GOUT

Syn. Arthritis , L. A painful disease that chiefly attacks the male sex, particularly those of a corpulent habit and robust frame. Persons who live temperately and take much exercise are seldom troubled with gout. Indolence, inactivity, luxurious habits of life, and free living, are the chief exciting causes of this disease; but exce ive study, grief, watchfulne , exposure to cold, and the too free use of acidulous liquors, also occasionally bring it on. In some persons it is an hereditary disease. Symp. Gout is generally preceded by unusual chilline of the feet and legs, and a numbne or a sensation of prickling along the lower extremities; the appetite fails, flatulency, indigestion, torpor, and languor ensue, and extreme la itude and fatigue follow the least bodily exercise; the bowels become costive, and the urine pallid. The fits usually come on in the night; the patient is awakened by the severity of the pain, generally in the first joint of the great toe, or occasionally in the heel, whole foot, or calf of the leg. The pain resembles that of a dislocated joint, accompanied by a sensation resembling the effusion of cold water; the pain increases, rigors and febrile symptoms ensue, accompanied with local throbbing and inflammation. Sometimes both feet and legs are attacked; at others, only one. Towards morning the patient generally falls asleep, and sinks into a state of copious perspiration, from which he awakes comparatively recovered. This constitutes what is called a ‘fit of gout.’ These fits or paroxysms are apt to return at intervals, commonly every evening, with more or le violence; and when frequent, the disease usually extends its action, the joints become affected, and concretions of a chalky nature (chalk stones, gout stones) are formed upon them, and they become stiff and nearly immovable. Treat. A plain or vegetable diet, moderate exercise, and the use of warm laxatives, gentle tonics, diaphoretics, and diuretics, are among the best preventives. The moderate use of alkaline remedies, as pota a and magnesia, has also been recommended. To relieve the fit of gout, or to check it at its commencement, the affusion of cold water will be often found effective. The use of the ‘ eau médicinale ’, or the ‘ vinum colchici ’ of the Pharma copœia, may also be had recourse to; a due dose of which taken at bedtime will frequently carry off the paroxysm, and nearly always mitigate the symptoms. The effect of the above remedies do not greatly differ from each other. The action of both medicines is accompanied with great languor, and a deadly nausea or sickne , which terminates in vomiting or a discharge from the bowels, or both. These symptoms have often reached an alarming extent, and in some constitutions follow even a moderate dose. This method of cure should not, therefore, be unadvisedly and incautiously adopted. Another remedy which has been recommended for gout is lemon juice, but experience has proved that this agent is not to be depended on. The dose proposed by Dr O. Rees, who originated this treatment, was 2 or 3 fl. oz., twice or thrice a day. To ensure the efficacy of lemon juice, it must be expre ed from the fruit into the gla shortly before being taken. That purchased at the shops is generally stale and disagreeable, and is often worse than usele . In some cases it is advisable to take the juice undiluted, but the more common practice is to mix it with about an equal quantity of water. See Rheumatism , Colchicum , Draught (Anti-arthritic), Lemon Juice , Vinegar of Colchicum , Wine of Colchicum , .