Imágenes de página
PDF
ePub

membrane, quite independently of inflamma- distinguished. In many instances, also, do ion.*

Aammation extends to the surrounding as c The diseases described by Mr. Chevalier and as to the descending parts; and benet Dr. Grames, seem to the editor to correspond scrotum, like the pubes in puerperal bapak to the enormous growth of the scrotum, so com is often peculiarly affected and distended the mon in Egypt and other warm countries, yet enormous magnitude; while, occasionally! sometimes met with in France, this country, glands of the axilla participate with those ola and other parts of Europe.f. Dr. Graves is groin, and the forearm becomes also calagir of opinion, that the example which he has pub- | In a few instances, the disease is sudham lished is entirely different both from phleg. commenced in the axilla; but such cases ar masia dolens and the Barbadoes leg, which affec- very rare, and not well established tions, he says, arise from inflammation. It In this manner the disease at length xxx certainly appears, that some extraordinary en- a chronic character : the monstrous site largements of the lower extremity have depended bloated wrinkles of the leg are rendered per upon a chronic growth and thickening of the manent; the pain, felt acutely at first, subunin integuments and cellular tissue, no inflammation gradually, and the brawny skin is altogether arr having occurred, at all events, until the disease sensible. Yet, even from the first, eser du was far advanced. Yet, in other instances, a ring the recurrence of the febrile par STORE similar alteration of the skin and cellular mem- the patient's constitution and general fantas brane has been preceded either by an attack are little disturbed : and he sometimes n. like that of phlegmasia dolens, as happened into an advanced age, incommoded only by car Mr. Chevalier's example, or by fever, and heat rying about such a trooblesome load of la: and redness of the skin, as illustrated in one which, however, as we have noticed alrea curious modification of the disease, described is regarded in the Polynesian Isles as a leg by Dr. Graves, and, as it seems, by no means of honour. uncommon in Ireland, where it affects the arms, In our own country, the disease is rarely perhaps, more frequently than the legs.] with but in its confirmed and inveterale ,

In the tumid leg of hot climates, the skin, after repeated attacks of sever and effusi dan instead of maintaining the paleness of the first I completely altered the organization of the species, very soon becomes suffused with a deep teguments, and rendered the limb aigetben red or purple hue ; while the saburral fluid incurable. In this state, the distende r that exudes from the cutaneous exhalants, con- hard, firm, and peculiarly thickened, and are cretes, as its finer parts fly off, into rough and horny ; while the muscles, tendons, ligusest sordid scales, and the skin itself becomes enor- and bones are, for the most part, little atled mously thickened and coriaceous.

[Most of the cases noticed in London ere The effusion is usually preceded by a febrile Africans. The editor has seen one or trade paroxysm, induced by the glandular inflamma examples in St. Bartholomew's Hospital. T tion just noticed ; and which, from the first, most remarkable of these was published in discovers a tendency to recur, though often at of the early volumes of the Medical and Pary irregular periods, so as to resemble an erratic ical Journal.) intermittent. Every fresh attack adds consid In this advanced stage, the disease sem >> erably to the effusion, and consequently to the be altogether hopeless : nor in any stage to morbid size of the limb, and exacerbates every the practice hitherto pursued been produire symptom; and hence the greater severity of this of striking success. This has copsied ebiede species than of the former, and the monstrous in endeavours to alleviate the febrile amor disfigurement of the leg and foot by which it is by laxatives and diaphoretics, and subsequently

to strengthen the system by the bark. It week * Trans. of the King's and Queen's College of be better, perhaps, by active and repeeted bees Physicians, vol. v., p. 56. A woman died in La Charité in 1820, with what Andral calls elephan-1

ings, as well general as local, and power tiasis of one of her lower extremities, but which. I gatives, to endeavour to carry oi pare probably, corresponded to the cases arranged by the first effusion as quickly as possido, Dr. Good under the present title. The muscles then to direct our attention to a great were found, after death, reduced to a few pale, the paroxysms to which the constan t slender fasciculi; but the cellular substance was to be peculiarly subject, after a single se converted into an enormous mass, very hard, and taken place, by prohibiting exposure OS including in some places cells filled with a serous | air of the evening, and by the use is fluid. At certain points it had all the physical qualities of cartilage.-(Anat. Pathol., tom. i., p.

| An original and chronic affection an d 277.) The same author has also seen an extraor.

