The modern practice of physic, exhibiting the characters, causes, symptoms, prognostics, morbid appearances, and improved method of treating the diseases of all climates / by Robert Thomas.

Date:
1810
Catalogue details

Licence: Public Domain Mark

Credit: The modern practice of physic, exhibiting the characters, causes, symptoms, prognostics, morbid appearances, and improved method of treating the diseases of all climates / by Robert Thomas. 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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    When the paroxysm has thus taken place, although there is an alle- viation of pain at the expiration of some hours, still the patient is not e»- tirely relieved from it, and for some evenings successively he has a return both of pain and fever, winch continue with more or less violence until morning. In time the paroxysms, however, prove more mud every day, till at length the disease goes off either by perspiration, urine, or some other evacuation; the parts which hqve been affected becoming itchy, the cuticle failing off in scales from them, and some slight degree of lame- ness remaining. * At first, an attack of gout occurs, perhaps, only once in two or three years; it then probably comes on every year, and at length it be- comes more frequent, and is more severe and of longer duration each succeeding fit. In the progress of the disease various parts of the body are affected, and translations take place from one joint or limb to another7 and after frequent attacks the joints lose their strength and flexibility, and become so stiff' as to be deprived of all motion. In some instances, little swellings of a very hard nature arise in the joints of the fingers, to which a late writer # has applied the title of nodosities. Concretions of a chalky nature are likewise formed upon the outside of the joints, and nephritic affections of the kidneys arise, from a deposit of the same kind of matter in them, which although fluid at first becomes dry and firm at last, and when put into acids is perfectly soluble. It sometimes happens, that although a gouty diathesis prevails in the system, yet from certain causes no inflammatory affection of the joints is produced; in which case, the stomach becomes particularly affected, and the patient is troubled with flatulency, indigestion, loss of appetite, eructations, nausea, vomiting, and severe pains ; and these affections are often accompanied with much dejection of spirits, and other hypochon- driacal symptoms. In some cases the head is affected with pains and giddiness, and now and then with a tendency to apoplexy ; and in other cases the viscera of the thorax suffer from the disease, and pal- pitations, faintings, cramps, and asthma arise. This is what is called atonic gout. It likewise happens sometimes, that after the inflammation has occu- pied a joint, instead of its continuing the usual time and so going off gradually, it ceases suddenly, and is translated to some internal part. The term of retrocedent gout is applied to occurrences of this nature. W hen it falls on the stomach, it occasions nausea, vomiting, anxiety, or great pain, with a sensation of coldness in the epigastric region: when on the heart, it brings on a syncope ; when on the lungs, it produces an affection resembling asthma; and when it occupies the head, it is apt to give rise to apoplexy or palsy. A third species of irregular gout is the misplaced, which implies where the gouty diathesis, instead of producing the inflammatory affec- tion of the joints, occasions an inflammatory affection of some internal * See Dr, Haygarth’s Clinical History of Diseases. L