Rheumatism, gout, and some allied disorders / by Morris Longstreth, M.D.

  • Longstreth, Morris, 1846-1914.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Rheumatism, gout, and some allied disorders / by Morris Longstreth, M.D. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    tions ; sometimes tliey may gradually lessen if tlie process of accretion is stopped. Probably no disease has had more infallible remedies proposed to its cure than gout. The quack remedies in themselves form an innumerable host, the old ones passing away and new ones taking their places. The alkalies and alkaline salts have always enjoyed a high reputation in the disease, and were used as a remedy for its acidity long before the presence and the nature of luic acid were pointed out. Theoretically much has been said in favor of one or other of two common alkalies over the other; but both of them, under certain circumstances, exercise a very bene- fifeial influence. I have always thought that their disadvantageous effects were greater on stomach digestion than their ultimate effect on the blood, and it is on account of the former rather than the latter that their exhibi- tion has to be discontinued. Of their neutralizing action, and the conse- quent benefits, there is, however, no doubt. Better in its effects, and apparently without the disadvantageous effects of the former alkalies, is lithium and its salts. The existence of this alkali has been known for many years, but only recently has it been introduced into the list of drugs for this disease. It is very common to find it in the natural mineral waters along with the other alkahes. Taken in this form, it too, like the other natural salts, produces its best effects ; but it is very common to administer it—and it is very useful in this way—in the form of a carbonate. The combination of lithium with uric acid forms the most soluble of all the ui-ates. Treatment of the Paroxysm. We know pretty well that a paroxysm of typical character will end, un- influenced by remedies, if unprejudiced by wrong regimen, within a few days. This at least is the rule in typical cases, and knowing this fact a gouty inflammation presents itself to us as a morbid process which re- covers more rapidly than any other of equal severity. We know of no other inflammation which passes away so soon, whatever may be its treat- ment. It is a question, therefore, whether it is not better to stand by with watchful care than to interfere actively. The results of active treat- ment, especially local measures, are known in many cases to be harmful. Nevertheless it is not proper, whatever may be our theoretical or prac- tical conclusions, to do nothing dui'ing the continuance of an acute attack.