| in which the integuments of the legs we dinary ossification of the layers of the intermus- thickened, the limbs swelled to sue o cular cellular tissue, in the leg of a subject that as to prevent the patient from walkng died with bucnemia. The muscles were in the crusted with such a vast geanta d e state of atrophy. The osseous matter, which was scurf and scales, that bandfuls of thes : deposited in the spaces between the layers of mus- / be taken out of his bed every marang sun cles, was blended, in the deeper part of the limb, l. with bony vegetations arising from the periosteum.

b cessfully attacked many years ago by assiske -Vol. cit., p. 297.

of one plant for another. The case me + See the editor's Dict. of Practical Surgery, by Dr. Pulteney; and the paterna art. SCROTUM, published by Harper & Brothers, been recommended te swallow a table and New-York, 1834.

l of the juice of the water-parsnip. w in

spoonfuls of wine, every morning fasting, was Arthritis, then, among the Greeks, was used erroneously supplied with half a pint of what in a generic sense, so as to include articular inafterward appeared to be the juice of the roots Aammations generally. But as almost every sort of the hemlock-dropwort (ananthe crocata, of articular inflammation has, in recent times, Lin.): the first dose produced such a degree been advanced to the rank of a distinct genus in of vertigo, sickness, vomiting, cold sweats, and itself, it has frequently become a question, to long-continued rigour, that it almost proved fa- which of them the old generic term should be tal. So strong, however, was the patient's de- peculiarly restrained. And hence some writers sire of relief, that, with the intermission of one have applied and limited it to gout; others have day, he repeated the dose with a slight diminu- made it embrace both gout and rheumatism ; tion in the quantity. The effects were still vio others again have appropriated it to white swellent, though somewhat less alarming ; and he ling; while a fourth class of writers, in order to persisted in using half the quantity for several avoid all obscurity and dispute, have banished weeks. At the end of a month he was very the term altogether. greatly improved, and, shortly afterward, the Now gout, rheumatism, whether acute or whole of his symptoms had nearly left him.- chronic, and white swelling, however they may (Phil. Trans., vol. Ixii.)

differ in various points, as well of symptoms as Amputation of the affected leg has some of treatment, have striking characters that seem times been made trial of, but apparently without naturally to unite them into one common group any success. Dr. Schilling informs us, that in Gout and rheumatism are so nearly allied in some, a locked jaw takes place about the sev- their more perfect forms, as to be distinguished enth day from the operation, which is soon fol- with considerable difficulty ; and in inany inlowed by tetanus, and ends in death; that, in stances, rather by the collateral circumstances others, fatal convulsions ensue immediately; of temperament, period of life, obvious or unand that those who survive the operation, have obvious cause, antecedent affection or health of wounds hereby produced that will not heal; the digestive function, than from the actual while the disorder, still connected with consti- symptoms themselves. Stoll maintains that tutional causes, often seizes on the other foot.- they are only varieties (Rat. Med., part ü., p. (G. G. Schillingii de Lepra Commentationes, 122-137; V., p. 420) of the same disease : 8vo., Lugd. Batav., 1776.) And, in this last as- Bergius, that they are convertible affections. sertion, he is corroborated by one or two cases White swelling, in one of its varieties, is now related by Dr. Hendy.- (On the Glandular Dis- uniformly regarded as a sequel of rheumatism, ease of Barbadoes, 8vo., 1784.)

or the result of a rheumatic diathesis ; while [In the modification of the disease repre- the other varieties cannot be separated from the sented by Dr. Graves as common in Ireland, species. and as following fever and repeated attacks of From the close connexion between gout and a kind of inflammation, more like erysipelas rheumatism, Sauvages, and various other nothan any thing else, he suggests the following sologists, distinguish some of the cases of dis. treatment. When the case is not of very long guised gout by the name of rheumalic goul. standing he recommends, during the febrile par- Mr. Hunter warmly opposed this compound apoxysms, antiphlogistic treatment, purgatives, pellation ; for his doctrine was, that no distinct leeches repeatedly to the inflamed parts, and diseases, or even diseased diathesis, can co-exist cold lotions. During the intermissions, rest, in the same constitution. And, as a common moderately tight bandages, bark, and, if it fails, law of nature, the observation is, I believe, strictly arsenic. The moment the inflammatory parox- correct ; one of the most frequent examples of ysms recur, the antiphlogistic plan is to be re- which is the suspension of phthisis during the sumed.]-(Dr. Graves, in Trans. of the King's irritation of pregnancy. But it is a law subject and Queen's College of Physicians, vol. v., to many exceptions ; for we shall have occap. 46.)

