifestations of gout. Again, such terms as 'latent,' 'retrocedent,' 'suppressed,' 'and 'visceral' gout can only apply to some internal affection. Swollen joints are not inherited, but we say of gout that it is hereditary. The word ' diathesis' also conveys, though in a nebulous form, the same interpretation. The clinical evidence in favour of the existence of a constitutional aspect of gout will probably be regarded as sufficiently strong to compensate for the almost negative pathological evidence. Constitutional gout often exists apart from its articular manifestations, which may not evolve till late, or even at all. The verbal difficulty which this admission implies may be lessened by the use of the term ' declared gout' for all cases in which the articular complication is developed ; whilst ' goutiness ' would con- veniently express the varied constitutional disturbances not associated with articular mischief, which are in many subjects the alternative expression taken by the affection. GOUT A PERVERSION OF NUTRITION. The skin of gouty people, their tissues, the incidents in their clinical history, and their functions, particularly those of the nervous system, all tell the same tale of delicacy, vulnerability, and excessive response to stimu- lation. The change is a pervading one. The skin is thin and vulnerable; the mucous membranes frail and irritable ; the nervous system quick and excitable. Yet we do not attempt to localize the disease in connec- tion with the skin, with the mucous membranes, or with the nervous system. The condition is one affecting the entire body and each cell within it, even the germ-cells sharing in the alteration, and transmitting it to the