Volume 1
The household physician : a family guide to the preservation of health and to the domestic treatment of ailments and disease, with chapters on food and drugs and first aid in accidents and injuries / by J. McGregor-Robertson ; with an introduction by John G. McKendrick.
- M'Gregor-Robertson, J. (Joseph), 1858-1925
- Date:
- 1899
Licence: Public Domain Mark
Credit: The household physician : a family guide to the preservation of health and to the domestic treatment of ailments and disease, with chapters on food and drugs and first aid in accidents and injuries / by J. McGregor-Robertson ; with an introduction by John G. McKendrick. Source: Wellcome Collection.
502/602 (page 432)
![GOUT. [Sect. XIV. taineil, the child should be bathed at home daily in a bath containing Tidman’s sea-salt, and should be vigorously rubbed afterwards. Food is to be liberally allowed, especially sweet milk, eggs, soups, &c. Cod-liver oil is the chief medicine, and should be given for a long period, indeed long after health appears quite re-established. Most children learn to like it. Small doses should be given at first, half a tea-spoonful twice daily, and the dose should be gi’adually increased till a dessert-spoonful or a table-spoon- ful is being taken thrice daily. To those who, after patient trial, cannot get over the taste of the oil, malt extract or malt extract and cod- liver oil may be given. Another valuable medi- cine is iron, given as dialysed iron (4 to 10 drops (according to age) five times daily in watei'), or as syrup iodide of iron (a half to one tea-spoon- ful thrice daily), or as Parrish’s syrup of the phosphates, commonly called chemical food, given in a half to one or two tea-spoonfuls thrice a day. The cod-liver oil and the iron tonic may be given at the same time. Glands that have become swollen and painful ought not to be rubbed, nor irritated in any way (see p. 209). The oil and the syrup of iodide of iron ought to be persevered with, and the neck simply protected by a strip of flannel. Frequently the affected glands will recover under this treatment if not worried into suppuration. If, however, matter forms in the glands, the sooner a surgeon opens them the better. GOUT. Gout is a markedly hereditary disease, de- scending from parents to children in a very remarkable way. Men are more frequently at- tacked than women; the age most liable to the disease is between thirty and forty-five. The cir- cumstances that usually determine an attapk in those liable by inheritance to the disease, or that excite the disease for the first time, are habitual excess in eating, specially in the over-eating of animal food and rich dishes, long-continued ex- cess in drinking, especially strong wines, such as port, sherry, madeira, and malt liquors (beer and porter), and prolonged want of proper exercise. It appears also that persons subject in their occupation to the influence of lead are rendei’ed more liable to an attack, if other circumstances favour it. It appears that the disease is due to an excess in the blood of a substance called uric acid, either becau.se it is formed in the body in too large quantity, or because it is not removed from the blood by the kidneys in the urine as it ought to be. It is a disease specially apt to re- turn frequently, very slight causes being suffi- cient to determine an attack in those subject to it. Thus even a slight degree of indigestion, irregularity of bowels, cold, mental anxiety or worry or excitement may occasion a fit of the gout in gouty persons. Symptoms.—An acute attack of gout usu- ally comes on suddenly during the night with pain and swelling in a joint, commonly the joint that forms the ball of the great toe. The joint becomes not only much swollen, but also turns red and shiny, the veins on the foot and part of the leg being very marked. The pain is often extremely severe, and is burning or shooting in character. Other joints may also be attacked, the smaller ones specially. The least movement is almost unbearable, and even the weight of the bed-clothes is not endurable. Towai’ds morning the pain lessens, but next evening it returns, and this may continue for a week or ten days, when the severe symptoms pass away, though the joint remains swollen and tender for some time longer. However swollen the joint may be, matter does not form. Attending the joint affection there are general symptoms of distui'bed health, shiverings and sweatings, loss of appetite, white tongue, increased heat of skin, quick pulse, confined bowels, and scanty high-coloured urine, from which a brick-red deposit separates out on cooling. The sleep is much disturbed; cramps and startings of the muscles of the leg are common; and the patient is of very irritable temper. After the first attack the joint appa- rently quite recovers. As a rule the disease returns sooner or later, generally within a year; and not only does it tend to return, but the intervals between each “ fit ” become shorter. With the greater frequency of attack, more joints are liable to suffer—joints of foot, hand, ankle, knee, &c. As the disease becomes chronic the joints become permanently altered. They enlarge,anddeformitiesare produced,due largely to the deposit within the tissues of the joint of masses of urate of soda, called “ chalk-stones,” which not only form prominences and irregu- larities, but by being deposited ai’ound the joint tend to fix it in unusual and awkward posi- tions. Abscesses may form round the chalk- stones, from which they may be discharged, leav- ing ulcers. The general system tends to become affected and the ])erson to grow feeble and weak. Those who suffer from attacks of gout are often warned of an on-coming “fit” by symp- toms not well marked, but which, by expei’ience, they know too well the meaning of. Those](https://iiif.wellcomecollection.org/image/b28124674_0001_0502.jp2/full/800%2C/0/default.jpg)
