Lingual neuralgia is usually experienced during the whiter, and often vanishes with the appearance of fresh fruits and vegetables, in the spring.
Leueoplak is is sometimes due to similar causes, but is a more obstinate affection. It should be treated with non-poisonous anti septic lotions, and the white patches on the surface of the tongue should be touched as often as once a week with a saturated solution of chromic acid, or with a one-half of one per cent. solution of the bichloride of mercury.
During the first twenty-four hours of its course tonsillitis may be sometimes aborted by the administration, every three or four hours, of five grains of powdered guaiac with half a drachm of potassium bicarbonate in a wineglass of lemonade. Sodium salicylate may be given in ten-grain doses every two hours until the acute symptoms begin to subside. The subsequent treatment should be adapted to the arthritic predisposition of the patient.
The biliary disorders that accompany gout are usually of a functional character unless chronic alcoholism also exists. Constipation, head ache, hemorrhoids, lassitude, and depression of spirits are among the most conspicuous symptoms. They demand the employment of the measures that have been already described —mercurials with colocyntli and colehicmn, saline cathartics, especially those that contain sodium sulphate, the mineral waters, and, in the later stages of the disorder, mineral acids and bitter tonics.
Bond disorders connected with arthritisin have been already suffi ciently described. Certain affections of the genital organs may be noted as usually dependent upon the gouty diathesis. Of these, boianitis and hopes prepatialis are not uncommon. They can be usually arrested by the application of listerine or other similar lotions containing boric acid, eucalyptol, and menthol. In severe cases it may be necessary to dust the parts with boric acid, and to insert a piece of lint between the glans penis and the prepuce. Pru ritus of the vulva requires essentially the same method of treatment. When dependent upon glycosuria, great attention to cleanliness, alkaline injections, borated lotions, mercurial ointments, and cocain ized salves are indicated. Priapism, of a persistent character some times torments elderly gouty subjects. Efficient elimination and the continued use of potassium iodide will generally give relief. Some times an attack of orchitis occurs as a manifestation of acute or retro cedeut gout. Its treatment must be conducted in accordance with the general principles that have been already enunciated. The same thing may be said of the non-venereal urethritis and ivostatiti.s that are
sometimes experienced. Severe attacks of cystitis, occasionally ac companied by vesical hemorrhage, are not infrequent. They are sometimes connected with the recession of an eczematous eruption from the skin. Rest, milk diet, copious draughts of linseed tea, in fusions of buchrt, uva ursi, triticum repent, or slippery-elm bark, with largely diluted solutions of potassium citrate, or lithium citrate, should occupy the patient during the acute stage of the disease. Londonderry lithia water and the waters from the Poland or Wau kesha springs are very grateful beverages. Opiates and the solana ceous extracts are needful for the relief of pain. Colchicum and mer curial laxatives are required at intervals.
Many cases of dysmenorrhcea and pelvic neuralgia are dependent upon the arthritic diathesis for their existence. Much unnecessary gynecological surgery might be avoided were this fact more generally appreciated. In addition to the general treatment, cannabis indica, potassium bromide, phenacetin, salol, or sodium salicylate may be used for their anodyne effect. Atonic constipation with universal torpor of the circulation is greatly benefited by the daily use of guaiacmn in laxative doses. Hepatic torpor and hemorrhoidal ten dencies may be counteracted by the long-continued daily administra tion of sulphur and potassium bitartrate in tablet form. Iron, quinine, strychnine, and arsenic should he given at the same time in order to increase the stability of the nervous system. Daily bathing in warm water should be practised, and, if possible, the patient should be encouraged to seek a change by periodical visits to the various hot springs in Virginia, Arkansas, South Dakota, and the Rocky Mountains.
The different cutaneous diseases that occur among the gouty — pruritus, psoriasis, eczema, urticaria, and herpes—all require the same recognition and treatment of their common diathetic basis. Their management will be fully considered in the volume on diseases of the skin, and may be briefly summarized as consisting of appro priate elimination, anodyne local applications, general correction of the functions of digestion, assimilation and metabolism, together with a chronic and mildly arsenical medication of the nervous system. Residence at a distance from the ocean, the prolonged use of warm baths, and abundant exercise in dry bracing air, are to be enumerated among the most efficient remedial measures.
For the treatment of the different forms of lithiasis which so fre quently accompany gout, the reader is referred to the volumes of this work that treat of renal and hepatic diseases.