CONTENTS. CHAPTER I. Different Species of Gout-Stages of the Disease-Its History- Theory of a Morbific Matter-Indigestion-Opinion of Cullen and Organized Principles-Definition-Dr. Prout's Opinion of the Origin of Uric Acid-Urea and Uric Acid not found in Animal Substances-nor in the Stomach-Inconvertibility of Or- ganized Principles-Hippuric Acid in the Urine of Herbivo- rous Animals-Relations of Urea and Uric Acid-Liebig's Opinion of the Origin of Urea-Effect of Respiration-of Minute Saccharine Impregnations of Urine-Subject yet Unex- plored-Sugar a Healthy Ingredient of Urine-Imperfection Inflammation not Essential to Gout-Languid Circulation in Gout True Nature of Gout--Visceral Congestion-Supposed Connection of Tubercle and Gout-Disorder of the Heart-Cause of Ede- Constitution of the Blood--Oxygenation-Fibrin and Gelatin- Assimilation-Composition of Albumen and Fibrin-Patho- Respiration a Process of Nutrition-its Importance to Health- the Red Globules-their Office--Pathological Observations- Exciting Causes-Sensuality-Moderate Indulgence-Women not subject to Gout-Men of Business much liable-Cause of this -Cullen's Opinion-Nervous Influence-Mortality of dif- Curability of Gout-its Origin in Infancy-Diet of Infants-of Youths of Adolescents-Nutrition necessary to Gout-Sub- sidiary Forces of Circulation-Exhalation of Plants and Ani- mals-Sir D. Barry's Opinion of Respiration-Effect of Mus- cular Exertion-Use of Exercise-Sydenham's Opinion of Morbid Matter-Low Diet Inadmissible-Milk Diet-Vege- Treatment of Regular Gout-Morgagni and Sydenham's Opinion -Quacks and Impostors-Bloodletting-Purgatives-Alka- Particular Application of Remedies-Cathartics-Choice of Re- medies-Diuretics-Colchicum-Local Remedies-Cases- Cure of Chalky form of Gout-Cases-Treatment of Irregular Gout-Hasty Interference condemned-Cases-Abuse of Brandy and Cordials-Benefit of Patience and Delay-Cases -Frequency of Organic Disease-its Nature-Diet-Colchi- GOUT; ITS HISTORY, ITS CAUSES, AND ITS CURE. CHAPTER I. OBSCURITY OF GOUT-ITS GREAT FREQUENCY-PREMONITORY SIGNS -ANOMALOUS SYMPTOMS. NOT any of the diseases to which man is liable is a cause of greater perplexity and disappointment than Gout; yet this does not arise from the oft repeated reproach of its intractable nature. It may indeed be said, with truth, that it is more curable than many, and it is certainly more amenable to relief than most diseases which fall under the cognizance of physicians. The regular attacks of gout cannot be said to give more embarrassment to a medical attendant than the assaults of any another malady; and, inasmuch as they are, for the most part, quite exempt from danger, they give little solicitude for the event. But it is quite otherwise with its irregular forms. In the beginning of a physician's practice especially, while he is yet unfamiliar with any but the noted and typical forms of disease, the changing and mysterious phenomena of gout, and particularly its complications with other disturbances of the system, or injuries of parts, are full of doubt and difficulty. In the earliest years of my professional life, my mind was frequently called to its consideration, to the observation of its various forms, the unravelling of its strange and confusing associations with other known forms of disease, and meditation on its cause and nature. I well remember how often I was perplexed by its obscure indications, how often I was surprised to discover it lurking unsuspected in the system, disturbing the healthy functions, and how greatly the intermixture of gout, swaying the symptoms of other diseases from their natural and ordinary course, puzzled and disquieted me. The records of medical science afforded a very imperfect solution of many of these difficulties. In them, indeed, were to be found laborious and often weary descriptions of the disease; its phenomena set down with a methodical accuracy, but very seldom presenting to me a picture of the facts I witnessed, and rarely, indeed, shedding any useful light on their nature. In these minute and exact histories, |