The student's guide to medical diagnosis / by Samuel Fenwick.

  • Samuel Fenwick
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to medical diagnosis / by Samuel Fenwick. Source: Wellcome Collection.

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    rigid from infiltration with urate of soda. The blood m gouty persons also contains the same substance, and in some instances oxalic acid has been detected Microscopically, the urate of soda appears in the form of fine crystalline needles or prisms closely interlaced (see fig 103). Chalk stones, which consist also of urate ot soda or lime, are apt to form in the helix of the ear the joints of the fingers, and other exposed parts of the body. r A first attack of gout generally takes place in the bail of the great toe. It may occur suddenly or be preceded by symptoms of dyspepsia. During the mght the part becomes painful, red, swollen, and very tender the veins proceeding from it being distended with blood. After a day or two the swelling in- creases, the pain lessens, the skin becomes cecfema- tous, and as the attack subsides the cuticle generally desquamates. The fit usually recurs within twelve months, and as time goes on a number of the articu- lations become affected at once. Gout is hereditary; it never attacks children, and men are more liable to it than females, who seldom suffer from it until after the cessation of the catamenia It is apt to be induced by free indulgence in wines' and malt liquors, by excess of animal food, and by severe mental exertion. Workers in lead are especially liable to be affected by it. 459- Acute gout may be distinguished from rheu- matic fever by the former usually affecting men of middle or advanced age, the latter young persons of either sex. Gout usually attacks the smaller Joints and persists for some time; as the pain lessens the skin becomes oedematous and the veins distended Acute rheumatism affects the larger joints, rapidlv changing from one to the other ; the skin over them is not shining, and there is no oedema. I „ acute gout the temperature is not high, the pain is worst at nights, the skin does not perspire freely, and there is usually a history of a previous attack which had u