Contributions to practical medicine / by James Begbie.

  • James Begbie
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical medicine / by James Begbie. Source: Wellcome Collection.

    17/334 page 7
    frequently known this sensation occurring at intervals, for many weeks or months, as a precursory sign of a fit of gout. The skin is early affected in the gouty diathesis. It becomes dry and harsh, and in some places hot and itching ; the soles of the feet and palms of the hands are particularly obnoxious to these conditions. Urticaria, erythema, eczema, and psoriasis are ordinary attendants on the gouty habit* At this stage I have frequently remarked the deposit of the oxalates and oxalurates in the urine, and have found them afterwards dis- placed by, or alternating with, the lithates and lithic acid. The kidney begins to labour, and the function of the liver is impeded. Fulness and deep-seated uneasiness of the right hypochondrium are observed; the bowels are found torpid and irregular, and the secretions morbid ; and hemorrhoidal affections begin, for the first time, to manifest themselves. It is a curious fact in the history of gout, that its local mani- festation in the foot or hand is often impeded, interrupted, or altogether prevented, by the occurrence of a hemorrhage, especially from the bowels ; and, on the other hand, that gout is often successful in displaying itself in a regular form, and in so doing, bringing to a close a long-continued hemorrhagic discharge. Haemoptysis, haematemesis, and haemorrhoids, have thus been found to yield and disappear only on the occurrence of an attack of gout. Examples of these vicarious discharges, and anomalous conversions, will be found in the sequel, and as it is not my present purpose to describe the fit of regular gout, or delineate the gouty diathesis, I shall proceed at once to the illustration of the disease as it has occurred to me in practice, noting chiefly those signs or features which may be considered characteristic of its natural history, and avoiding * The offspring of gouty parents are often found affected with these skin disorders, without any other indication of the gouty diathesis ; and it is worthy of remark, thai in them the disorders arc found amenable to. a plan of treatment suitable to gout.
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