sion, as we proceed, to notice the co-existence of measles and smallpox; and I had not long

since under my care, a lady in her forty-ninth GENUS XII.

year, of delicate health and gouty diathesis, who ARTHROSIA.

was labouring under a severe and decisive fit of ARTICULAR INFLAMMATION.

gout in the foot, which was prodigiously tumefied

and inflamed, and had been so for several days, INFLAMMATION MOSTLY CONFINED TO THE JOINTS;

brought on by a violent attack of lumbago,* to SEVERELY PAINFUL; OCCASIONALLY EXTEND

which she was then a victim, and which rendered ING TO THE SURROUNDING MUSCLES.

her nights more especially sleepless and highly ARTHRosia is a term derived from dp pów, painful. The constitutional disease had in this * to articulate," whenee arthrosis, arthritis, and case been roused into action by the superadded many other medical derivations. The usual irritation of the accidental disease; and the two term for the present genus of diseases, among were running their course conjointly. It is also the Greek physicians, was arthritis, which would have been continued without any change,

* Lumbago is so common in gouty subjects, that but that for the sake of simplicity and regu

the editor is inclined to believe it is as frequently

met with in them as in rheumatic patients. He larity, the author has been anxious to restrain

cannot, therefore, regard the above case as dethe termination itis to the different species of cidedly proving the co-existence of gout and rheu. the genus EXPRESMA.

matism in the same individual

[ocr errors]

a striking fact, that one of the severest illnesses, in very young children, and, out of one hundred that attacked Mr. Hunter's own person, and rheumatic patients, ninety are above the age of which ultimately proved to be disguised gout, sixteen. The following is the result of what podagrala rvata, he suspected, in its onset, to be was noticed in relation to this point by M. à rheumatic ailment. The case, as given by Chomel, in La Charité. Out of seventy-three Sir Everard Home, in his life of Mr. Hunter, patients attacked by rheumatism, thirty-five is highly interesting and curious, as showing were between the ages of fifteen and thirty, the singular forms which this morbid Proteus twenty-two between thirty and forty-five; seven sometimes affects, and the various seats it oc- between forty-five and sixty ; seven were turned cupies ; as also, that a life of abstemiousness sixty; and only two were under fifteen. and activity is no certain security against its Daily experience proves that both seses are attack; for Mr. Hunter had at this time drunk subject to rheumatism. If women more fre. no wine for four or five years, and allowed him- quently escape from it, owing perhaps to then self but little sleep at night.

| less rcbust constitutions, and their being generArthrosia, therefore, as a genus, may, I think, ally less exposed to cold and damp than the be fairly allowed to embrace the following spe- other sex, they are still known to be particularly mies:

liahle to it when, after being tenderly brought 1. Arthrosia Acuta. Acute Rheumatism. up, they are exposed to the exciting causes ; 2. — Chronica. Chronic Rheumatism.

and their tendency to be attacked by it is known - -Podagra. Gout.

to be increased by interruption of the menstrual Hydarthrus. White Swelling. discharge. Hence, also, women between the

ages of forty and fifty frequently suffer from it.

Rheumatism is not so prevalent in certain famiSPECIES I.

lies as gout ; in other terms, it is less hereditary. ARTHROSIA ACUTA

Yet, though the disease can hardly be called he ACUTE RHEUMATISM.

reditary, an individual born of theumatic pa

rents will certainly be in greater risk of suffer. PAIN, INFLAMMATION, AND FULNESS, USUALLY

ing from the complaint than another person ABOUT THE LARGER JOINTS AND SURROUND

whose parents were quite healthy. According ING MUSCLES; OFTEN WANDERING; URINE

E to a table kept by M. Chomel, out of seventy DEPOSITING A LATERITIOUS SEDIMENT; FEVER

two rheumatic patients, thirty-six had rheumatic A CAUMA.

| parents, twenty-four had healthy parents, and The disease varies in respect to violence of twelve could furnish no information on the subthe fever, and seat of the pain. The varieties, ject.] How far the observation of Sir C. determined mostly from the last feature, are as i Wintringham is true, that those who have follow :

| suffered amputation are susceptible of this disa Artuum. Pain felt chiefly in the joints

ease more than others (Comment. de Morbus Articular rheu- and muscles of the extrem

quibusdam, art. 79), the author cannot say from matism. ities.

his own practice ; but it is the remark of a phy. 8 Lumborum. Pain felt chiefly in the loins ; sician who was not accustomed to forir, a hasty Lumbago. and mostly shooting up

judgment. wards.

