Page:Encyclopædia Britannica, Ninth Edition, v. 11.djvu/18

Rh harm and gravely advocated by a few among eminent modern physicians, who regard the disease as beyond the reach of remedies. But that gout, although, as has been shown, a malady of a most severe and intractable character, may nevertheless be successfully dealt with by appropriate medi cinal and hygienic measures is a belief largely entertained, and one which happily guides the practice of the physician, The general plan of treatment can be here only briefly indicated. During the acute attack the affected part should be kept at perfect rest, and have applied to it warm opiate fomentations or poultices, or, what answers fully better, be enveloped in cottan wool covered in with oil silk. The diet of the patient should be light, without animal food or stimulants. The administration of some simple laxative will be of service, as well as the free use of alkaline diur etics, such as the bicarbonate or acetate of potash. The medicinal agent most to be relied on in the treatment of gout is colchicum, which manifestly exercises a powerful action on the disease. This drug (Colchicum autnmnale), which is believed to correspond to the hermodactyl of the ancients, was introduced as a remedy for gout about a century ago, and has proved of such efficacy in modifying the attacks that, as observed by Dr Garrod, &quot; we may safely a sert that colchicum possesses as specih c a control over the gouty inflammation as cinchona barks or their alkaloids over intermittent fever.&quot; The mode of action of colchicum in gout is by no means determined, since it would appear to have no certain effect upon the uric acid excreted from the system ; and the general opinion seems to be that this drug has a special sedative effect on the gouty inflammation. It is usually administered in the form of the wine in doses of 10-30 drops every four or six hours, or in pill as the acetous extract (gr. |-gr. i.). The effect of colchicum in subduing the pain of gout is generally so prompt and marked that it is unnecessary to have recourse to opiates ; but its action requires to be carefully watched by the physician from its well-known nauseating and de pressing consequences, which, should they appear, render the suspension of the drug necessary. Otherwise the remedy may be continued in gradually diminishing doses for some days after the disappearance of the gouty inflam mation. The statements often made that colchicum tends to encourage the speedy return of the disease do not seem to be well founded. Should gout give evidence of its pre sence in an irregular form by attacking internal organs, besides the medicinal treatment above mentioned, the use of frictions and mustard applications to the joints is indi cated with the view of exciting its appearance there. When gout has become chronic, colchicum, although of less service than in acute gout, is yet valuable, particularly when the inflammatory attacks recur. More benefit, how ever, appears to be derived from iodide of potassium, guaiacum, and more especially from the alkalis potash and lithia. This latter drug is strongly recommended by Dr Garrod from its solvent action upon the urates. It is usu ally administered in the form of the carbonate (gr. v.. freely diluted). The treatment and regimen to be employed in the inter vals of the gouty attacks are of the highest importance. These bear reference for the most part to the habits and mode of life of the patient. Restriction must be laid upon the amount and quality of the food, and equally, or still more, upon the alcoholic stimulants. &quot; The instances,&quot; says Sir Thomas Watson, &quot; are not few of men of good sense, and masters of themselves, who, being warned by one visita tion of the gout, have thenceforward resolutely abstained from rich living and from wine and strong drinks of all kinds, and who have been rewarded for their prudence and self-denial by complete immunity from any return of the disease, or upon whom, at any rate, its future assaults have been few and feeble.&quot; The same eminent authority adds &quot; I am sure it is worth any young man s while, who has had the gout, to become a teetotaller.&quot; By those more advanced in life who, from long continued habit, are unable entirely to relinquish the use of stimulants, the strictest possible temperance must be observed, Regular but moderate exercise in the form of walking or riding, in the case of those who lead sedentary lives, is of great advantage, and all over-work, either physical or mental, should be avoided. Unfortunately the complete carrying out of such directions, even by those who feel their importance, is too often ren dered difficult or impossible by circumstances of occupation and otherwise, and at most only an approximation can be made. The effect upon the gouty constitution of certain mineral waters and baths is well known. The particular place must in each case be determined by the physician, and special caution must be observed in recommending this plan of treatment in persons whose gout is complicated by organic disease of any kind.  GOUVION SAINT CYR, (1764- 1830), a French marshal, was born at Toul, 13th April 1764. At the age of eighteen he went to Rome with the view of prosecuting the study of painting, but, although he continued his artistic studies after his return to Paris in 1784, he never definitely adopted the profession of a painter. In 1792 he was chosen a captain in the chasseurs repiilli- cains, and served on the staff of General Custine. His pro motion rapidly followed, and in the course of two years he had become a general of division. In 1796 he commanded the centre division of Moreau s army in the campaign of the Rhine, and by coolness and sagacity greatly aided him in his brilliant defence against superior numbers, and in his subsequent celebrated retreat. In 1798 he was appointed to the command of the army of Italy, the officers of which had revolted against their general Massena, and he was speedily successful in obtaining the complete re- establishment of discipline. In the following year he com manded the left wing of Jourdan s army in Germany; but when Jourdan was succeeded by Massena, he joined the army of Moreau in Italy, where, in face of great difficulties, he was not only completely successful in his defensive tactics, but gained, on the 13th December, an important victory at Albano. When Moreau, in 1800, was appointed to the command of the army of the Rhine, Gouvion St Cyr was named his first lieutenant, and on the 9th May gained a victory over General Krayat Biberach. In 1801 he was sent to Spain to command the army intended for the inva sion of Portugal, and was named grand officer of the legion of honour. When a treaty of peace was shortly afterwards concluded with Portugal, he succeeded Lucien Bonaparte as ambassador at Madrid. In 1803 he was appointed to the command of an army corps in Italy, and he gained in 1805 a victory over the Austrians at Castel Franco. He took 1808 he commanded an army corps with some success in Catalonia; but, not wishing to comply with certain orders he received from Paris, he resigned his command, and remained in disgrace till 1811. On the opening of the Russian campaign he received command of the 6th army corps, and on the 7th August 1812 obtained a victory over the Russians at Polosk, in recognition of which he was created a marshal of France. He distinguished himself at the battle of Dresden, 26th and 27th August 1813, but, after a stubborn resistance, capitulated there to the allies on the llth November following, and remained for some time a prisoner in Hungary. On the restoration of the Bourbons he was created a peer of France, and in July 1815 was appointed war minister, but resigned his office in the November following. In June 1817 he was appointed minister of marine, and in September following again re-
 * part in the Prussian and Polish campaigns of 1807, and in