Pharmacologia anti-empirica, or, A rational discourse of remedies both chymical and Galenical wherein chymistry is impartially represented, the goodness of natural remedies vincidated, and the most celebrated preparation of art proved uncapable of curing diseases without a judicious and methodical administration : together with some remarks on the causes and cure of the gout, the universal use of the Cortex, or Jesuits powder, and the most notorious impostures of divers empiricks and mountebanks / by Walter Harris ...

CHAP. XIV.

That it was a Custom heretofore, for Physi∣cians to apply themselves more particu∣larly to One Disease. That this Custom was not so absurd, as may at first be ima∣gined. How the Genius and Opportu∣nities of men do lie different ways. That Reputation, is procured by Artifices, as well as Merit. That the wisest men have had but a mean opinion of their own Knowledg. A more particular Appli∣cation of the Author to the Cure of the Gout, why no hindrance to his other per∣formances. This his Particular Appli∣cation vindicated. A Hearty Profession of the Author hereupon. The Gout de∣scribed, and distinguished from a Fitt. The Cure of the Gout, and the Cure of the Fitt, to be differently managed. The Pain why to be cured by Outward Appli∣cations. That the leaving the Pain to Nature is a gross mistakes, and why. How Topicks have come to be suspected by Prudent men. That Repellents and A∣stringents, and even Cold Applications, are justly to be suspected in all Gouts whatsoever. That Narcoticks are as bad as the others. The Quacks Oyls, Waters,

and Plaisters for the Gout considered. Proper Topicks of what nature they ought to be. That in the Declination, whether suddenly procured by Applications, or leafurely attained according to the Course of Nature, Catharticks have a good use. Why Bayrus his Caryocostinum hapned to be so successful to him, even in the height of his Fitt. Venaesection in the Gout, to whom useful, and to whom ex∣tream dangerous. Emeticks why so Ex∣cellent a Remedy in the Cure of the Gout, as well as in other cases. A word of Sudorificks. The Cure of the Gout pro∣perly Prophylactick. How that is to be managed. The Cure by Nervous Medi∣cines a long time continued, none of the best. That by Evacuations why preferred. Whither Bacchus and Venus be the com∣mon Causes of it. Three Aphorisms of Hippocrates in favour of Venery's cau∣sing it, distinctly considered, and explica∣ted differently from Galen, and the Com∣mentators. The preceding opinion, as to Wine and Women, proved unjust and uncharitable. The Cure by Diet examin∣ed. Some instances in favour of Diet af∣terwards answered. That those who are subject to the Gout, are seldom men of Common Understandings. The most

Universal Cause of the Gout hardly yet taken notice of. The Milk-Diet oftner injurious, than beneficial.

HErodotus, an ancient Author, tells us that Physicians before his time were wont to apply themselves more particu∣larly to the Study and Improvement of some one Disease; his words are these: 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉,* 1.1 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Every Physician should have One Disease for his Province, and no more; and in this respect there is no want of Physi∣cians neither; for some are Physicians to the Eye, others to the Teeth, and some to the rest of the Head; others again take are of the Belly, and some apply themselves to oc∣cult Diseases. But every one chose some Particular Part or Disease, wherein he thought fit to employ his utmost Industry for the good and service of Mankind. And Baricellus to the same purpose:* 1.2 Erat apud Aegyptios inviolabile decretum, ut singulis morbis singuli adhiberentur medici, &c.

Now this old Custom, as narrow as it may seem, and liable rather to our Cen∣sure and Merriment, than Imitation, yet

was more commendable and beneficial to the Publick, at least in those times, than may appear upon first thoughts. Indeed it ought justly to be acknowledged, to the present Honour of the Faculty of Physick, that the Professors of this Art are general∣ly men of as Ʋniversal Learning, and as Real-Learning in the best acceptation of it, as any Faculty whatsoever. And there∣fore it should seem very hard and impro∣per, to confine men of so Ʋniversal Capa∣cities, and diffusive abilities, to such nar∣row limits, as those Ancients could be well contented with. But notwithstanding, if in so large a place as London, which is so happily provided with great variety of most Able and Ingenious men in our Pro∣fession, every one would please to use a more particular diligence, in order to im∣prove his Faculty in some one Disease above others, I cannot conceive any Absurdity, Ridiculousness, or even Derogation from their other performances, by this more Particular Application. And I do verily believe, that if Learned men, after a com∣pleat acquisition of the Ʋniversal Method of Physick, and a necessary search into the Nature and Cures of those manifold In∣firmities and Diseases, which, with a kind of infinite variety, do afflict Mankind,

would with their utmost vigour and re∣solution prosecute the knowledge of some one Disease, eminently above others, they would most certainly find a Particular Providence attending and assisting them in so good and honest a Design.