[The generality of writers, down to the he y Coxendicis. Pain felt chiefly in the hip-ginning of the present century, admit that the Sciatica. joint, producing emaci.

seat of rheumatism may be either in the muscles ation of the nates on the

or the fibrous tissues, so called by Bichat, conside affected, or an elon

sisting of the capsules of the joints, fibrous gation of the limb. sheaths, the periosteum, and other fibrous memĆ Thoracis. Pain felt chiefly in the mus

branes, the aponeuroses, tendons, and liga Spurious pleurisy. cles of the diaphragm,

ments. This is the doctrine of Rivière, p. often producing pleurisy

Hoffman, A. Leroy, and Pinel ; to whom is to of the diaphragm.

be added M. Chomel. Among those who be

lieve that rheumatism may be seated indifer The common remote cause of ARTICULAR ently, either in the muscular system or RHEUMATISM, as of all the other varieties, is fibrous, some conceive that the disease never cold or damp applied when the body is heated : extends to the muscles but secondarily, and that though it may possibly be produced by any other it always first attacks the fibrous or ligament cause of inflammatory fever, where the consti. Jous structures. Dr. Clutterbuck, in his lectores lution has a peculiar tendency to a rheumatic even defines rheumatism to be an inflammat action. This tendency or diathesis seems to of the ligamentous structure, connected w exist chiefly in the strong, the young, and the different joints, and covering the muscle active ; for, though it may attack persons of tached to them ; which is in fact the theory every age and habit, these are principally its Bichat. Dr. Scudamore, who regards the victims. We may hence, as well as from its dinous portions of the muscles as the seat symptoins, prove rheumatism to be an inflam- rheumatism, believes that, if the musc * matory disease. “Even in the weak and ema- fibres were inflamed, they would be affected ciated,” observes Dr. Parr, " the pulse is hard, swelling, which is not the case, while an the blood coriaceous, and bleeding often indis- crease of volume is always observable pensable." (Rheumatism is seldom met with fibrous structures attacked. In opposition

o the

hypothesis of Dr. C. Smyth, that the essential | its peculiar inflammation does not continue lung seat of rheumatism is in the muscles, Dr. Scud- enough in any one organ to injure the structure amore does not consider the permanent weak- of the arterial tunics; often, in effect, as in gout, ness of these organs, the diminution in their we witness its disappearance in a moment, and size, the imperfection of their action, and the find it migrating to some other part of the body. pain following their contraction, as proofs of the As a general rule, it may be asserted, that inflammation having its seat in the muscular rheumatic inflammation does not tend to supfibres; but only as the consequences of the im- puration. [It is one of the characters of the pairment of the synovial and tendinous struc fibrous system hardly ever to suppurate. Bi. tures, and of the extension or disturbance of chat believed that rheumatic inflammation never these textures in a state of inflammation, when- ended in the formation of an abscess, though ever the muscles are put in action.

coagulable lymph might be sometimes eflused Acute rheumatism chiefly attacks the fibrous round the tendons affected.] In a few rare inparts of the large joints of the shoulder, hip, stances, the contrary has been known to take knee, elbow, &c., and the muscular aponeuro- place (Morgagni, De Sed. et Caus. Morb., ep. ses.* This inflammation is not in reality attend. Ivii., art. 20; Med. Comment. Edin., vol. iv., ed with much swelling of the texture 'essential p. 198); and, in one or two cases, I have myly affected, the density of which prevents any self been a witness to an extensive abscess. considerable effusion of lymph into its intersti | But the general rule is not disturbed by such ces. It is true, however, as Dr. Clutterbuck rare exceptions. The inflammation, therefore, has remarked, that a good deal of swelling often | is of a peculiar kind. There will often, indeed, attends acute rheumatism; but this is owing to be effusion, and the limb will swell considthe extension of the inflammation into the sur erably ; but the effused fluid is gradually absorbrounding cellular texture.]

