A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
The salts of iodine are generally supposed to have a special action in
removing the consequences of chronic fibrous inflammation in gout and
rheumatism. They often disturb the digestion and provoke troublesome
irritations of the skin and mucous membranes. In removing the sclerotic
{133} effects of gouty inflammation they do not exhibit the same
sorbefacient power which they show in their action upon the granulation
tissue of syphilitic origin. It must be admitted, however, that in
certain catarrhal affections of a gouty nature the iodides of potassium
and sodium are almost specific in their good effects. In the
pharyngeal, laryngeal, and bronchial catarrhs from which some gouty
persons suffer, where there is a dryness and irritability of the mucous
membrane, the administration of these salts produces the most prompt
and beneficial result. As solvents of uric acid they do not appear to
equal the salts of the organic acids.
As to the mode of administering salines in the treatment of the gouty
dyscrasia, it is hardly necessary to observe that it must vary with the
effect desired. As antacids in acid dyspepsia they should be given soon
after meals, and for this purpose the salts of soda are to be
preferred, for the reason that they not only neutralize excessive
acidity, but they increase the efficiency of the peptonizing process.
Where it is desired to introduce these salts into the circulation for
their solvent action, as diuretics or to assist the process of
sanguification, they should be given three or four hours after meals
and largely diluted with water.
Before concluding the consideration of the treatment of the gouty
dyscrasia it should be remarked that the ability of water as a solvent,
as a means of stimulating tissue-changes and eliminating waste, is not
generally estimated at its true value. The use of copious libations of
hot water in the treatment of gout, recommended by Cadet de Vaux in
1825, has been revived from time to time, and is at present attracting
considerable attention.
TREATMENT OF ACUTE ARTICULAR GOUT.--There are three distinct methods of
managing an attack of acute gout--the antiphlogistic, the expectant,
and the abortive.
The antiphlogistic method, in the strict application of the term, is
practically obsolete. Bloodletting, both general and local, brisk
catharsis and diaphoresis, with low diet, were formerly advocated as
the natural and imperative antagonists of gout as well as of all other
acute inflammatory affections. Carried to its extreme degree, this
method was deprecated by Sydenham and his disciples as tending often to
prolong the attack and precipitate the manifestations of atonic gout.
The natural reaction from the vigorous antiphlogistic practice was what
has been termed the expectant method.
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