GOUT


The treatment of Gout may be divided into that of the acute paroxysm and that of the general symptoms. In an acute attack the following have been most successfully used: Colchicum, Benzoic acid, Bryonia, Rhus tox, Nux vom, Ledum pal, Arnica….


GOUT is a disease as obstinate as it is painful. If owes its origin usually to high living, although heredity has much to do with its development. Murchison, in his able lectures on functional diseases of the liver, traces Gout to Lithaemia; that is, to imperfect oxidation in the liver with the consequent production of excreta less oxidized than normally-lithic acid and lithates, instead of urea.

Now., Dr. Garrod determined that the gouty joint contained a concretion of lithates of soda. This salt accumulates in the blood by reason of its excessive production, which excess is favoured by over indulgence in rich foods and by a functionally imperfect liver. The surcharged blood seeks to rid itself of the offender through the kidneys, and also by depositing it in various tissues removed from the central organs.

This deposit would seem to be made first in the smaller joints, later in larger joints, and finally it encroaches on several of the viscera. If the kidneys are able to eliminate the lithates, the patient maintains comfortable health; but when these organs fail in their work or are overburdened, or again, if perchance, exposure start an articular inflammation, the joints become involved.

As the disease progresses, the kidneys may become affected with Morbus Brightii, the heart may suffer from inflammation, the stomach becomes deranged, and arthritic headache and Ophthalmia complicate the case, rendering the torture intolerable. The Frenchman’s diagnosis between Rheumatism and Gout is trite and painfully true: ‘Put ze finger in ze vice and screw him tight; zat is ze rheumatism; now give him one under screw-zat is ze gout”

But why is it that all who indulge to excess in the pleasure of the table are not affected with Gout? And, too, why is it that this lithic deposit so frequently selects the great toe for its punctum saliens?

The answer is involved in that great unanswered problem of constitution, the soil in which disease is to grow, and by which disease is so materially modified. Hahnemann and Grauvogl gave us each three constitutions, but there must be many more. The physician who daily cauterizes the Chancre or checks Gonorrhoea with injections, is forming a “constitution” for his patient which will last him through life and seriously impress his offspring.

No disease is ever cured except it be removed to the periphery. When we begin to treat our patients according to their several tendencies to disease, rather than according to the acute symptoms only. we will attain an amount of success never yet even dreamed of. Until then let each physician endeavor to make his prescription as accurately as his Materia Medica will permit. always valuing symptoms from the centre to the circumference; from mind to body; from more to less vital parts; from function to organ.

The treatment of Gout may be divided into that of the acute paroxysm and that of the general symptoms.

In an acute attack the following have been most successfully used:

COLCHICUM: In the evening fretful, cannot tolerate any annoyance; any external impression, noise, odor, touch or bright light makes him irritable. Toe-joint becomes inflamed, dark-red hot and intensely painful; he is besides himself with agony. The foot becomes oedematous. Urine scanty and dark-red. The smell of food makes him sick at the stomach. Greatly prostrated.

LEDUM PALUSTRE : After abuse of alcoholic drinks; pimples on the forehead; face bloated; awakened with a hot, tensive swelling of the toe and foot, with tearing, shooting, grinding pains; cannot bear the least covering or the warmth of the bed; foot becomes oedematous, and yet the urine is copious and frequently passed. Old nodes, the sequalae of former attacks, become excessively painful.

E. A. Farrington
E. A. Farrington (1847-1885) was born in Williamsburg, NY, on January 1, 1847. He began his study of medicine under the preceptorship of his brother, Harvey W. Farrington, MD. In 1866 he graduated from the Homoeopathic Medical College of Pennsylvania. In 1867 he entered the Hahnemann Medical College, graduating in 1868. He entered practice immediately after his graduation, establishing himself on Mount Vernon Street. Books by Ernest Farrington: Clinical Materia Medica, Comparative Materia Medica, Lesser Writings With Therapeutic Hints.