Uric acid in the clinic : a clinical appendix to "Uric acid as a factor in the causation of disease" / by Alexander Haig, assisted by Kenneth G. Haig.
- Date:
- 1910
Licence: In copyright
Credit: Uric acid in the clinic : a clinical appendix to "Uric acid as a factor in the causation of disease" / by Alexander Haig, assisted by Kenneth G. Haig. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![Five montlis later said that everyone congratulated him on his general appearance and B.D. has improved to -9 or -95. I now gave some bicarbonate of soda to see if that would diminish pains and flatulence by increasing solubility. . . . Three months later, however, it had rather increased the pain (just as it does in acute or chronic rheumatism, till you get enough alkali to produce coi7iplete solution and removal). Had a fall which increased pain in one leg. Pulse 76 ; C.R. 6 ; B.P. 135. Still has morning headache. I then began to try retentives, as solvents rather made the pain worse, but they also did no good as they were unfortimately being used in the heat of July when their retention was overcome by the heat. I then gave aspirin, and this did good, especially when he was able to keep cool. Two months later he was distinctly better, but only taking aspirin occasionally. Pulse 72; C.R. 6; B.P. 140. Still some headache, still clearing out. Urea 2-5 gr. per lb. Six months later had had a rigor and vomiting in the night (temperature 103, pulse 120), and could digest nothing for some days after. Since that was taking a little meat once a day for six weeks. His joints, however, are better, as he now walks with one stick in place of two as at first. Is beginning to walk in place of hobbling. Aspirin does most good for the joints, but tends to increase dyspepsia {i e., collcemic dyspepsia). Three months later had had no more fever or rigors. Pulse 64 ; C.R. 6; B.P. 145 (tends to rise). Urea still about 2-5 gr. per lb. He is a stout man, 13 to 14 st. (and we have possibly someivhat over-estimated his real [bone and mtiscle] tueight, and as B.D. is improving he is probably having enough proteid, especially as there wre noio no signs of heart lueakness). He is now getting longer intervals without pain in his joints. Soda bicarbonate to extent of 60 gr. a day now does some good. This is a matter of relative quantities of uric acid and solvent; the quantities of urate in the body are diminishing, and now this dose of soda can hold it in solution. The objection to increase of potatoes is that they seem to increase his vpeight, otherwise potato would do in place of soda. Five months later is considerably better as to joints, but still has a good deal of flatulence (possibly, as lue shall see later, a part of this was due to organic irritation). Pulse 72; B.P. 145; first sound long, second sound loud {collcemic lieart). Five months later, having now been nearly three and a half years on diet (three years of collcemia and clearing out of deposits), he was not feeling so well; appetite for breakfast had diminished, so he was only taking two meals a day and had lost some weight. After this, however, he improved, and urea went up to nearly 3 gr. a pound. His joints were all much better, and his chief com- plaint now was the flatulence. He finds bicarbonate of soda useful in the cold weather, though it makes the joints a little worse when he first takes it. My last record of him was: pulse 84; C.R. 6-5; B.P. 145. (Was there an organic factor here also?) B.D. '95 (a great improvement on its original condition). Weight 13 st. 5 lb., steady now. I never saw him again, and he died four months later with symptoms of gall-stone colic complicated with inflammation of the bowels and pneumonia, a condition which was considered to preclude any opera- tion ; he died in twenty days from the onset of the colic. (Evidently the rigor nearly two years before was due to gall-stone irritation, and not to mere liver chill.) A letter from a son telling me of his father's death ends by saying : We are a,ll agreed that the treatment which you advocated for my father gave him freedom from pain and lengthened his life. Yes, it relieved the joints as the urates were slowly excreted, and the pains diminished as he began to get clear, but it caused three years of coUaemia, and this may have been at least a part cause of the gall-stones by rendering the bile, like all other secretions and](https://iiif.wellcomecollection.org/image/b21994109_0251.jp2/full/800%2C/0/default.jpg)
