The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . asthenic gout, this state continues unin-terruptedly; most persons, however, suffer from periodical exacerbations;and cluring intervals of either comparative quiescence or moderated fit, freshjoints, tendinous sheaths, or burste, may become involved ; also, and this is ofespecial importance, it is during this sort of diseased action that gouty degen-erations, such as are found in the vascular coats, cliiefiy occur. After several fits of gout, or after a considerable period of the more quie
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . asthenic gout, this state continues unin-terruptedly; most persons, however, suffer from periodical exacerbations;and cluring intervals of either comparative quiescence or moderated fit, freshjoints, tendinous sheaths, or burste, may become involved ; also, and this is ofespecial importance, it is during this sort of diseased action that gouty degen-erations, such as are found in the vascular coats, cliiefiy occur. After several fits of gout, or after a considerable period of the more quietform of suffering, great accumulations of chalk-stone are found, as well in thejoints as in the sheaths and burspe. I have seen the end of the first Fig. 644. metatarsal bone, and the corre-sponding part of the phalanx ofthe great toe, so completely occu-pied that they seemed convertedinto urate of sodium, with sparsetrabeculie of osseous matter run-ning through them; and thesheaths of tendons, both at theankle and wrist, with the bursaeover the olecranon processes, andseveral others, merely bags of. chalk-stone. Both hands were Hand beset with , deposits. From a prepara., Tin 1 n tion in the Museum ot the Channg-Oross Hospital. grotesquely padded and swollen, wdth irregular lumps, so that they looked like bunches of badly grown horse-radish. Attacks of misplaced or of metastatic^gout are dangerous accordin^^ to thevital importance of the organ involved; they frequently observe, in boththe acute and chronic forms, a sort of alternation with the joint affection—while the one is severe, the other will be slight, and vice versa; the non-arti-cular form is sometimes called suppressed. These internal affections inte-rest us only in a secondary manner.^ I need only mention gouty encephalitisand cephalalgia, sometimes delirium, and rarely mania, canlialgia and angina,syncope, bronchitis and asthma, gastritis, gastralgia and enteritis, as also theaffections of the ski
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