Drinks.—Weak tea (no sugar), milk, buttermilk, toast water, pure water, cold or hot.
Must Not Take—
Veal, pork, goose, duck, turkey, salted, dried, potted or preserved fish or meat (except fat bacon), eels, mackerel, crabs, salmon, lobster, eggs, rich soups, gravies, patties, tomatoes, sweet potatoes, asparagus, mushrooms, rhubarb, lemons, pickles, vinegar, fried or made dishes, rich puddings, spices, pies, pastry, sweets, nuts, dried fruits, tobacco, coffee, cider, malt liquors, sweet wines, champagne.
Treatment.—In an acute attack raise the affected limb and wrap the "sick" joint in cotton wool; warm fomentations may be used. The wine or tincture of colchicum in doses of twenty to thirty drops may be given every four hours in combination with the citrate of potash, fifteen grains, or the citrate of lithium five to ten grains. Stop the tincture of colchicum as soon as the pain is relieved and then you can give wine of colchicum ten drops every four hours, watching for irritation of the stomach, bowels and kidneys.
Dr. Hare of Philadelphia says.—For hospital practice a very useful mixture is made by adding one part of bicarbonate of sodium to nine parts of linseed oil. The joint is then wrapped in a piece of lint soaked with this concoction. In some cases oil of peppermint has been recommended. In chronic gout Dr. Hare also gives for diet milk and eggs, the white meat of chicken; fruits, cooked without sugar being added, are allowed. Tea and coffee being used only in moderation. If any wine is taken it must be followed by copious draughts of pure water and the last article should be used ad libitum. On the other hand, pastries and, more than all, sweet wines, are the worst things that such a patient can take, and must be absolutely prohibited.
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RHEUMATIC FEVER (Articular Rheumatism).—Causes. This may be acute or chronic. It is an infectious disease characterized by inflammation of several joints. The joints are held in place by ligaments and are inclosed by a thin membrane. In this acute rheumatism these parts become congested and inflamed, there is redness and swelling, heat and pain. Fluid is passed into the joint sometimes and then the parts look watery (oeclematous). The inflammation and swelling cause great pain in the joint.
Predisposing.—A damp climate, winter and spring, young adults and persons who are exposed to damp, wet and cold.
Condition.—There is congestion of the soft parts of the joints and effusion into the joint cavities of a watery fluid. Endocarditis, pericarditis, myocarditis, pleurisy and pneumonia may complicate it. The first named, endocarditis, is very common and as the mitral valves become inflamed it is likely to leave valvular trouble unless carefully watched and treated at the time.
Symptoms.—The invasion may be gradual, with a very tired feeling and often tonsilitis; but it is usually sudden, with pains, soreness in one or more joints and fever. The knees, ankles, elbows and wrists are much affected, but it frequently goes through almost every joint in the body and sometimes repeats the terrible dose. I know, for I had it twice. The suffering, torture and pain sometimes are simply indescribable and almost too hard to bear. The joints become hot, red, painful, swollen and tender to touch and motion. It seems to hurt worse when anyone comes near, for the patient is afraid of careless handling.