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.

    31/612 (page 15)
    LESSENED TISSUE RESISTANCE diseases of metabolism is properly applied, and to these belong, among others, gout and obesity. In some of the peculiarities of both affections we trace indications of a slowing rather than of an acceleration of the metabolic changes. This view has been ably put forward by Professor Beneke, and subsequently by Pro- fessor Bouchard, under the significant titles of ' maladies par ralentissement de la nutrition ' and of * nutritions retardantes.' But it would be rash at this stage to dogmatize on so abstruse a subject. We must bear in mind that the fault may be not so much in the rate as in the direction which metabolism may assume. In the end-products we certainly have to deal with errors in pro- portion—too much fat in one case, too much uric acid in the other. This would rather suggest a deviation from the normal chemical routine than a mere alteration in its rate. LESSENED TISSUE RESISTANCE IN GOUT. As regards fimction, the direct outcome of this intimate derangement of nutrition is a lowered resistance of cells, tissues, and organs. Gout is evidently a disease of diminished resistance, and, in that sense, of debility—an important point to be remembered in connection with treatment. In the individual case the resistance may be diminished m some special direction, i.e., one organ or system may be specially susceptible, and the goutiness will then lead to well-defined symptoms ; or it may remain widely distri- buted, without special locahzation, and ill defined in its manifestations. The joints stand out among all other tissues as least resistant to the gouty influence. Their susceptibility is characteristic of gout, though it cannot be regarded as an exclusive, universal, or absolutely essential feature. Their