The modern practice of physic, which points out the characters ... and improved method of treating the diseases of all climates / [Robert Thomas].

  • Thomas, Robert, 1753-1835
Date:
1834
Catalogue details

Licence: Public Domain Mark

Credit: The modern practice of physic, which points out the characters ... and improved method of treating the diseases of all climates / [Robert Thomas]. Source: Wellcome Collection.

    1051/1054 (page 1029)
    During a paroxysm of the gout, if the attack is severe, it may be necessary to confine the patient in bed, keeping the inflamed parts of a moderate temperature. The confinement of morbid heat by covering of a very warm nature, might only serve to increase pain and prolong the disease. He is at the same time to be kept as quiet and free from all irritation as possible; and as gouty people are generally captious, from the severity of the pain which they suffer, they should be solaced, and not be thwarted. If the patient is young and plethoric, he should abstain from all sorts of animal food, aromatics, and fermented liquors; living on water-gruel, panado, sago, arrow-root, and other farinaceous sub¬ stances. His drink should be some mild diluting beverage, such as barley-water, toast and water, or tea. In elderly people, where the tone of the stomach is weak, or where the patient has been in the constant habit of using strong liquors, and of living principally on animal food, a more generous diet, with a moderate use of wine, may be allowed ; and as Madeira and Sherry wines are the least apt to become acid on the stomach, they ought therefore to be used in preference to any other kind. The fostering of arthritic inflammation by the topical use of increased temperature, or covering the parts with flannel, &c., together with the internal employment of stimulant medicines, with a view to obviate its retrocession, and ensure its final extinction, on the part affected, is supposed, by Dr. Kinglake,* to be a very erroneous practice, and as repugnant to the indication of relief furnished by every constitutional feature of the disease. He tells us, that observation and reflection have forced on his conviction the fact, that however loose the analogy may be between the respective proximate causes of ordinary phlegmonous and arthritic inflammations, the resemblance is sufficiently close in the degree of concomitant temperature. In both, the vascular actions of the system, and of the part affected, generate a morbid excess of heat, alike referable to distempered conditions of motive power. Impressed with the persuasion that with regard both to inordinate temperature, and to its general as well as topical mani¬ festations, a radical similitude subsists between these nominally different inflammations, it has appeared to him strictly warrantable to institute a perfectly similar plan of cure, viz. that of reducing heat by keeping cloths wetted with cold water constantly to the parts affected. In support of the efficacy of this plan, he recites several cases which were successfully treated by topically abstract¬ ing the stimulus of heat from the parts by water and such other cold media. We are further told by him, that he thinks himself justifiable in drawing the following inferences; viz. that a high temperature, whether the cause or effect of the morbid conditions of vital power, which proximately constitute gout, is safely and speedily * See liis Treatise on the Gout.