In the inflammatory variety of rheu matism colchicum is of but little value except in purgative doses. In subacute rheumatism the combination with po tassium iodide is very useful. II. C. Wood ("Therapenties: Its Principles and Practice," ninth edition, '94).
It is better to reserve colchicum for the treatment of the acute paroxysms of gout, giving a little opium (as in Dover's powder) at night, particularly to relieve the pain and to procure sleep, enjoining perfect rest and quiet and using warm applications locally. In chronic gout and the uric-acid diathesis it is not as useful. Biddle Oat. Med. and Ther.," thirteenth edition, '95).
While efficacious in chronic rheuma tism and occasionally of some benefit in rheumatoid arthritis, it is of no value in acute articular rheumatism. Its value is more apparent in acute than in chronic gout, and in the first attacks than in succeeding ones. Chronic gout, as well as chronic rheumatism, yields better to a combination of potassium iodide than to colchicum alone. In combination with certain other agents this drug serves an excellent purpose as a cholagogue, full doses being frequently very effective in relieving ascites due to obstrnctive dis eases of the liver. It is also sometimes employed as a drastic purgative in cere bral and portal congestion, although when given in doses sufficient for this purpose it occasions considerable nausea and abdominal distress. It has also been recommended in the treatment of gonorrlmea and chordee. Hypochondria sis resulting from renal insufficiency is frequently benefited by this remedy. Butler ("Text-book of Mat. Med., Then, and Phan." '96).
Given during an attack of gout it most markedly relieves pain; in smaller doses, given between the attacks, it diminishes their severity. It is often very useful for dyspepsia, eczema, headache, neu ritis, conjunctivitis, bronchitis, and other conditions which, when occurring in those suffering from gout, are prob ably related to it. Occasionally it is
combined with other cholagogues, espe cially if it is desired to give these reme dies to a person who is the subject of gout. Hale White ("Mat. Med. and Then," '96).
Colchicum is a remedy of undoubted value in gout and the gouty diathesis. The larger doses of the drug should be reserved exclusively for able-bodied men of the brewer's-drayman kind, and the effect is marvelous, the patient usually being able to resume work on the third day; but the treatment is severe and produces persistent purging not uncom monly accompanied by vomiting. In less severe eases give 10 minims of colchicum wine with 5 grains of potassium iodide in a mixture flavored with spirit of chloroform and syrup of orange-flower, three times a day; this often acts as a laxative, and produces a peculiar me tallic taste in the mouth; many patients take this mixture at intervals all the year round, Murrell ("Manual of Mat. Med. and Tiler.," '96).
The effect of colchicum on gouty in flammation is very rapid; a large dose will often relieve the most severe pain in the course of one or two hours, and soon afterward the swelling and heat will subside. While the pain is thus quickly subdued, the temperature of the body falls very little during the first day, but on the following morning there is generally a considerable decline, and often a return to a healthy temperature; should the fall be postponed a longer time, then on the second day after the use of the colchicum a continuous de cline of temperature will take place, and all fever gradually disappear. There are two methods of employing the dnig: large doses which extinguish the pain at once, and small doses which give the same result only after some days. It is sometimes used in chronic rhemnatism and rheumatoid arthritis, but without any very apparent benefit. Ringer and Sainsbury ("Hand-book of Ther.," thir teenth edition, '97).