Medical Inquiries and Observations, Vol. 2: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
Science
Medical Inquiries and Observations, Vol. 2: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
I shall now briefly enumerate the symptoms of the gout, as they appear
in the ligaments, the blood-vessels, the viscera, the nervous system,
the alimentary canal, the lymphatics, the skin, and the bones of the
human body, and here we shall find that it is an epitome of all disease.
I. The ligaments which connect the bones are the seats, of what is
called a legitimate or true gout. They are affected with pain, swelling,
and inflammation. The pain is sometimes so acute as to be compared
to the gnawing of a dog. We perceive here the sameness of the gout
with the rheumatism. Many pages, and indeed whole essays, have been
composed by writers to distinguish them, but they are exactly the same
disease while the morbid actions are confined to this part of the body.
They are, it is true, produced by different remote causes, but this
constitutes no more difference in their nature, than is produced in
a coal of fire, whether it be inflamed by a candle, or by a spark of
electricity. The morbid actions which are induced by the usual causes
of rheumatism affect, though less frequently, the lungs, the trachea,
the head, the bowels, and even the heart, as well as the gout. Those
actions, moreover, are the means of a fluid being effused, which is
changed into calcareous matter in the joints and other parts of the
body, exactly like that which is produced by the gout. They likewise
twist and dislocate the bones in common with the gout, in a manner to be
described hereafter. The only difference between what are called gouty,
and rheumatic actions, consists in their seats, and in the degrees of
their force. The debility which predisposes to the gout, being greater,
and more extensively diffused through the body than the debility which
precedes rheumatism, the morbid actions, in the former case, pass more
readily from external to internal parts, and produce in both more acute
and more dangerous effects. A simile derived from the difference in the
degrees of action produced in the system by marsh miasmata, made use of
upon a former occasion, will serve me again to illustrate this part of
our subject. A mild remittent, and a yellow fever, are different grades
of the same disease. The former, like the rheumatism, affects the bones
chiefly with pain, while the latter, like the gout, affects not only the
bones, but the stomach, bowels, brain, nerves, lymphatics, and all the
internal parts of the body.
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