Every mans Natural Genius must needs Incline him to make more absolute Obser∣vations, and to Delight especially in some kinds of Cures rather than others. As Complexions do notoriously differ, so must their Inclinations to this and that; and they are not so easie to describe, as to ob∣serve, every man for himself, upon Sober Consideration. One man shall happen to have abundance of Patients in this Dis∣ease, and another in that; and therefore after a reasonable Practice he will be able to determine, and suit his Observations best both to some Particular Disease, and some Particular Inclination. I have heard a very Eminent Modern Physician declare to me in discourse, that he never had a Patient in an Epilepsie all his life-time, and yet a man of as Ʋniversal a Practice, and deservedly too, as most that can be named. In the mean time some others of perhaps ten times less Experience may compute Scores of Patients that have been Epileptick. Time and Chance do happen to

us all, and as the Wheel of Fortune turns round, it raises a man in some respects, and is apt to depress him in others, and it is our part in Prudence to submit our concerns peaceably and without froward∣ness to the irresistible and necessary Laws of Nature and Fortune, or rather Provi∣dence. It is in our power not to neglect our Duty, and to be careful that we di∣ligently acquit our selves as we ought, but it is not in our power to regulate and oversway, as we think fit, the future de∣termination of Contingents.

The Field of Medicine is as large as the Field of Nature; and though a man may read, or write of all sorts of things in the general, yet it is as impossible for him to give an accurate and certain judgment of the vertues, uses, and real intrinsick fa∣culties of all sorts of Natural Subjects, as it is for one and the same man to lay his foot upon every turf of the earth, or to number the sands on the Sea-shore. He may be diligent in the examination of one thing, and shall be negligent in the exa∣mination of others. No doubt but the Physicians of former times were suffici∣ently satisfied in their profound skill in Anatomy, and yet our Modern Anatomists, standing upon their shoulders, have seen

a great deal farther in that Art, and Po∣sterity, I do not doubt, will upon farther prying into those matters, discover more and more to the Worlds end. It is per∣haps as convenient to the Designs of Pro∣vidence, that one man should busie his head in Ʋseless, as that others should in Ʋseful things. There is as much need of Servile minds to perform Servile offices, and of Asses to carry Burthens, as there is of Liberal Spirits, and of Liberal Arts and Sciences. And therefore it is but Natural for some men, who pretend to Physick, to pursue Curiosities of no moment to Pra∣ctice, with all the eagerness imaginable; they had much rather be trying some fine and pretty Experiments to gratifie the Eye, or the Fancy, and to be highly ad∣mired by those that are altogether Igno∣rant in Nature, than spend any time or thoughts in the loathed habitations of Poor Sick people; where nevertheless, if they were Wise, they would gain better Experience, and more to their true purpose, than from the little Experiments they took so much Delight in. Thus again others can dedicate the chief of their time, if not their whole time, to the Critical knowledge of the Figures and Descripti∣ons of all sorts of Plants in nature, and of

Exoticks especially; and these shall ride. as many Miles to see a New Ʋnknown Plant, brought from the Indies, or else∣where, as another man would to make a Good Purchase, or to gain a considerable Sum of Money; whereas in the mean time they are but little concerned about the Ʋse and Application of our Domesticks; the Cure of Diseases by the admirable en∣dowments of our Commonly Known Plants, they altogether despise, as a subject too inferior for their Inquisitive temper. Others again do acquire a good hand at Dissecti∣ons, and value themselves only there∣upon; there's not a Fish in the Sea, or a Bird in the Air, or even a contemptible Insect that moves upon the ground, but these Gentlemen make it their Chief busi∣ness to obtain, and Compare all the diffe∣rent fabricks which Nature has distingu∣ished them by, but in the mean time do overlook the Alterations of Diseases in Hu∣mane Bodies, as if they were insignificant; they had much rather be Curious Anato∣mists, than Expert Practicers.

