The hands are liable to attacks of gout, and, after repeated recurrences, the finger joints become the seat of deposits of a white concretion, called " chalk stones," and are thus rendered stiff and useless. The disease may become chronic if not guarded against by careful dieting. • The heart or brain are either of them liable to suffer in this disease. In the event of the heart becoming the seat of an attack, there is pain, with severe palpitation and difficulty of breathing. Nervous symptoms, such as headache, and MEfeiCiNAL 34i sometimes paralysis, or even apoplexy, may attend an attack of gout, and show that the brain is affected by the disease. Gout and rheumatism are often confounded. To distinguish between them the following points should be borne in mind: Acute gout is generally confined to one joint, and the pain is more acute. The constitutional antecedents differ. Gout is an hereditary disease. In the chronic form, these diseases are intermingled with each other, are not easy to distinguish in their acute form. There is a disease called rheumatic gout which combines the two so closely as to render necessary the name applied to it. To distinguish chronic gout from chronic rheumatism, it is necessary to remember that gout is heredi- tary, rheumatism is not generally so. The history of the attacks, the habits of life of the patient, must also be taken into account. If the patient is indolent, self-indulgent, and given to what are called the "pleasures of the table," the chances are that what he is suffering from is an attack of the gout. Treatment. — In a person oi the above habits, the pre- monitory attacks of indigestion, want of sleep, and feverish- ness, should be treated with three or four grains of mercurial pill (blue pill) at bed- time, and the following draught early the next morning: Powdered rhubarb, 40 grains; tartrate of pot- ash, I drachm; compound spirits of ammonia (salvolatile), one- half drachm; water to one and one-half ounce. Mix. The attack of gout should be treated as follows: If the pain be severe, and redness of the joint be excessive, a few leeches should be applied to the inflamed surface, but it will not always be necessary to apply them, as hot fomentations or poultices will be sufficient. A small blister raised near the inflamed joint, either by plaster or the "blistering liquid," will sometimes give speedy relief to the pain. When the pill and draught above advised have been taken, and the bowels are thoroughly cleansed, the following medicine may be given: Iodide of potassium, 40 grr' 1; bicarbonate of potash, 2 drachms; colchicum wine, 2 drachms; water to make 8 ounces. Mix. Take two tablespoonfuls three times a day. If there be want of sleep, compound ipecacuanha powder (Dover's powder) should be given in ten grain doses at bed- time; if the fever be great, antimonial powder (James's pow- der), combined as follows, will allay it, and relieve pain: Com- pound ipecacuanha powder, two and one-half grains; antimo- nial powder, three grains. Mix. Take one every four hours. Warm baths should be given every day while the attack lasts. At bed-time, a foot-bath of mustard and hot water gives comfort, especially if the feet be afterwards wrapped in cotton- wool, and kept so until the swelling abates. U% MEbiCiNAL.

AI-modernized reading of the original text

The hands are liable to attacks of gout, and, after repeated recurrences, the finger joints become the seat of deposits of a white concretion, called " chalk stones," and are thus rendered stiff and useless. The disease may become chronic if not guarded against by careful dieting. • The heart or brain are either of them liable to suffer in this disease. In the event of the heart becoming the seat of an attack, there is pain, with severe palpitation and difficulty of breathing. Nervous symptoms, such as headache, and MEDICINAL. sometimes paralysis, or even apoplexy, may attend an attack of gout, and show that the brain is affected by the disease. Gout and rheumatism are often confounded. To distinguish between them the following points should be borne in mind: Acute gout is generally confined to one joint, and the pain is more acute. The constitutional antecedents differ. Gout is an hereditary disease. In the chronic form, these diseases are intermingled with each other, are not easy to distinguish in their acute form. There is a disease called rheumatic gout which combines the two so closely as to render necessary the name applied to it. To distinguish chronic gout from chronic rheumatism, it is necessary to remember that gout is hereditary, rheumatism is not generally so. The history of the attacks, the habits of life of the patient, must also be taken into account. If the patient is indolent, self-indulgent, and given to what are called the "pleasures of the table," the chances are that what he is suffering from is an attack of the gout. Treatment. — In a person oi the above habits, the premonitory attacks of indigestion, want of sleep, and feverishness, should be treated with three or four grains of mercurial pill (blue pill) at bed- time, and the following draught early the next morning: Powdered rhubarb, 40 grains; tartrate of potash, I drachm; compound spirits of ammonia (salvolatile), onehalf drachm; water to one and one-half ounce. Mix. The attack of gout should be treated as follows: If the pain be severe, and redness of the joint be excessive, a few leeches should be applied to the inflamed surface, but it will not always be necessary to apply them, as hot fomentations or poultices will be sufficient. A small blister raised near the inflamed joint, either by plaster or the "blistering liquid," will sometimes give speedy relief to the pain. When the pill and draught above advised have been taken, and the bowels are thoroughly cleansed, the following medicine may be given: Iodide of potassium, 40 grr' 1; bicarbonate of potash, 2 drachms; colchicum wine, 2 drachms; water to make 8 ounces. Mix. Take two tablespoonfuls three times a day. If there be want of sleep, compound ipecacuanha powder (Dover's powder) should be given in ten grain doses at bedtime; if the fever be great, antimonial powder (James's powder), combined as follows, will allay it, and relieve pain: Compound ipecacuanha powder, two and one-half grains; antimonial powder, three grains. Mix. Take one every four hours. Warm baths should be given every day while the attack lasts. At bed-time, a foot-bath of mustard and hot water gives comfort, especially if the feet be afterwards wrapped in cottonwool, and kept so until the swelling abates. U% MEbiCiNAL.

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