Gout : its etiology and treatment / by Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
1911
Catalogue details

Licence: In copyright

Credit: Gout : its etiology and treatment / by Anthony Bassler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    (2) GOUT: ITS ETIOLOGY AND TREATMENT. By ANTHONY BASSLER, M.D., Visiting Gastroenterologist to the People’s Hospital, etc., NEW YOBK CITY, N. Y. Gout, in common with most of the katabolic conditions of the human body, has passed through a mass of literature in which the important matter of its true etiology has received hut scant attention. In the early considera- tions of the subject, the true gouty manifestation of acute inflammation of the small joints and the local and constitutional treatments therefor predomi- nated for many years. After this, and up to the present time, the attention was centered on uric acid as the cause, simply because crystals of sodium biurate were found deposited. The outcome was a flooding of the American . • and English physicians with literature in which the terms “Uric acid disease,” ^ “Uric acid dyscrasia,” “Uric acid diathesis,” flgured largely, and the vaunt- ing by manufacturing houses of innumerable saline eliminants for the cure of the condition. Some of the drug firms even went to the trouble and expense V of publishing special journals on the subject, and still, throughout it all, we were dealing only with the cause of the clinical manifestations and not the true etiology of the disease. It seems to us that the time has come when we are justified in looking upon the past of this subject about as follows: Assum- ing that we have a patient with an acute gouty inflammation of the metatarso- phalangeal joint of the big toe, by placing him in bed we rest the joint; the flannel and absorbent cotton dressings of the foot increase the warmth and thus relieve the local pain; the milk and reduced diet lower the food intake and therefore minimize the loading of the circulation with toxins from the intestine and the necessity for their elimination by the emunctories, and the taking of large amounts of fluid internally, the saline purgatives, hot baths, etc., increase the elimination. Treated along these lines the patient finall}’ leaves the bed and is returned to his life activities; but the gout still remains, for we have treated only one of its manifestations. What is the real etiology of gout? A close personal study of 8 cases of bona fide gout showed that every one of them had present a chronic excessive putrefaction in the intestines. In all of these cases the stools were highly acid from butyric acid formation, a product of putrefaction, and hence bacterial and dietetic in its origin. All showed an almost doubled bacterial content, in which the anaerobic organisms.