Mother's Remedies Part 70

CONSt.i.tUTIONAL DISEASES.

RHEUMATIC GOUT. (Rheumatic Arthritis. Arthritis Deformans).--Cause.--It occurs most often from thirty to fifty-five, usually in women, generally at or after the change of life, and most frequently in those who have not had children. The involvement of the joints is most common in adult males.

Exciting cause may be: Exposure to cold and wet, improper food, unhygienic surroundings, worry, blows and acute infections.

Conditions.--Several joints are usually involved symmetrically. At the edge of the joints there is formation of new bone covered with cartilage, causing the enlargement of the bone and often partial loss of motion in that joint.

Symptoms.--Several distinct types exist. 1. General progressive types which may be acute or chronic.

Acute.--This occurs usually in women from twenty to thirty and at the change of life. It comes on like acute joint rheumatism, many joints being affected, permanent enlargement appearing early, redness of the joints rarely existing, the pain being very severe, some fever, feel very tired, with anemia, loss of flesh and strength. The first and later attacks are often a.s.sociated with pregnancy, confinement or nursing.

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Chronic Type.--There is a gradual onset of pain or stiffness in one or more joints, usually of the fingers, then of the corresponding joints of the other side and then other joints. The swelling at first may be in the soft parts of the joints with effusion in the joints and tenderness. The pain varies from slight to severe. Periods of improvement and getting worse alternate; the joints becoming enlarged and deformed, often nearly stiff in partial bending on account of the thickened bone and soft tissues. The muscles that move the joint dwindle and there may be changes in the skin and nails of the parts affected due to the want of proper nourishment. Disturbances of the stomach and anemia are common. The heart is not affected. There may be only a few joints affected, or many, with great deformity, before the disease reaches the period of inactivity.

2. Monarticular or one joint type.--This usually occurs in males over fifty; one joint or a few large joints may be affected, generally with shrinking of the corresponding muscles. If it occurs in the hip it is called Morbus c.o.xae Senilis,--Hip joint disease in the aged.

Recovery.--The disease usually goes on with intervals of improvement and often results in great crippling and disability. In some cases it becomes permanent.

General Treatment.--The climate should be warm and dry. The patient should avoid exposing himself; lead a general hygienic life, with as nouris.h.i.+ng food as his digestion will permit. The chief line of treatment should be to improve the general health and relieve the pain. The stomach, bowels, and kidneys should be kept working well. Nouris.h.i.+ng food should be taken, but its effect must be watched. Cod-liver oil to build up the system, iron and a.r.s.enic may be of value. Sometimes iodide of potash is good. Early and thorough treatment at Hot Springs offers the best hope of arresting its progress, the Hot Springs in Bath County, Va., and in Arkansas. Much can be done at home by hot air baths, hot baths, and compresses at night to the tender joints.

Local.--Ma.s.sage carefully given is helpful. The hot air treatment is good.

Baking the joints is now frequently done.

GOUT (PODAGRA).--A disorder of nutrition characterized by excess of uric acid in the blood, attacks of acute arthritis (inflammation of joints) with deposit of urate of sodium in and around the joints; with various general symptoms.

Causes.--Heredity; male s.e.x, usually appears from thirty to fifty and rarely under twenty; from continued use of alcoholic liquors, especially fermented, with little or no exercise; too much meat. Unhygienic living with poor food, and excessive drinking of ale and beer may be followed by the "poor man's gout." It is common in lead workers.

Symptoms. Acute Type.--There is often a period of irritability, restlessness, indigestion, twinges of pain in the hands and feet; the urine is scanty, dark, very acid, with diminished uric acid and deposit when it is cooled. The attack sets in usually early in the morning with sudden intense pain in a joint of the big toe, generally the right; less often in an ankle, knee, wrist, hand or finger. The part swells rapidly, and is very tender, the overlying skin being red, glazed and hot. The patient is usually as cross as a wounded bear. The fever may be 103. The pain may subside during the day, and increase again at night. There is no suppuration (pus forming). The symptoms usually decrease, gradually, the entire attack may last from five to eight days. Scaling of the skin over the sore part may follow. After the attack, the general health may be improved, and the joint may become normal or but slightly stiff. It recurs at intervals of a few months commonly.

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Retrocedent Gout.--This is a term applied to serious symptoms which sometimes go with rapid improvement of the local joint conditions. There are severe pains in the stomach, nausea, vomiting, diarrhea, pain in the heart, difficult breathing, palpitation, irregular and feeble action of the heart with brain symptoms, probably from uraemia. These attacks often cause death.

