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 expectant method may be said to be founded upon the aphorism of
Mead that "gout is the cure of gout." The discovery of the salts of
uric acid in the blood-serum and in the affected tissues gave a
scientific basis to the humoral pathology of gout and led to the
formulation of definite principles in the application of the expectant
method of treatment. These principles are the prevention of the further
accumulation of the urates in the blood and the promotion of their
oxidation and elimination. The first principle involves restriction to
a rigid diet during the attack, excluding albuminous foods and the
fermented preparations of alcohol, and allowing only milk and
farinaceous gruels. The oxidation of the urates is encouraged by the
administration of alkalies and by an abundant supply of air, the
inhalation of oxygen even having been recommended. The elimination of
the urates is accomplished chiefly {134} by diuretics and moderate
catharsis. The local treatment commonly used with this medication
consists in the application of alkaline and anodyne fomentations or of
dry flannel or cotton. Local bloodletting and blistering are now rarely
commended. Under this treatment the intensity of the inflammatory
process is abated, the suffering is allayed, but the progress and
duration of the disease are not materially modified. The recovery,
however, is satisfactory, and it is claimed that the chances of early
recurrence of the attack are diminished. This method has many
advocates, though it cannot be said to represent the common practice of
the present day. It is becoming traditional, and may be said to be
gradually giving place to the specific or abortive method.
The abortive method consists in cutting short the attack by the
administration of colchicum, veratria, or the salicin compounds.
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