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.

    18/334 page 8
    s any detail of its more ordinary form of manifestation in the foot or hand. Dr. Graves has justly remarked that there is no proposi- tion in pathology better established than that there exist several constitutional affections capable of generating and modifying local inflammatory action ; and that local inflam- mations depending on a constitutional cause, are subject to very different laws from those which regulate the phenomena of common inflammation. The cases which follow illustrate this in the case of gout as the constitutional origin of some local inflammations. I.—At the age of thirty-five, and at the close of autumn, some twenty years ago, Dr. B. had his first attack of gout. He had hereditary claims to the disease, and had long been familiar with the dyspeptic and nervous derangements which usually precede or accompany its development. More parti- cularly, he had often suffered from cardiac pain and uneasi- ness, from flatulent distention and acidity, from broken rest and depressed spirits. But with these exceptional ailments, he enjoyed good health, and continued in the discharge of professional duty. At the period referred to, he was under- going more than usual fatigue, and on returning from a long walk in the country was seized, suddenly and unexpectedly, with acute pain in the inner part of the left knee-joint, imme- diately in the line of articulation. He was instantly brought to a halt, and a minute or two elapsed before he was able to resume locomotion, which was now conducted homewards with considerable difficulty, in consequence of a painful sense of heat, swelling, and stiffness of the parts. In the course of a few hours the synovial capsule was distended with fluid, and motion was painful and restricted. The effusion in- creased still more, and early next morning, after a restless night, the knee-joint was greatly swollen and painful, without discoloration, however, of the surface, except what arose from
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image