Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    840/976 (page 820)
    solid, and tlie patient is reduced to a very weak state of health, inflammation and suppuration may arise, and pus mixed with white fragments is then freely discharged. It is not uncommon to find that patients in whom chalk-stones have been freely formed, have a great number of abscesses discharg- ing at one time, and it is astonishing to see how little disturbance of the system is produced by them. Occasionally five or six such abscesses will be open on each hand, and nearly as many on the feet; the free outlet thus given to the matter appears, in fact, to give relief to the system. Constitutional Symptoms in Chronic Forms of Gout.—It remains, before completing the description of chronic gout, to speak of the symptoms which accompany the changes of structure above de- scribed. It may be here assumed (a fact which will be afterwards proved) that the blood in chronic gout is always in an impure state, and we should expect, therefore, that symptoms indicating its irritating action upon various organs would be present. This is often the case, and chronic dyspepsia, accompanied with acidity, heart-burn, flatu- lence, pyrosis, and pain after food, are common accompaniments; the bowels are apt to be disordered, and the function of the liver impaired, palpitation and irregular action of the heart may be present, and ocasionally symptoms referable to the nervous and muscular systems, as cramps, twitcliings of limbs, nervous depression, and so forth. Although the patient is apt to be afflicted with some or even several of the above-named miseries, yet it is not always the case, for it would seem that in many such subjects the system gets gradually accustomed to the impurity of the circulating fluid, and it is only when there is an excess of such impurity that they become sen- sible of its presence. The urine of patients suffering from chronic gout, with extensive deposit of chalk-stones, is generally pale, of light weight, and often contains a little albumen; the occurrence of deposits is rare, except about the time of a paroxysm of a more acute character. Irregular Gout— The subject of irregular gout is one of no small difficulty, and requires careful handling in order to avoid falling into error. Some pathologists appear to assume that all the ailments which happen to patients subject to Gout, necessarily owe their origin to that diathesis, and hence the descriptions given of gouty pneumonia, gouty hepatitis, and many other inflammatory affections ; but a closer investigation of several so-called gouty complications has led me to believe that they are nothing more than ordinary forms of inflam- matory disease, modified, indeed, to some extent by the diathesis off the patient. A man with a gouty diathesis may be exposed to cold, and have pneumonia developed from such exposure, and yet the lung inflammation may not differ in its essential character from wliat occurs in a previously healthy person. Such a subject is, in fact, as liable I be attacked with inflammatory disease as any other individual; it is necessary, therefore that good proofs should be shown that