In acute gout piperazin causes a rapid amelioration of the pain and a progress ive diminution of the swelling and red ness. In chronic gout it appears to have an elective action upon tophi and upon the articular stiffness. The author has seen tophi disappear and de formed limbs assume an almost normal aspect, due to the persistent usage of the remedy, which is possible by its harmless action upon the organism. Delmis (Gaz. des Hap., Mar. 5, '96).
Gouty tophi removed by injections of piperazin, each consisting of S minims of distilled water and grain of piperazin. A little burning followed the first injec tion, but this was allayed by the ap plication of ice, and in subsequent oper ations all pain was avoided by having the part first sprayed with ether. The complete absorption of the tophus was effected by the treatment. Gioffredi (Gaz. degli Ospedali, Aug. 20, '09).
Sidonal, a combination of chink acid and piperazin, is very effective in dis solving an excess of uric acid. In doses of 15 grains every two hours no unpleas ant results ensued. Salfeld (Miinchener med. Woch., Apr. 2, 1901).
Sidonal is a preparation made by the combination of chinie acid and piperazin. Weiss discovered that this substance was capable of diminishing the forma tion of uric acid in the body, and Blu menthal showed that this reduction in the excretion of uric acid was real, and not merely due to its retention in the system. When 75 to 120 grains are given in twenty-four hours, the excre tion of uric acid sinks 30 to 50 per cent. Von Leyden, Ewald, and Goldscheider report favorable results with their use of sidonal in gout, and Mylius has con firmed their statements. The latter
found it worked advantageously in cases which resisted alI other modes of treat ment. It alleviated the pains, rendered motion less difficult, and shortened the duration of the attack. Improvement began after about four days instead of in three to four weeks. Seventy-five to 120 grains of sidonal were given daily at first, but later it was prescribed in much smaller doses. It was satisfactory not alone in the acute, but in the chronic cases as well. In other instances Mylius felt convinced that when he gave 75 grains at the very beginning of an attack he aborted its course, so that it was, in a sense, prophylactic.
The appetite appears to be affected only favorably, and Mylius noted no unpleasant or dangerous consequences from the use of the drug. E. P. Joslin (Boston Med. and Surg. Jour., July 11, 1001).
Quinic acid recommended in gout. It tends to check the formation of uric acid, as shown experimentally by Weiss.
The same obtained from fruit does not depend on the alkalies contained in them, but to the presence in them of quiuic acid. This agent is changed in the organism into benzoic acid, which, in its turn, is converted into hippuric acid. This acid is thought to be much more soluble m water than uric acid. Hugo Sternfeld (Miinchener med. Woch.. xlviii, No. 7, 1901).
Uricedin, a new remedy proposed by Mendelsohn, is a combination of citrate of sodium, sulphate of sodium, and small quantities of common salt and citrate of lithium. It may be of use in the treat ment of uric-acid gravel, but in gout it is about on a level with the other com pounds of soda.