Now I cannot deny but such men may make a considerable Figure in Physick, and may perhaps be admired with greater height, than those who better understand the Cure of Diseases. For men are more

apt to gain esteem in the World, by Arti∣fices, by Shew, and by Appearances, then by Real worth. Wise men, the best judges of things, are much fewer in num∣ber, than the weak, and half-witted. A competent and reasonable knowledge, even in Curiosities and Niceties, may not be amiss for any; but a continual addicti∣on to any sort of subjects, which do little relate to Ʋse, in a most Ʋseful and Pra∣ctical employment, whatever some may think, does deserve a real Censure.

Where-ever a mans thoughts are intent and fixed, where-ever his Genius does Naturally incline, and all his aims and application do continually tend, whi∣ther it be to pertinent or insignificant matters, whither it be to Ʋseful, or else meerly Curious things, if he has but toler∣able parts, and Education corresponding, he can hardly ever miss, it is hardly possi∣ble he should miss, the becoming Emi∣nent, and in great measure Perfect (I mean Perfect according to the Modulum of Humane Capacity) in that one point. Do'nt we every day see many a dull heavy creature, who has only Wit to keep his Shop, and mind his business, only his busi∣ness, and his Natural Inclination runs only that way he is pitch'd in, come to gain a

very good Estate from nothing, in some ordinary Servile Trade, whilst a man more refined and accomplished, a man of far more Sense, and a more Liberal mind, who was by some accident Chained, or driven to a Trade he never fancied, takes no De∣light in, this man can hardly keep things even, and instead of advancing, rather declines in the World, until some Acci∣dent or other at last Blows him up, and he disappears from the Station that he was very unfortunately placed in.

I should be very glad, if one man's head were able to contain all that Know∣ledge which is stored up with much lux∣uriancy in a very large capacious Library. Some Heads indeed are much larger than others, in Capacity, as well as Dimensi∣ons; and Diligence, and Industry, vivaci∣ty of Apprehension, and strength of Me∣mory, may fill one Head much fuller than others; but after all, we must remember, that the most Eminent and Wisest Philoso∣phers, who might justly have been thought the most Knowing of all others, were not ashamed to acknowledge, that they knew little, or Nothing in reality, Nothing, I say, not in companion with other men, but in regard to the multiplicity of things

themselves, or what might possibly come under the Sphear of our Imperfect Know∣ledge. Nay if we state the Extent of Humane Knowledge upon the determina∣tion of the most Celebrated Wise men in former ages, we shall at last find, that the Proportion of mans Knowledge of Na∣ture to the infinite multiplicity of Natural subjects, is not perhaps much greater, than the Proportion of our Body to that of the Globe of the Earth. A man that can speak and write great variety of Languages, shall sometimes prove but a very indifferent Head-piece in things of ordinary Discreti∣on. We know that sometimes one and the same Author will furnish us with a whole Encyclopaedia, and set himself forth as if he were skilled in every thing ima∣ginable in Nature. If he had as many Eyes as they say of Argus, and could read with every pair distinctly, and also Di∣gest his Readings at the same time, he could hardly know more than some Empty men will pretend. And yet we say, and truly enough, Aliquis in omnibus est in singudis nullus. He that has a Smat∣tering in every thing, is thought to be Good in Nothing. A few things well known, and to a mans proper purpose, are worth a great many more Superficially

known, and extraneous to his real busi∣ness. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; said Aeschylus well. A man is wiser in one Useful thing, than in a great many im∣pertinent, or really Useless.

