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Retrocedent Gout





Category: Constitutional Diseases

This is a term applied to serious symptoms which
sometimes go with rapid improvement of the local joint conditions. There
are severe pains in the stomach, nausea, vomiting, diarrhea, pain in the
heart, difficult breathing, palpitation, irregular and feeble action of
the heart with brain symptoms, probably from uraemia. These attacks often
cause death.

Chronic Gout, Causes, etc. Frequent acute attacks; many joints, beginning
with the feet, become stiff and deformed, perhaps with no motion. The
overlying skin may ulcerate, especially over the knuckles. Dyspepsia,
arterio-sclerosis, enlargement of the left ventricle of the heart and a
great quantity of urine with low specific gravity are common. The patient
is morose and irritable. Eczema, chronic bronchitis, frequently complicate
the case.

Death often occurs from uraemia, meningitis, pleurisy, pericarditis or
peritonitis.

Treatment, Preventive. Live temperately, abstain from alcohol, eat
moderately, have plenty of fresh air and sunshine, plenty of exercise and
regular hours. These do not counteract the inherited tendency. The skin
should be kept active, if the patient is robust, by the morning cold bath
with friction after it; but if he is weak and debilitated, the evening
warm bath should be substituted. The patient should dress warmly, avoid
rapid alternations in temperature, and be careful not to have thc skin
suddenly chilled.

Diet in Gout. Most persons over forty eat too much. Eat reasonably and at
regular hours and take plenty of time to eat. Do not eat too freely of
meats and avoid too much starchy and sugary foods. Fresh vegetables and
fruits may be used freely, except cranberries and bananas.

Dr. Osler of England says. While all stimulants are injurious to these
patients some are more so than others, particularly malted liquors,
champagne, port and a very large proportion of all the light wines. Take
large quantities of water on an empty stomach, mineral waters are no
better than others, but treatment of chronic and irregular gout at springs
gives the advantage of regular hours, diet, etc.


purpose of locating piece of needle. Photo by P. M. Campbell, Detroit,
Mich.]

CONSTITUTIONAL DISEASES 317

Diet from a prominent hospital for gout patient:--

May Take--

Soups. Fresh fish soups, vegetable broths clear.

Fish. Raw oysters, fresh fish, boiled.

Meats. Fat bacon, boiled or broiled chicken, game (all sparingly).

Farinaceous. Cracked wheat, oatmeal, rice, sago, hominy, whole wheat
bread, or biscuits, rye bread, graham bread or rolls, crackers, dry toast,
milk toast, macaroni.

Vegetables. Mashed potatoes, green peas, string beans, spinach, cabbage,
cucumbers, cresses, lettuce, celery.

Desserts. Plain milk pudding, junket, rice and milk, sago and milk,
stewed fruits, all without sugar.

Drinks. Weak tea (no sugar), milk, buttermilk, toast water, pure water,
cold or hot.

Must Not Take--

Veal, pork, goose, duck, turkey, salted, dried, potted or preserved fish
or meat (except fat bacon), eels, mackerel, crabs, salmon, lobster, eggs,
rich soups, gravies, patties, tomatoes, sweet potatoes, asparagus,
mushrooms, rhubarb, lemons, pickles, vinegar, fried or made dishes, rich
puddings, spices, pies, pastry, sweets, nuts, dried fruits, tobacco,
coffee, cider, malt liquors, sweet wines, champagne.

Treatment. In an acute attack raise the affected limb and wrap the "sick"
joint in cotton wool; warm fomentations may be used. The wine or tincture
of colchicum in doses of twenty to thirty drops may be given every four
hours in combination with the citrate of potash, fifteen grains, or the
citrate of lithium five to ten grains. Stop the tincture of colchicum as
soon as the pain is relieved and then you can give wine of colchicum ten
drops every four hours, watching for irritation of the stomach, bowels and
kidneys.

Dr. Hare of Philadelphia says. For hospital practice a very useful
mixture is made by adding one part of bicarbonate of sodium to nine parts
of linseed oil. The joint is then wrapped in a piece of lint soaked with
this concoction. In some cases oil of peppermint has been recommended. In
chronic gout Dr. Hare also gives for diet milk and eggs, the white meat of
chicken; fruits, cooked without sugar being added, are allowed. Tea and
coffee being used only in moderation. If any wine is taken it must be
followed by copious draughts of pure water and the last article should be
used ad libitum. On the other hand, pastries and, more than all, sweet
wines, are the worst things that such a patient can take, and must be
absolutely prohibited.





Next: RHEUMATIC FEVER (Articular Rheumatism)

Previous: GOUT (PODAGRA)



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