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.

    861/976 (page 841)
    The character of the beverages used by these different people, has probably more influence upon the production of Gout than the climate under which they live. As far as regards the development of an attack, climate and season have a very decided influence ; for example, a gouty man may often escape his accustomed winter attacks by removing from England to Malta or Egypt during the cold season in this country; and the his- tories of gouty patients afford abundant proof of the comparative frequency of gouty seizures in the winter months. In the early stages of Gout the attacks are most frequent in spring, and are often confined to that season ; after a time an autumnal seizure is added; but when the disease has become further engrafted into the system, the fits may occur at any season, and at most irregular intervals. There are occasionally found exceptions to the above rules, for some patients, owing probably to individual peculiarities, suffer far more in summer than in winter. In warm climates and during hot seasons the function of the skin becomes more active, and this fact affords an explanation of any influence dependent on these circumstances. Influence of Lead Impregnation in causing Gout.—About fifteen years since I was struck with the fact that a large percentage of the gouty patients which had come under my care in hospital practice consisted of painters, plumbers, or other workers in lead, and a more careful investigation of the subject forced the conclusion on my mind, that the influence of this form of metallic impregnation in inducing a gouty condition of the system was very considerable.* Since that period I have made many observations on the point, and the con- clusions may be summed up in a few words :— 1. Among the patients in London hospitals, a very large propor- tion of the gouty (about 30 per cent, in my hospital practice) have been subjected to the influence of lead; many of these have had painters’ (lead) colic; some have suffered from wrist-drop or more severe forms of lead paralysis; and all have exhibited the peculiarly characteristic blue line on the gums. On careful inquiry into the habits of these men, nothing remark- able has been elicited; they have been about as temperate as other men employed in different occupations. It is not painters alone who form this high percentage, but plumbers, composition doll makers, workers in lead mills, and others whose trades have caused them to be exposed to the use of lead. It may be considered as established, that the metal lead acts as a powerful predisposing cause of Gout. 2. Many cases have occurred which have induced me to believe that individuals suffering from the gouty diathesis are more suscep- tible of the influence of lead than the majority of other people. It is a well-known iact, that when the drinking water in any house is slightly impregnated with this metal from the cistern or pipes with transactions of Medico-Ckirurgical Society, vol. xxxvi. 18G4.