A fit of gout (paroxysmus podagrae) : a study in pathology / by George W. Balfour.

Date:
1898
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Licence: Public Domain Mark

Credit: A fit of gout (paroxysmus podagrae) : a study in pathology / by George W. Balfour. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    IN PATHOLOGY.1 By George W. Balfour, M.D., LL.D. Edin. and St. And. “Non fingendum, aut excogitandum, sed inveniendum quid Natura faciat, aut ferat.”—Bacon. Gout as a disease has been known to physicians from time immemorial, yet its most graphic description is of no earlier date than Sydenham, who, in memorable words, has depicted it with all the skill of a physician and all the accuracy of a sufferer. Succeeding writers have but copied Sydenham’s de- lineation of the disease, and have modified his theory of its rationale. This, as we know, was a reversion from the doctrine prevalent in his day, of tartar accumulated in the blood and deposited as chalk stones in the joints, to the still older theory of an effort of the system to expel a peccant humour, the result of imperfect coction. To Cullen’s logical mind we owe the differentiation of gout into its several varieties of regular, atonic, and aberrant. And to Cullen also is due the statement that the supposition of any morbific matter is unsupported by any evidence, is quite superfluous, and is useless, “as it has not suggested any successful method of cure.”2 Cullen’s own idea was that gout “is manifestly an affection of the nervous system.”3 Modern advances in zoo-chemistry and in morbid anatomy have introduced various modifications of our ideas as to the ultimate pathology of gout. Some of these modifications are more closely allied to the humoralism (Haig, etc.), and others to the solidism (Ord, Bristowe, etc.) of our forefathers; while even those who with Cullen regard the nervous system as the primum mobile of this disease (Duckworth, etc.) are forced to recognise the exciting influence of a pre-existing toxtemia. 1 Read before the Edinburgh Medico-Chirurgical Societj7, 4th May 1898. 2 “ First Lines,” ccccxcii. p. 375. 3 Ibid occcxciv. p. 381. 36 ED. MED. 516—NEW SER.—VOL. III.—VI.