Chronic Gout.

– RUDDOCK.E.H,

DEFINITION. A persistent constitutional affection, characterised by stiffness and swelling of various joints with deposits of urate of soda.

SYMPTOMS. The deposits in the joints constitute the distinguishing feature; chronic stiffness and swelling of various joints, with pain, are considered as cases of Chronic Rheumatism. The original condition of the Chalk stone Deposits is that of a liquid, rendered more or less opalescent from the presence of acicular crystals; as the fluid part is absorbed, the consequently becomes creamy, and at last a solid concretion is produced. When the effusion is confined to the cartilages, unless very excessive, the injury to the mobility of the joint is comparatively slight; but when the ligaments are infiltrated, they are rigid, and the play of the parts is consequently interfered with. If a bursa has been infiltrated the resulting chalk stone is free and of uniform composition, but the distortion is considerable. The visible occurrence of chalkstones is not constant, but when external deposits do occur in any patient, no possible doubt can exist as to the nature of the case, for as the deposition of urate of soda in the tissues occurs only in Gout, its presence constitutes a pathognomonic sign (Garrod).

EPITOME OF TREATMENT.

Sub acute Gout. Colch., Sulph.

For the gastric symptoms. Ant. C., Puls., Rob., Merc., Nux V., Sulph.

LEADING INDICATIONS.

Colchicum. This drug exerts a powerful influence in diminishing the sub acute inflammation in old standing cases.

Pulsatilla. Wandering pains, especially when those dyspeptic symptoms exist for which this remedy is suited.

Antimonium Crud. Gastric derangements, white coated tongue, nausea; pains increase after eating; gouty nodes.

Nux Vomica. Sub acute attacks brought on or aggravated by indulgence in wine, heavy suppers, or late dinners. Constipation, Piles, Spasms, etc., are additional indications.

TREATMENT OF GOUTY DEPOSITS. The following simple method Sir William Broadbent has found effectual Wrap the hands in linen or flannel dripping with water, warm or cold, and enclose them in a water proof bag all night. This very speedily removes inflammatory stiffness, and little by little the concretions of urate of soda soften, frequently disappearing entirely. Sir W. Broadbent has, in other cases, applied alkaline solutions, and water acidulated with Nitric Acid to one hand, while water alone has been applied to the other, and has come to the conclusion that water is the agent in the process of removal.