Gout (arthritis) :

-JAHR Georg Heinrich Gottlieb

Gout
Description of disease :
Pains in the joints, with inflammatory or chronic cold swelling, and symptoms of deranged digestion. The pains are generally severe, and the inflammation mostly attacks the smaller joints, particularly the first joint of the great toe, which becomes red, hot, and swollen. It sometimes suddenly changes from one location to another, and returns at intervals, various joints or parts becoming affected after repeated attacks. Gout is mostly an hereditary disease, coming on without any evident external cause, generally preceded by disorder of the digestive organs, and accompanied by a plethoric state of the system.

Medicinal treatment
Aconitum napellus
If there is considerable fever, with great sensibility to the touch, or throbbings in the foot.
Dose. -Two drops in a dessertspoonful of water every two, three, or four hours, according to the severity of the symptoms.
Bryonia alba
If the pains if the pains are worse when moving the part, or if there is red, hot swelling, with shooting pains.
Dose. -As Aconitum.
Colchicum autumnale
In acute gout affecting the joints this medicine is a specific.
Dose. -Five drops in a dessertspoonful of water every twenty minutes to an hour during the attack. Increase the intervals as the pain subsides.
Nux vomica
Is often useful for the warnings or gout, or if spirituous liquors are the cause of the attack, or if there is a sensation of torpor and numbness in the parts affected.
Dose.-As Aconitum.
Pulsatilla pratensis
In wandering gout, with shifting pains, or if worse when rising from a seat, or lying down.
Dose. -As Aconitum.

Accessory treatment
See under Rheumatism. -The diet must be very spare during the acute symptoms, as thin gruel, bread and milk, light bread puddings, barley water, arrowroot and the like, oranges, roasted apples, grapes, etc. Keep the affected part in such a moderately cool state as to be comfortable to the patient, without being so warm as to aggravate the severity of the attack, or so cold as to check the insensible perspiration. External applications are generally of little use un a fit of gout; those which are warm doing no good, and those which are cold having the tendency to suddenly check the inflammation, and thereby produce harm. The application of cold water bandages, renewed as they get warm, has, however, in many cases been found a useful adjunct, as is likewise fomenting the part with a weak lotion of Arnica (one teaspoonful of the tincture to a pint of water). Friction with the flesh-brush during convalescence is beneficial, and the limbs and affected parts should be regularly sponged with cold salt water every morning and well wiped and rubbed afterwards. The diet, during convalescence, should consist of a little digestible animal food once a day, with eggs, bread, etc., but no wines or spirits. A careful diet and regimen are essential to the proper treatment of gout. -See Rheumatism.

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