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

      Constitutionaldiseases 317

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, cucumbers, 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, buttermilk, 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 colchicum 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 colchicum as soon as the pain is relieved and then you can give wine of colchicum 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.

[318 Mothers’ remedies]

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 passed into the joint sometimes and then the parts look watery (oeclematous).  The inflammation and swelling cause great pain in the joint.