Now because the World is so wide, and a mans Knowledge cannot be so dextrously and so efficaciously applicable to all Infirmi∣ties which attend Humane Nature, as it may be more Particularly to some, where∣to his Genius may Incline him, and his Fortune may have been most Assistant, it may be obvious enough to demand, whi∣ther I have any Particular Reason, or Ex∣perience, for the urging that obsolete, and unwelcome Custom of the Egyptians, and other Ancients, who took one Disease for their sole, or at least more Particular Pro∣vince? And I am not ashamed to acknow∣ledge, that I have taken some more than ordinary Pains in one Particular Disease, which is now grown more General and Epidemical, than it was in former times, and does more especially afflict the most Ʋseful, and Eminent men in all Professions, Nor do I find that the time I have spent in searching more nicely than ordinary into the Nature and Cure of that Grievous Disease, has at all spoiled my hand in the treating of other Distempers. For as there

is a Connexion of Virtues, in the Founda∣tion of Prudence, as the Schools do deter∣mine, and a man can't therefore be truly said to have attained the Habit of any one Single Virtue, unless he has likewise Ha∣bituated himself to the Practice of all the rest; so it may in some proportion be like∣wise said of the Cure of Diseases, that there is a Natural Connexion of Curing Diseases, in the Foundation of Method, and Prudent Management of Medicines; and he that is not acquainted, as he should be, with the Ʋniversal Method of Phy∣sick, and is not thereby Prepared to ob∣viate all Accidents which may happen, and to answer variety of Indications, with pro∣per and suitable Medicines, can never be truly said to Cure any one Disease, let his Remedies or Receipts be never so choice and good. He may indeed happen to do what is the part of an Understanding Physician, though he be an Ignorant, or an Empirick, but then it must be consi∣dered, that the Cure was an effect of Chance, not this mans Skill; and that al∣though the Chance did then hit right, yet it must be expected that it will much oft∣ner hit very wrong. And thus if a good Physician does prove so Fortunate as to Perfectionate his Method of Curing any

one Great Disease, with more Accuracy and Certainty, than others, (who never∣theless may in other things as much ex∣cell him, as he does them in this) he shall be the better able, and not the worse, to steer his course in the prosecution even of other Distempers. Though it be rea∣sonable enough to imagine, that if he did Absolutely Confine himself to the Man∣agement of no more than one only Kind of Disease, he would in all probability Adorn and Improve that Particular Pro∣vince much better, than by letting loose between whiles into variety of other matters. Nor would one Kind of Disease be so narrow and small a task, as some may think. For every Kind has a great many different Species under it, and the various Constitutions of men, ways of living, circumstances of Age and Sex, the frequent Alterations of the Air, and con∣sequential impressions on mens bodies, and lastly the Complications of it with other Diseases, do continually diversifie every Kind of Disease into a great many several sorts.

To be plain, I have for some years past applied my mind more particularly to un∣riddle the Nature, and, as much as lies in my small power, to perfectionate the Cure

of that Opprobrium to most Physicians, the Gout. I beheld with much regret, that Worthy and Excellent men, the Prime and Glory of our Faculty, after all their Trials and Endeavors in this most lamentable Disease, have thought it prudent, if not necessary, to advise many of their Patients to let Nature take its free course, and re∣main as contented with their misery as they can, and so not to meddle with Physick, for fear of doing more hurt than good. But some Comfort being expected from the ve∣ry Presence of their Physician, he is not altogether wanting in that point, to give them Joy very couragiously, as if they were now more surely entitled to the Happiness of a long, though in great part miserable, Life. And thus they come to pass over divers Fits as well as they can, doing nothing at all, until at last an habitu∣al, knotted, and immoveably fixt Gout gains upon them, and they just live a life that is really worse than Death it self.

Now some may account it vain, others arrogant, or, if they will, ridiculous, that after the fruitless attempts of such Emi∣nent and Able men, any one man of the Faculty, much less so indifferent a person as I have reason to acknowledge my self, should presume to make another Attempt,

in a case that has baffled the Greatest Champions of our Art. To which I can without Arrogance, and with Truth enough answer, that the most Celebrated, and perhaps Best Physicians, may be sometimes overseen in a Particular Method, wherein another of less noted qualifications may either by a Particular Providence, or by a more intense application acquit himself with abundantly more Success; that if it were not so, upon many occasions, the Excellent Observation in Diseases of many very Acute, and very Fortunate Physicians, must be neglected or despised, because forsooth they are not in the First and most Conspicuous Classis; that if Great Diseases were not capable of Greater Improvements than we yet have from the most Eminent Ancient, as well as Modern Physicians, we should now without any manner of doubt have more Certain and more Compleat Methods in abundance of cases than we yet have; and lastly that undeniable Mat∣ter of Fact, and the Observation of all ages (and herein I appeal to the Present) do unanimously testifie and evince, that the most Celebrated, and justly Fa∣mous Physicians have been commonly taken notice of, as more Eminent in some than other cases, and more Dangerous,

or less Fortunate in some rather than others.

