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Treatment - Arthritis Deformans

disease, patient, diet, tends, air and usually

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In advanced and in very chronic cases of arthritis deformans it is usually impossible to bring about apy material amendment in the pa tient's condition, and our treatment must be chiefly directed to the palliation of his sufferings. This is, however, by no means the case when the patient is comparatively young, and when the disease is still in an early stage, for under these circumstances marked improve ment under treatment may certainly be looked for, although it can never be confidently promised, seeing that not infrequently the mor bid process continues to advance in spite of every endeavor to stay its progress.

In the general treatment of arthritis deformans two main princi ples need to be borne in mind, viz. : 1. That this is a disease which tends to attack persons whose vitality is lowered and who are iu popular phraseology "run down," and that any lowering course of treatment, even if apparently benefi cial for the moment, tends to favor the progress of the malady ; 2. That any treatment, in order to be effectual, must be steadily persevered in for a long time.

No greater mistake can be made than that of treating the sufferers from the disease under consideration as if they were the victims of gout. The carefully regulated diet, with a limited supply of animal food which experience has shown to be beneficial in gouty cases, is positively injurious to patients with arthritis deformans, who re quire a diet as nourishing as their condition allows ; and drugs such as colchicum and alkalies, which are usually prescribed for the gouty, are worse than useless in cases of arthritis deformaus, while the patients derive benefit from tonics.

Good hygienic conditions ; the removal as far as possible of busi ness and other worries; removal from a damp house or neighbor hood; the taking of such amounts of recreation and exercise as are compatible with the sufferer's state are all important elements in the treatment. Indeed it is probable that change of air and scene not infrequently contribute materially to the benefit derived from a visit to some mineral-water resort.

The patient should reside in a mild but not relaxing climate, pre ferably away from the sea, for sea air usually tends to aggravate the articular and other pains. Dampness of air and soil should be_ avoided, and woollen clothing should be worn next the skin both in summer and winter. A winter residence in a warm climate in which the fluctuations of temperature are not extreme is often very bene ficial.

In the acute stages and when there is much febrile disturbance a light but nutritious diet should be prescribed, but in the more chronic stages of the disease, if any rules are laid down as to diet, those ar ticles should be specially selected which are likely to agree best and are at the same time nutritious. Meat should by no means be avoided, but the patient should be recommended to take nitrogenous food freely.

If the patient

is accustomed to take some wine with his meals he may continue to do so, and a glass of stout at midday may often be prescribed with advantage if it can be taken without discomfort.

It is obvious from what has been said that when dyspepsia is present as a complication it is important to treat this condition which tends to interfere materially with the nutrition of the patient, and it is sometimes advisable, before commencing any other line of treat ment, to devote our efforts to getting the stomach into better order.

These rules are not based upon any theoretical considerations as to the supposed nature of the disease, and in laying them down I am merely echoing the opinions of physicians who have made this disease the subject of a lifelong study, and who have formulated them as the outcome of a ripe experience. Of their correctness no one who has had opportunities of comparing the progress of cases in which they have been followed with that of others treated upon the oppo site plan can entertain any doubt.

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