Note 5 — Chapter IV · DEFINITION, CLASSIFICATION, ETIOLOGY, AND MORBID ANATOMY
Reading edition
Physiognomy of the Goutily Disposed.—Taking the principles as laid down by Laycock, the peculiarities of those thus affected fall under the head of the sanguine arthritic diathesis. (That careful observer did not fail to note the modifying influences of gout upon struma and other cachexia.) Thus may be compared the physiognomy of the diathesis and its associated cachexia (developed in time):—
Blood-vessels numerous; heart large and powerful; blood-corpuscles numerous; skin over malar bones highly vascular (florid complexion); skin fair, firm, oleaginous, perspirable; eyes blue; hair thick, not falling easily; teeth massive, well-enamelled, regular, even, undecayed in advanced life; malar bones flattened; head symmetrical; nasal bones well-formed, nose aquiline or of mixed form; lower jaw massive; lips symmetrical.
Form.—Figure for the most part tall; thorax broad at the summit; ribs well-curved; abdomen full; muscles firm, large; limbs large, robust; gait erect, well-poised. Nutrition active; digestion vigorous; appetite great for animal food and alcoholic stimuli. Respiration deliberate, deep; circulation vigorous; animal heat abundant; locomotion active; aptitude for exercise and outdoor amusements. Reproductive powers active; innervation abundant, the mental powers vigorous and enduring.
Physiognomy of the Sanguine Gouty Cachexia.—Blood-vessels largely developed over the malar bones and varicose; skin oily, yellow from subcutaneous deposit of fat; hair thick and white; teeth numerous, discoloured, crusted with tartar; lips bluish, nose reddish, hypertrophied; arcus senilis; abdomen pendulous; limbs thick; joints nodose; nodosities on the ends of the fingers, lobes of ears, fascia of muscles, and tendons; respiration hurried, wheezing; pulse intermittent, irregular; stomach flatulent; digestion acid; urine loaded with lithates; temper irritable; mind sometimes enfeebled.
The local diseases of the arthritic cachexia are principally seen in adult males past the age of forty-five. They consist especially in chronic inflammation of the muscular and articular tissues; in calcification of the basilar and coronary arteries, and of the cardiac valves. These changes give rise to hæmorrhagic apoplexy, angina pectoris, cardiac hypertrophy and dilation; and to secondary pulmonary affections, as emphysema, pulmonary apoplexy, and asthma. Irritation of the mucous surfaces may give rise to nephritis, pharyngeal and laryngeal coughs, and diarrhœa.—Med. Observation and Research, 2nd edition, pp. 96-98.