. A text-book of medicine for students and practitioners . ft fluctuating masses, which arc very painful. If these l)urstsjjontaneously, or if they are incised, they are found to contain little, if any,pus, but much detritus, and nunurous crystals of uiic acid and urates (mainlythe monosodiuiii niates). Fig. 11.! sliows some of these ci-ystals taken troui agouty node (if the big toe; on closer examination they turn out to be pureuric-acid crystals. When these nodes bicak o])en they may develop into tediousulcers; similar gouty nodes (arthritic tophi) may develop in other portions of 124 COxNST
. A text-book of medicine for students and practitioners . ft fluctuating masses, which arc very painful. If these l)urstsjjontaneously, or if they are incised, they are found to contain little, if any,pus, but much detritus, and nunurous crystals of uiic acid and urates (mainlythe monosodiuiii niates). Fig. 11.! sliows some of these ci-ystals taken troui agouty node (if the big toe; on closer examination they turn out to be pureuric-acid crystals. When these nodes bicak o])en they may develop into tediousulcers; similar gouty nodes (arthritic tophi) may develop in other portions of 124 COxNSTITUTIONAL DISEASES the skin, particular!V in the lohi- ol (he far, and sonR-tiincs also in tho iondonsand muscles. The cartilaginous tissues, however, seem to jjossess a speciallystrong chemical and physical attraction for uric acid. (ioul may atlect the mucous memhranes. A gouty dyspepsia is vcrv Ire-(picnt. Its symptoms are more or less severe. The gouty are also subject toinicsiinal catarrh of varying severity, and to bronchitis and conjunctivitis, as. Fig. 112.—Clianges in the joints of the fingers in genuine chronic gout. (Personal observation.) well as to catarrh of the urinary organs. Ebstein regards gouty gonorrhea as essentially a catarrh of the excretory ducts of the prostate gland. It is notan cas} matter to explain why these various forms of catarrh should occur ingout. Some of them may he complications. In other cases they are doubtlessthe result of passive congestion, due to cardiac failure (vide infra), but in stillother instances it must be confessed that they are apparently due to the toxicinfluence of the accumulated uric acid or other noxious products of abnormalmetabolism. Inflammation of serous membranes—for exam])le, of the pleura—also oc-curs, and there may be pneumonia. I believe that 1 have twice observed genu-ine gouty orchitis. The skin not infrequently suffers from acute or chroniceczema, wliicli sometimes appears to be referable directly to th
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