GOUT. 



45 



be merely tea and toast, water gruel, &c. The affected part should 

 be bathed frequently in tepid water. Then colchicum may be given 

 combined with alkaline diuretics or diaphoretics. Ten grains of 

 bicarbonate of potass, three drachms of liq. am. acet. and ttlxv — xx. 

 vini seminum colchici in a draught every six hours ; or a fluid drachm 

 of acetum colchici, with twenty grains of carbonate and a drachm of 

 sulphate of magnesia, in a draught thrice a day are favourite forms. 

 But the great object should be, at the same time, or before giving 

 the colchicum, to unload the liver and kidneys, and to avoid causing 

 the nausea and faintness which are the poisonous effects of the drug, 

 and which are by no means accessory to its curative effects. The 

 patient should not be weakened by too much purging. 



During the interval, the patient should observe such a course of 

 life as would prevent the formation of much lithic acid, and cause it 

 when formed, to be oxydized, and so converted into wrm, which is 

 much more soluble and easily eliminated from the system. 



The diet should therefore be abstinent, to the exclusion of too much 

 animal food and wine. Animal food in excess at once supplies the 

 pabulum for lithic acid ; whilst alcoholic liquors, and other arti- 

 cles of diet in excess abstract the oxygen which ought to convert it 

 into urea. Plentiful exercise in the open air is good, as the most 

 ready means of burning up effete and excrementitious matters ; but 

 great fatigue is always liable to bring on the gout. Plenty of liquid 

 may be taken, to hold the lithic acid well in solution ; and vegetables 

 and most fruits (if they agree with the stomach) are wholesome from 

 their containing an alkali. The bowels should be regularly kept 

 open ; and a pill containing one grain of blue pill, one of acetous ex- 

 tract of colchicum, and three of colocynth, is often prescribed, and 

 of great use. Acidity in the stomach, moreover, should be combated 

 by alkalies and magnesia ; and if the urine becomes loaded, small 

 doses of vin. colchici, with tartarized soda {sodcB potassio-tartras), 

 should be administered ; for the acid of the salt is digested, and the 

 alkali passes off with the urine. 



For the chronic gout^ the great points are to improve the tone of 

 the digestive organs, open the bowels, and keep up the strength with- 

 out heating thesystem. The iodide of potassium in doses of gr. ij. 

 ter die with a light bitter infusion ; the dec. Aloes c. with sodse carb. 



For sudden attacks of gout in the stomach, heart, &c., the indica- 

 tions are to put the feet in hot mustard and water, to apply mustard 

 poultices to the epigastrium, and to give some warm stimulant inter- 

 nally. These may be followed, as soon as the symptoms permit by 

 a dose of calomel and opium, succeeded by a laxative to remove the 

 offending matter from the stomach and bowels. 