ed, and the swelling not unfrequently, though A few years ago, the proximate cause of not always, is accompanied with an alleviation rheumatism was imputed to inflammation of the of the pain. arteries themselves of the muscles and tendons; Sometimes the pains take the precedency of in short, to an immediate arterilis. Some ca the fever ; but, in other cases, the fever apses and dissections, in support of this doctrine, pears first, and the local affection does not diswere brought forward in France by M. Barde cover itself till a few days afterward.* There (Obs. communiquées à la Société de Méd.), and is no joint, except perhaps the extreme and miMM. Dalbant and Vaidy (Dict. des Sciences nute joints of the fingers and toes, but is susMéd. Journ. Compl., vi., Août, 1819); but the ceptible of its attack, although it usually comanomalous diseases to which they refer have mences in, and even confines itself to, the larger. not been generally received as examples of rheu- Among these, however, it frequently wanders matism.

most capriciously, passing rapidly from the In the case related by Mr. Barde, the heart, shoulders to the elbows, wrists, loins, hips, knees, all the larger arteries, and even the vena cava, or ankles, without observing any order, or enagave evident proofs of inflammatory action. bling us in any way to prognosticate its course; Their coats were thickened, hardened, of a always enlarging the part on which it alights, dark-red colour, in some parts covered with a and rendering it peculiarly tender to the touch. whitish purulent matter, and in some the inte- | The urine is often at first pale, but soon berior tunic was destroyed : the heart itself being comes high-coloured, and deposites a red sediconsiderably enlarged and inflamed.

ment. It may be distinguished from gout by [The foregoing hypothesis of arteritis being being little connected with dyspepsy, commenthe proximate cause of acute rheumatism, is suf- cing less suddenly, evincing more regularly-markficiently refuted by the consideration, that, if ed exacerbations at night, but less clear remis. it were true, rheumatism would always accom sions at any time : to which we may add, its pany arterial inflammation, which is not the fact. attachment to the larger, rather than the smallIr another argument were required to subvert er joints ; and its connexion with exposure to the opinion, it might be readily found in the fly cold and damp. It runs on from a fortnight to ing and very wandering nature of rheumatic three weeks; and the average of the pulse is pains, which pass, as Bichat (Anat. Gén., tom. rarely under a hundred. ii., p. 263) expresses himself, with astonishing The fever is generally accompanied with copi. quickness, from one situation to another. Brous ous and clammy sweats (often of an exceedingly sais, in his Leçons Pathologiques, thus accounts sour smell]; but the skin still feels tense and for rheumatism: “When," says he, “the ac- harsh ; nor does the sweat issue freely from tion of the skin is diminished, it is determined to another part; and here it is to the capsules

* Acute rheumatism presents a state of active or articular ligaments, the textures around the fever, accompanied with inflammation of the joints, that the irritation is determined."! fibrous tissues about the joints. One point not In the general course of acute rheumatism, entirely decided is, whether the fever is the cause

or the effect of the inflammation? Sydenham * The parts are generally hot and red, and fre adopted the first of these views, which has found quently the pain is situated in the theca of the an able advocate in Dr. Barlow (Cyclop. of Pract. tendons : Dr. Elliotson has noticed red streaks in Med., art. RHEUMATISM), who endeavours to the direction of the latter parts.-Lect. at Lond. prove (a fact generally acknowledged) that the Univ.. as published in Med. Gaz. for 1833, p. state of the constitution is what principally claims 852.-ED.

regard in the treatment of acute rheumatism-ED. the immediate seat of pain. It seems to be an camphire. Aperients are userul to a certain exineffectual effort of the remedial power of na- tent; but they have not been found so service ture to carry off the complaint : for it is by this able as in various other intiainmations. Smal evacuation alone that we can at length succeed doses of calomel have occasionally, however, in effecting a cure. But the perspiration will seemed to shorten the term of the disease, though be always found unavailing, so long as it contin- they have not much influence in diminishing the ues clammy, and the skin feels harsh, and there pain. To obtain this, Dr. Hamilton has comis a sense of chilliness creeping over the body, bined calomel with opium; and, in his hands, or any part of it, during the perspirable stage. it appears to have been successful Opium The exacerbation, which regularly returns in alone is rather injurious; nor has any decided the evening, increases during the night, at which benefit resulted from other narcotics, as hyostime the pains become most severe; and are cyamus, hemlock, and aconite. then chiefly disposed to shift from one joint to No constitution is invulnerable to the attack another. *

