On gout as a peripheral neurosis / by Willoughby Francis Wade.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: On gout as a peripheral neurosis / by Willoughby Francis Wade. 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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    teachiDg looked upon the joints as the seat of the trouble. The circumstances previously stated led me to investigate the matter impar- tially and de novo. What did I find ? In the first place that passive movement of the joint surfaces upon themselves, the first phalanx held firmly between finger and thumb and all possible pressure made upon the joint was absolutely painless. There was no evidence of fluid in the joint. It is impossible without cutting into it to obtain stronger evidence that the joint was healthy. On critical examination the tenderness was and will be found as above mentioned in one or more of three situations. If we look at Swan's demonstrations (pi. xxiv., fig. 2), we find that two branches of the internal plantar nerve lie one to the outer side and one to the inner side of the plantar aspect of the great toe. I have demonstrated to myself on myself many scores of times that what appears on off-hand examin- ation to be tenderness in the great toe-joint is really one or two lines of tenderness occupying