The Croonian lectures on some points in the pathology of rheumatism, gout and diabetes : delivered at the Royal College of Physicians, London, March 30, April 1, 6, 1886 / by P. W. Latham, M.A., M.D., F.R.C.P.

Peter Wallwork Latham

Date:: 1887

Credit: The Croonian lectures on some points in the pathology of rheumatism, gout and diabetes : delivered at the Royal College of Physicians, London, March 30, April 1, 6, 1886 / by P. W. Latham, M.A., M.D., F.R.C.P. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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$patient,—not, as in former times, to sweat the poison out of him; and the cooler he is kept the sooner will the temperature be lowered. In fever increased heat increases the metabolism, just as in a cold-blooded animal*. These are the seven rules upon which I act. I have given the true salicylic acid, where there have been both aortic and mitral mischief; and I have also given it in rheumatism com- plicated with pericarditis, and as yet I have seen no bad result from it. Of course, in cases of pericarditis, accompanied with delirium, the use of the remedy requii'es caution; you cannot tell when the system is saturated with the remedy, and you must therefore trust to smaller doses and other means for controlling the disease. Further, if pericarditis or endocarditis, pneumonia, or pleurisy, have been developed, the remedy is powerless over the mischief which is done; it will neutralise the poison producing the mischief, so as to stop its extension; but the inflammatory exu. dations will undergo their usual changes unabbreviated in their course. We see the same thing in tonsillitis. Given early enough, salicylic acid will stop the mischief; but if exudation of lymph have taken place, salicylic acid is powerless to cause its absorption. There is another important point to be noticed here. In my first lecture I showed that, from condensation of two molecules of rOH ICN' ^^^^^^ ^^^'^ carbonic acid could be formedt. By seizing therefore upon this antecedent of glycocine, salicylic acid lessens the formation both of uric acid and of lactic acid. During the administration of even large doses of salicylic acid in rheumatism, a certain amount of uric acid is still sometimes excreted by the kidneys. How is this to be explained 1 As the molecular constituents of albumen fall asunder, the , , ^„ rCNOH , , , molecule CH^ \c]si-OH become detached, and as it passes from CH * Stirling and Landois, Physiology, p. 451. t See p. 27.$