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Retrocedent Gout

Categories: 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 joint
, 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


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,



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


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.