Stengel covers the surface with lint smeared with salicylate of methyl ointment, and then applies a plaster bandage over all. This removes muscular spasm, pain and swelling and is rarely required for longer than a few days.
In cases in which salicylates fail, other agents have been resorted to in man and to a lesser extent in the lower animals. Greenhow strongly advocates a combination of quinine and potassium iodide internally, while Russell Reynolds has successfully employed tincture of muriate of iron in large doses repeated every three hours.
In chronic cases these would especially commend themselves as calculated to repair the general health and overcome the loss of hæmoglobin. In chronic rheumatism a course of tonics is often the best resort, and in dogs especially cod liver oil has benefited when all else had failed. Arsenic too (3 to 8 drops Fowler’s solution thrice daily) has been beneficial in both dogs and pigs. In other cases iodide of iron has been helpful. So also with gum guaiacum given in combination with potassium iodide. In such cases too, treatment by alkalies and salicylates may be called for, and close attention should always be given to secure a free action of the liver, bowels and kidneys. The local treatment recommended for acute rheumatism, (hot baths, frictions with essential oils and above all blisters of mustard or cantharides) is even more applicable to the chronic. A firm bandage over a covering of cotton wool, and a systematic application of electricity will often help. Warmth, a run at grass in a sheltered sunny paddock, moderate exercise and a nutritious and easily digestible diet are important conditions.
GOUT. PODAGRA. ARTHRITIS URICA.
Definition. Affects birds, dogs, perhaps pigs. Causes: excess of nitrogenous food, imperfect oxidation, impaired metabolism and elimination. Susceptibility of birds in confinement. Xanthin bases. Nuclein. Hepatic torpor. Contracted kidney. Affects tissues of little vascularity. Lesions: chalky deposits around joints, and in internal organs. Solubility of biurate of soda in synovia, serum, etc. Symptoms: arthritis, joint tenderness, resting on breast, hard or fluctuating swellings, desquamation, ulceration, chalky urates. Diagnosis: test for biurate. Treatment: less albuminoid diet, eliminating salts, colchicum, piperazin, surgical and antiseptic dressing.
Definition. An arthritis characterized by periodical exacerbations, by the deposit of sodium biurate in and around the joints and at times in other parts of the body, and by more or less constitutional febrile disturbance during the paroxysms.
Animals susceptible. Among the lower animals the disease has been noticed almost exclusively in birds, which even normally excrete so much uric acid that the liquid may be semi-solid as found in the cloaca or in the droppings. While this is a constitutional peculiarity in the bird yet it is enhanced in connection with an abundant diet of rich nitrogenous materials, as in forced feeding, and in old animals in which the eliminating action of the kidneys is more or less impaired. Ebstein has shown that gout can be produced in birds by tying the ureters. All domesticated birds, chickens, turkeys, pigeons, ostriches, geese, ducks, Guinea fowl, have been found to suffer. A case of gout has been reported in a dog, and Pradal has described it as existing in swine, but the symptoms given are more in accord with articular rheumatism.
Causes. The causes of gout are overfeeding especially on highly concentrated nitrogenous food, acid sweets, and in turn sweet and acid alcoholic drinks, an excess of uric acid in the blood and tissues, imperfect oxidation of albuminoids, impaired metabolism, imperfect elimination of uric acid, and impaired innervation. Probably no single morbid condition is in itself sufficient to induce the disease but a combination of several, unquestionably operate in many cases.
The uric acid theory is favored by the constant presence of this acid in considerable amount in the blood of birds, and by Ebstein’s experiment in tying the ureters, but it has to face the fact that young and active birds living in the open air, and hunting for their food do not suffer, that it is usually scanty in the blood of man just before an attack, that Gilman Thompson failed to produce any symptoms of gout by injecting into the blood of animals more uric acid than the amount which they normally excrete in twenty-four hours, that the familiar symptoms of uric acid poisoning are not at all those of gout, and that the excess of uric acid in leucæmia, anæmia and pneumonia produces no such symptoms. In addition to excess of uric acid some other factor is required.
Xanthin bases (Xanthin, hypoxanthin, etc.) found in the blood by various observers, are derived from albuminoids, especially nuclein and nuclein bases, including in man caffein and theine, and being closely allied to uric acid are believed to have a nearly similar action.