As I am in my Natural Temper far from being subject to the over-admiring my self, and my own slender performances, so I have no reason to Despair, but my hearty and earnest desire to be truly service∣able to Mankind in my Profession, may be attended with the doing something which I may Hope will not prove altogether un∣acceptable, or to no purpose at all, even in the foresaid Disease. And if I know my self a little, I can farther declare, that the very Act it self, of Doing some unexpected Good to those who are afflicted with it, will be a greater Comfort and Pleasure to my own mind, than any consequential Profit, Honour, or other Satisfaction. It is very true, that the Providence, which governs the World, does not leave us so destitute in the Cure of Diseases, as some mens fears may suggest. And if we would not haughtily overlook sometimes plain and obvious Medicines, which are not less Excellent than Common, and would but expect less from the ingenuity and subtil∣ty of our own Preparations and beloved Contrivances, we should much oftner than we do find Admirable Remedies ready pro∣vided for our use, which when rightly

managed by an understanding man, would do wonders that are often vainly expected from the Indies, and remote parts.

I shall not now design a full History of the Gout, or enter deeply into the Nature, the Causes, Signs, and Cure of this Dis∣ease, but content my self with making a few Transient Remarks, which are rather Practical than Notional, relating to it. And in the first place we ought diligently to distinguish, between the Gout, and a Fit of the Gout, as we do at other times between the Stone, and a Fit of the Stone. The Gout is an habitual, or long-contra∣cted Disposition of nature to throw off offensive humours upon the Joynts, as often as upon any remarkable irregula∣rity, or a gradual collection of such mat∣ter as is like to prove injurious to the Sto∣mach, or the Vitals, the Principal Parts are threatned with danger. The Fit is a subsequent act, or present discharge of the offensive humours, upon either one, more, or even all the Joynts, according to their greater or lesser weakness, or else the greatness of the Prepared Disorder in the body. Now a man may have a Gouty Disposition of body, even when he is quite free from any Actual Fit; and thus another may have a Stone lodging quietly

in his Kidneys or Bladder, and may even then be properly said to have the Stone, though he is not at all troubled with any sensible Fit.

The Cure of the Gout, and the Cure of the Fit, are also two very different things, and ought in reason to be diversly man∣aged according to their different circum∣stances. If therefore a Patient in a Fit of the Gout sends for a Physician, he must then only expect to be Cured of his Fit; and if instead of a Fit that would accor∣ding to the course of nature hold him six, or eight weeks in Pain, and weakness, he shall be relieved of his Pain in a few hours, and delivered of his weakness in a few days, he has reason to Thank God for this Assi∣stance of Art, and to embrace it with Joy.

The first thing therefore, and the chief that is to be done of the Fit, is to take away the Pain each part, where the Defluxion has fallen, by Proper Outward Applications, and to free the parts as well as may be from that load which within swells and dilates preternaturally the Nerves, and which frets and exagitates the Spirits there inhabiting. For although the Defluxion does at first appear Spiritu∣ous, and Insensible, yet in a little time it

turns to be Humoural, and palpably evi∣dent. And a great many little disputes about we know not what, and what we never can know, but only pass a Learned Guess concerning, are no ways material to the True Cure of the Gout any ways con∣sidered. We are certain of a precedent disorder in the body, we are certain of a sub∣sequent Pain in the Joynts, and upon a Metastasis, or translation of the foresaid disorder from within the trunk of the body to the outward parts, we are cer∣tain, that the diseased persons do find themselves much relieved within, and as much aggrieved in the outward parts. And the settling Notions nicely, whither it be a vapour, or humour, wind, or spirit, either or neither, which is the Matter or Form of the translation from within out∣warldly, would indeed make a divertive discourse, but will be very insignificant in reality to the laying a good Foundation for the Cure of this Disease.

