A treatise on gout / Sir Dyce Duckworth.

  • Dyce Duckworth
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on gout / Sir Dyce Duckworth. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    chronic rheumatic or rheumatoid arthritis, often miscalled (as I think) rheumatic gout. All that it is proposed to treat of in this volume relates to true and unequivocal gout, as distinguished from all other forms of disease which affect and disable joints. Articular gout is only a variety of gout, the best-marked forms of which constitute the extreme outcome of the malady. Unlike other forms of arthri- tis, in which disorder is mainly or altogether confined to the structures of joints, gouty arthritis is only a part of a widespread disease affecting variously many other parts of the body. It is this character which has led to the application of the term protean to gouty manifestations,—a term not, perhaps, inap- propriate, but one which has no doubt sheltered much hasty and erroneous diagnosis.1 As will be shown later, many troubles may occur in a gouty person which are not truly gouty ; and certainly many such occur in non-gouty persons which are wrongly attributed to gout, albeit, in a truly gouty individual, any disturbance of the balance of health is apt to be modified specially by the diathetic habit of body. Hence, I cannot accept Ebstein's dictum that we must seek the causes of gout in the place where uric acid is formed. Before proceeding to discuss the specific relations of uric acid to gout, as commonly recognized, it will be well to endeavour to gain as large and comprehensive a view of the entire chain of morbid events as possible. In the first place, we have to face the fact, that although the disorder is very widely spread, it is not universal. As is the case in respect of rheumatism, not every one is or can become rheumatic; so, I believe, not every one is or can become gouty. Rheumatic proclivity is, however, greater and more widely spread than gouty proclivity. Nothing is better established in the nature of gout than its hereditary transmission. Where in any community there is most gout, there has probably been much gout in the ancestry. It is also believed that the disease may be induced or newly acquired, or, at any rate, so far as careful inquiry allows past family history to be invoked, the disease occurs in persons who can trace no overt inheritance of the tendency. Without doubt, one is on difficult ground here, for none so well know the fallacies surrounding inquiries into family history as those who have been at the pains honestly to try and learn it. In the case of gout, however, we may be the more 1 Almost every sj'mptom, from an eruption on the skin to threatening apoplexy, may be gout.—Herbert Mayo, F.R.S., Philosophy of Living, p. 25, 1837.
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