Copy 1, Volume 2

The study of medicine. Containing all the author's ... improvements / [John Mason Good].

  • John Mason Good
Date:
1829
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Licence: Public Domain Mark

Credit: The study of medicine. Containing all the author's ... improvements / [John Mason Good]. Source: Wellcome Collection.

    686/724 (page 676)
    Gen. XII. Spec. IIT. a A. Pod- agra regu- laris. Gout-con- eretions, or -chalk. stones, as they are wrongly called. Urate of soda thrown off by the skin. CL. 111.] : HAMATICA. [ORD. 18. mination of the fit, but they become at length: so: con- tracted and disabled, that, although the patient can stand, and perhaps walk a little, yet itis very slowly, and with great lameness and difficulty. In many persons, though not in all, this immobility of the joints is further increased by the formation of concretions of a chalky appearance on the outside of them, and for the most part immediately under the skin. The secretion, or deposition of this matter is characteristic of the disease, being the consequence of gouty inflammation alone. It seems to be deposited at first in a fluid form, but afterwards becomes dry and firm ; in which state the concretions have the appearance of a friable earthy substance, and have been erroneously called chath-stones. By the investigations of Dr. Wollaston, however, it has been ascertained, that they contain no cal- careous or earthy matter; but consist of lithic or uric acid combined with soda, forming what the chemists term the hithate or urate of soda. These concretions occur prin- cipally about the joints of the toes and fingers in little nodules, which Sydenham compares to crabs’ eyes; but sometimes they appear about the larger joints, where they which becomes gradually inflamed and red. There is an instance of a very large concretion of this nature, re- corded in the surgical works of Sir E. Home. But per- haps the most curious case is that related by Mr. Watson: the patient, who was a raartyr to gout, had so extensive a deposition of urate of soda, that the concretions ‘not only enveloped the joints of his great toes; formed tumours on his legs, and rendered the synovia of the large joints as thick as cream, but “ the joints of the fingers were swelled and knotty, every knot being a lump of chalk ; and I was told (says Mr. Watson) that, when he played at cards, he used frequently to score up the game with his knuckles *.” It is singular, that our author, with his very extensive in- formation on all subjects connected with medical science, should have fallen into the error of describing gout-con- cretions as really composed of lime.]} It seems probable, that urate of soda has sometimes * See Medical‘Communications, vol. i. art. 3.