| ℞ | Hydrarg. sub chlor. | gr. ⅟₁₀ |
| Guaiaci resinæ | gr. 3 | |
| Sulph. precip. | gr. 3 | |
| Fiat. cachet. Ter in die sumenda post cibos. | ||
Such is useful as a corrective in intestinal fermentation when given for three or four days, after which the calomel may be withdrawn and the guaiacum and sulphur continued in doses adequate to produce a daily evacuation.
The compound confection of guaiacum or the Chelsea Pensioner Powder have also stood the test of time, and may be taken in the appropriate dose daily for weeks. Personally, I have for years employed a cachet containing guaiacum, iodide of potassium, colchicum, and cinchona as a prophylactic measure in the inter-paroxysmal periods of chronic gout.
I would here, too, advance a plea for the use of guaiacum as the most useful laxative for constipation in the gouty, and in combination with sulphur where there is inactivity of the skin. The following is an excellent and well-tried formula:—
| ℞ | Sulph. precip. | |
| Pulv. guaiaci | ||
| Pot. bitart. āā | ʒj. | |
| Pulv. tragac. co. | ʒij. | |
| Fiat pulv., ½ to 1 teaspoonful to be taken stirred up in water or milk at bedtime. | ||
Such is a useful laxative and, during the day, may be often advantageously combined, in lingering articular gout, with a mixture containing iodide of potash, nux vomica, and cinchona. Luff, by the bye, holds that iodide of potash acts more beneficially when given in the compound decoction of sarsaparilla—the latter also is lauded by Garrod as having properties somewhat similar to guaiacum.
In conclusion, the subjects of long-standing gout not infrequently are anæmic. In such cases iron is often not well borne, and has been said to favour recurrence of acute attacks. Small doses, however, of a less astringent form agree well, always provided that the bowels are kept freely open. The ammonio-citrate, the iodide of iron, or one or other of the organic iron compounds are most suitable. These may be given alone or in combination with arsenic. For improving the general condition and promoting the nutrition of such subjects, Robin speaks highly of the following:—
| ℞ | Acidi arseniosi | gr. ⅟₈₀ |
| Potassii iodidi | gr. 1 | |
| Pulveris rhei | ||
| Extracti gentianæ | āā q.s. | |
| Misce. Fiat pilula i. “Two pills to be taken daily at meal time.” | ||
In drawing to a close our discussion of the drugs most useful in the treatment of chronic articular gout, it will be noted that our usage of them is largely empirical, viz., the outcome of experience. We do not know exactly their mode of action, but this we do know, that they have stood the most searching of tests—that of results. That we should be largely, if not entirely, ignorant of their mode of action is regrettable, but no reason whatever why we should discard them in favour of newer compounds administered on some pseudo-rational basis.