Gout, with a section on ocular disease in the goutyLlewellyn, Llewellyn J. (Llewellyn Jones)
Science
Gout, with a section on ocular disease in the gouty
Llewellyn, Llewellyn J. (Llewellyn Jones)
Eye -- Diseases; Gout
But to return to the researches of physicians, those of Aretæus seem
to have been the most enlightened of his time. A succinct account of
the mode of invasion of gout and its centripetal spread in later stages
to the larger joints is followed by enumeration of the exciting causes
of outbreaks. Anent these, he quaintly notes the reluctance which the
victims display to assigning the malady to its true cause—their own
excesses—preferring to attribute it to a new shoe, a long walk, or an
injury. Noting that men are more liable than women, he tells us, too,
that between the gouty attacks the subject has even carried off the palm
in the Olympic games. The white hellebore, to his mind, at any rate in
early attacks, was the remedy _par excellence_. But, for the true nature
of the disease, he, with humility and piety, avows that its secret origin
is known only to the gods.
Not so his successor Cælius Aurelianus, who affirmed it to be not
only hereditary but due to indigestion, over-drinking, debauchery,
and exposure. Under their maleficent influence morbid humours were
generated which sooner or later found a vent in one or other foot, with
a predilection for tendons and ligaments; these structures he averred
being the locus morbi. An abstemious dietary with exercise was his sheet
anchor in therapy, with local scarification in preference to cupping and
leeching, but violent purging and emetics he decried, and drugs to him
made little appeal.
More ambitious than his predecessors, Alexander of Tralles, in the
sixth century, held that there were many varieties of gout, some due
to intra-articular effusions of blood, reminding us of Rieken’s view
(1829) that hæmophilia is an anomalous variant of gout. Other cases,
Alexander averred, were the outcome of extravasation of bile or other
peccant fluids between tendons and ligaments. Abstinence, especially
from wine and blood-forming foods, was enjoined and a plentiful use of
drastic purgatives, elaterium, etc., with local sinapisms and blisters.
For the absorption of chalk stones he commended unguents containing oil,
turpentine, ammoniacum, dragon’s blood, and litharge.
Aetius, a contemporary, is noteworthy in that during the intervals of
attacks he highly eulogised the use of friction while, like Alexander
of Tralles, he seems to have been much impressed with the virtues
of colchicum, of which he says, “Hermodactylon confestim minuit
dolores.” Planchon, in 1855, in his treatise, “De hermodactes au point
de vue botanique et pharmaceutique,” claims to have proved that the
hermodactylon of the ancients was _Colchicum variegatum_, of similar
properties to the _Colchicum autumnale_.
Public-domain text, read in full here on John Shaqi.
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