Chronic Gout, Causes, etc.--Frequent acute attacks; many joints, beginning with the feet, become stiff and deformed, perhaps with no motion. The overlying skin may ulcerate, especially over the knuckles. Dyspepsia, arterio-sclerosis, enlargement of the left ventricle of the heart and a great quant.i.ty of urine with low specific gravity are common. The patient is morose and irritable. Eczema, chronic bronchitis, frequently complicate the case.

Death often occurs from uraemia, meningitis, pleurisy, pericarditis or peritonitis.

Treatment, Preventive.--Live temperately, abstain from alcohol, eat moderately, have plenty of fresh air and suns.h.i.+ne, plenty of exercise and regular hours. These do not counteract the inherited tendency. The skin should be kept active, if the patient is robust, by the morning cold bath with friction after it; but if he is weak and debilitated, the evening warm bath should be subst.i.tuted. The patient should dress warmly, avoid rapid alternations in temperature, and be careful not to have thc skin suddenly chilled.

Diet in Gout.--Most persons over forty eat too much. Eat reasonably and at regular hours and take plenty of time to eat. Do not eat too freely of meats and avoid too much starchy and sugary foods. Fresh vegetables and fruits may be used freely, except cranberries and bananas.

Dr. Osler of England says.--While all stimulants are injurious to these patients some are more so than others, particularly malted liquors, champagne, port and a very large proportion of all the light wines. Take large quant.i.ties of water on an empty stomach, mineral waters are no better than others, but treatment of chronic and irregular gout at springs gives the advantage of regular hours, diet, etc.

[Ill.u.s.tration: A Skiagraph (X-RAY photograph) of the hand. Made for the purpose of locating piece of needle. Photo by P. M. Campbell, Detroit, Mich.]

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Diet from a prominent hospital for gout patient:--

May Take--

Soups.--Fresh fish soups, vegetable broths clear.

Fish.--Raw oysters, fresh fish, boiled.

Meats.--Fat bacon, boiled or broiled chicken, game (all sparingly).

Farinaceous.--Cracked wheat, oatmeal, rice, sago, hominy, whole wheat bread, or biscuits, rye bread, graham bread or rolls, crackers, dry toast, milk toast, macaroni.

Vegetables.--Mashed potatoes, green peas, string beans, spinach, cabbage, cuc.u.mbers, cresses, lettuce, celery.

Desserts.--Plain milk pudding, junket, rice and milk, sago and milk, stewed fruits, all without sugar.

Drinks.--Weak tea (no sugar), milk, b.u.t.termilk, 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 colchic.u.m 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 colchic.u.m as soon as the pain is relieved and then you can give wine of colchic.u.m 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 pa.s.sed 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.

Fever.--This runs from 102 to 104 and is modified by profuse perspiration with bad odor and, generally, it does not afford any relief. The urine is very acid, very thick and looks like thick, strong coffee. The symptoms frequently disappear partially from one joint or joints as they begin in other joints, attacking several in rapid succession, the fever varying and changing with the degrees of joint involvement.

We may see the shoulder and hip, the elbow and wrist, knee and ankle, etc., all affected at once: Heart complications are frequent and bear close watching, for they are dangerous to life and the future health of the patient. The patient becomes very anemic and this progresses rapidly.

When improvement does begin it is gradual; or the disease may become chronic. Care must be taken not to be too active when improvement sets in or you will cause a return by using the joints before they have become thoroughly well. I did the same thing in my anxiety to get out, but would never be as reckless again. Pain and stiffness of the joints often last long after convalescence has set in. One who has had this disease once is liable to another attack if he is not careful.

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MOTHERS' REMEDIES. 1. Articular Rheumatism.--A gentleman sends us the following treatment for articular rheumatism and writes as follows: "I send you the following treatment for articular rheumatism because I used it myself and was cured in a very short time, in fact, about ten days. It was a number of years ago in the early spring when my knee joints, ankles and wrists began to pain me and continued to become worse for about a week, at the end of which time both my knees were perfectly stiff. I sent for my physician; he wrapped my knees with common baking soda; taking long wide bandages he was enabled to have the baking soda a fourth of an inch thick around the knee, raising the bandage as he laid the soda on; after this was completed I had heavy wet hot cloths laid around my knee and renewed every fifteen or twenty minutes for probably eight or ten hours.

In the meantime I was taking the salicylate of soda and the cathartic, veronica water, as directed below. The following day I sat up with my legs resting on a chair, straightened out, and hot flat irons at my knees. I began this treatment on Sat.u.r.day, and the following Thursday was able to walk about and go out of town, and never had rheumatism since, but at two or three different times I suspected it was coming on and used the salicylate of soda and veronica water as a successful preventive; at least the rheumatism did not materialize.