of rheumatism, although the young and the rig. [Acute rheumatism is not, generally speaking, orous fall most frequently a prey to its torture, attended with danger. Sometimes, however, it Hence not unfrequently we meet with it in perinduces inflammation in parts of great impor sons of weak and irritable habits, who will not tance to life ; seemingly, in consequence of their bear the lancet with that freedom which gives partaking more or less of the ligamentous or any chance of its being useful. Local bleeding fibrous tissue. The periosteum is a structure is here to be preferred, but it cannot be dependthat is frequently attacked ; and hence those ed upon; since, though the pain may diminishi, aching pains in the bones by which patients are or even totally subside, it is in many cases only severely tortured. The pericardium is another to make its appearance in some other quarorgan to which rheumatic inflammation is fre- ter.* Here also, if in any case, we have reaquently directed: the case being indicated by son to expect benefit from uniting stimulants great pain in the region of the heart, and great with diaphoretics, as ammonia, camphire, and disorder in the action of this viscus. Some- the resinous gums and balsams. times the dura mater, another fibrous membrane, In such habits, and particularly if opium should suffers; the patient being afflicted with severe disagree with the system, it may be worth while headache and delirium, and often falling a victim to try the rhododendron (r. Chrysanthum, Lin.). to the disease. There is also no doubt, that This plant is a native of the snowy summits of the pleura and diaphragm are very liable to the Alps and mountains of Siberia; and in Rus. acute rheumatic inflammation; and surgeons sia, as we learn from Dr. Guthrie, is employed most experienced in diseases of the eye, recog very generally, both in gout and rheumatism, nise a species of rheumatic inflammation to with a full assurance of success, a cure seldom which that organ is subject, and which has its failing to be effected after three or four doses seat in the sclerotic coat, whose fibrous texture (Med. Comment., vol. v., p. 434): in cons is well known. Frequently it affects the loins, quence of which, it has formed an article in the producing lumbago; the muscles at the back of Materia Medica of the Russian Pharmacopes the neck, the face, or any other part, where for nearly a century. Dr. Home tried it upon fibrous membranes, aponeuroses, ligaments, ten-a'pretty extensive scale in the Edinburgh Infirdons, or perhaps muscles, are situated.]

mary, and found that it acts both as a powerful Where fever is violent, and especially where diaphoretic and narcolic; and is at the same the frame is robust, our only effectual remedies time one of the most effective sedatives in the are copious bleeding and the use of diaphoret- | vegetable kingdom. In most of the cases !! ics : by the former, which will often demand retarded the pulse very considerably, and, in repetition, we take off the inflammatory diathe one instance, reduced it to thirty-eight strokes sis; and by the latter, we follow up the indica- | in a minute. It has also the advantage of occas tion which nature herself seems to point out, sionally proving aperient. But it sometim and endeavour, by still farther relaxing the ex- produces vertigo and nausea ; and, as a gener tremities of the capillaries, to render that effect. medicine, is not to be preferred to Dore ual, which, without such collateral assistance, powder (Clinical Experiments, Histories of D is, as already observed, for the most part exert- sections, 8vo., Edin. 1780), or even the ant ed in vain, and with an unprofitable expenditure monial powder with opium, where the latter cah of strength. The most useful diaphoretic is be borne without inconvenience. Dover's powder, and its benefit will often be It is possible also in habits of this irritable increased if employed in union with the aceta- kind, if in any, that we are to look for that er ted ammonia, and sometimes if combined with traordinary and decisive benefit from a free us

nes

of the bark at an early period of the disease # When the disease subsides, the parts do not which we are told has been obtained. Contem desquamate and itch, as they do after gout; but they merely cease to be hot, swollen, and inflamed. * Dr. Elliotson finds that free local bleeding gem. (Dr. Elliotson's Lectures.) Rheumatism does | erally answers better than venesection : 410 not begin, like gout, particularly in the night. observes, that whether leeches or cupping be time, and it arises from an evident exciting cause, I ployed, great benefit will result from app exposure to cold, or cold and wet, which is not cold lotions as long as the temperature of the the usual occasion of gout. In the latter disease, is higher than it ought to be. See his you have not, in the early stage, the same tendens at the Lond. Univ., as published in the cy to profuse and often sour perspirations.-Ed. I for 1833, p. 853.-Ed.

e em

« AnteriorContinuar »