Full Title:
Medical Admonitions to Families, Respecting the Preservation of Health, and the Treatment of the Sick. Also, a Table of Symptoms, Serving to Point out the Degree of Danger, and, to Distinguish one Disease from Another. With Observations on the Improper Indulgence of Children, &c. By James Parkinson, M.D. Hoxton. First American, from the Fourth English Edition. Portsmouth, New-Hampshire: Printed for Charles Peirce, by N. S. & W. Peirce. 1803.
Gout.
The paroxysms of this tormenting disease are most commonly preceded, by a general uneasiness; the feet and legs are afflicted with numbness and coldness, and frequently also with the sense of prickling; the veins on the surface are also said to become unusually turgid, and the muscles of the leg to be affected with the cramp. But the circumstances which have been observed, most particularly to precede the attacks of this disease, are the changes which, for some little time before, take place in the stomach; this organ generally suffers a considerable derangement of its functions; the appetite being much impaired, and the stomach and bowels distended with wind, the consequence of digestion not being properly carried on; the appetite becoming, however more eager before the attack.
According to the observations of the attentive Sydenham, the paroxysm generally begins about two o’clock in the morning. The patient, having gone to bed free from pain, is waked about the time with pain possessing commonly some part of the foot. Soon after this, comes on a coldness and shivering, which terminates in fever. The pain increasing, sometimes resembles that which might by expected to be produced by the stretching and tearing of the ligaments, or the gnawing of a dog; at others, the parts seem to suffer the effects of a tight stricture, or considerable pressure, being so feelingly alive, as not only, not to bear the weight of bed-clothes, but not even the heavy tread of any one across the room. In this miserable state the patient continues, tossing about the bed, in vain trying the effect of variety of posture to lessen his sufferings. At about the same hour of the following morning, the patient, in general, experiences a sudden mitigation of the pain, which he commonly attributes to the last position in which the limb was placed. Soon after this, a moderate sweat coming on, he falls asleep, and, upon waking, finds that the pain is considerably diminished; but that the part which suffers is affected with a red shining swelling. The pain sometimes continues two or three days, increasing at night, and becoming more mild towards morning.
If, after the disease has thus completed its course in one foot, it disappears entirely, the patient regains use of the foot, and experiences a most grateful change–strength and alacrity having taken the places of debility and languor. But it often happens, that after the violence of the first attack has subsided, a second will be experienced in the other foot. In more inveterate cases, both feet, sometimes, are affected at the same time; an repeated paroxysms sometimes extend the sufferings of the patient for six weeks or two months, or even longer.
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