Rheumatism, gout, and some allied disorders / by Morris Longstreth, M.D.
- Longstreth, Morris, 1846-1914
- Date:
- 1883
Licence: Public Domain Mark
Credit: Rheumatism, gout, and some allied disorders / by Morris Longstreth, M.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![judging fi-om the records of some published cases, the disease has been prolonged beyond the time in which it would i^robably have recovered unassisted. The complaint is a stubborn one most generally, and re- quires assistance very judiciously applied. Remembering the disease is an inflammation which, untreated, usually runs a moderate course, it does not apj^ear judicious to make use of dej^le- tion, either local or general. The local depletion by leeches or scarified cups is apt to be harmful in the thinly covered joints such as the knee ; perhaps in the deeply seated ones, as the hip or shoulder, which, owing to their thicker covering can be less easily affected by other remedies, blood- letting may find its uses, and for the same reason is less likely to do harm. From the use of leeches I have seen both peri- and intra-articular sup- puration, and from the use of the scarified cups, both an increase of j^ain, inflammation, and superficial suppuration. Besides its liability to harm, the mode of procedure is certainly not frequently required. Cold, applied in the form of ice, is likewise not usually indicated. Cooling by evaporating lotions is much more frequently serviceable, and this may easily be carried out by a lead-w^ater lotion. Rest is essential, and the limb should be elevated when this can be done. I have found a bed of pillows raised above the bed quite as useful and much more comfortable than any fixed apparatus or splint which re- (]uires bandaging. When the shoulder is affected, but little can be done by these means, but a pillow, or pillow and splint, is easily arranged for the elbow. The knee-joint is much more frequently affected than any other, and I have met this indication for it by a light extension apparatus attached to the foot and ankle, with the limb properly elevated on the pillow and allowed to bend at the knee, si ace this is the most comfortable posi- tion for the joint when an effusion is present in it. The slight extension serves not merely to keep the limb quiet during sleep, but also to separate very slightly the inflamed surfaces. It is to be recommended as a source of ease to the patient; a similar appliance might be found of use when the hip is affected. Splints must be used with caution, since their fixation of joint favors a false anchylosis, unless their angle is frequently changed. An application which has served well in the earlier stages of the in- flammation—in fact as long as the inflammatory process continues—is a mixture of lead-water and laudanum. The full strength of these drugs in equal prof)ortion or slightly diluted with water is to be used. Let a cloth or piece of lint be saturated with the mixture, and placed over the in-](https://iiif.wellcomecollection.org/image/b21445333_0260.jp2/full/800%2C/0/default.jpg)