The Pain being often so great as to cause a Symptomatick Feaver with it, we ought diligently to apply our selves to remove this Grievous Pain, and a man may as well maintain, that it would be injurious to the body to part with a Quar∣tan Ague, before it has been shook with

it for a full year, as that it would not be safe to lose the Pain, before so many weeks are over, and Nature it self has as it were in Pity to the Diseased at last gi∣ven them a convenient respite. The Cause of the Pain being Conjunct in the Part, or Parts affected, why may not the removal of the Conjunct, and even Conti∣nent Cause, be a proper stroke to the Cure of the Pain, as well as the removal of the Antecedent Cause Prevent or Cure the Gout? the same Natural Principle, which threw the disorder upon the Joynts, would doubtless, if it had been able, have throughly discharged it even from the Outworks of the body. Unless we will think, that it is delightful, and some ways convenient to Nature, to have an Enemy remain so near it, as the Hands, or Feet. Possibly it may, by way of a Spiritual Ex∣ercise, and to help Contemplation; but who∣ever thinks himself altogether secure in the main Fort, because the Enemy is dri∣ven into the Outworks, may be surprized before he's aware, and come to lose Pos∣session of the whole.

The Benefit of Outward Applications, when properly and safety administred, in a raging Fit of the Gout, is a great, as the freedom from Pain in any other part is

ease and comfort in respect of that part. But the unhappiness of them is, that they have been generally managed by Quacks and Ideots, rather than by Physicians; that divers instances are to be met with, where∣in Outward Applications have proved un∣happy, and have perhaps directly threat∣ned the Life of the Patient; but still the irregular use of any sort of Medicine, is no just exception to the thing it self. For otherwise we must lay aside Vomits, and Purges, and Opiats; nay we ought as well to abstain front every sort of Meat, and Drink, because Gluttons and Sots have abused the use of them.

Repellents and Narcoticks are favoured too much, as well by the generality of Authors, as by Women and Empiricks. And though abundance of Formulae are descri∣bed by Excellent men, in this Disease, yet upon the Experience that I have had in it, I can hardly conceive any Arthritick case, which necessarily, or property requires them. Upon a considerable Declination of the Fit, they may happen to be used, when no great hurt may ensue, and some good may appear to follow, but the mis∣chievous consequences will even then be durable, and in time convince them of their Error. It may suffice to give one

instance out of Trincavellius,* 1.3 concerning the Fatal effects of them in one, and the terrible danger of them in another Noble∣man of Venice. The first upon the appli∣cation of them to his Knees, and Hands, repelled the Arthritick humour into his body, and fix'd him into an irrecoverable Asthma, which soon concluded his life: the other by the same Method fell into a most grievous, and vehement Feaver, ac∣companied with a Paralytick Trembling of all the parts of his body, and Stupor of all his Senses, but his Gentleman had the good fortune to escape immediate Death, and with a great deal of difficulty, by the help of his Physicians, made a shift at last to recover. Repellents are so directly con∣trary to the Invention of Nature, that I cannot but Wonder, how Learned and otherwise Able men, could either recom∣mend, or at any time have recourse unto them, in many other Defluxions, or Dis∣charges, besides the Arthritick. For if Nature, or Art, in a Malignant Feaver, do happen to throw off great part of the Morbifick matter upon the Inguina, the Alae, or behind the Ears, or else into some other place which is not so proper an Emunctory of the Principal parts, use but Repellents a little to the Tumour, and strike

it back upon the Vitals, and I dare leave the person to a Dismal, if not inevitable Prognostick. Nature does exceeding kind∣ly in freeing the Vitals from a considera∣ble part of that which caused the Feaver, and if we presume to return it upon her again, she will take it very unkindly, and is presently overcome, being not able to make a second Defence against an Enemy, that she had much ado to struggle with before.

But the use of Repellents and Astringen∣topicks, is rather recommended by Authors in Hot, never in Cold Gouts, called Hot and Cold, from the visible Complexi∣on of the Parts affected, or else of the body in general. Now even in those Hot, Cholerick, or Sanguine Gouts, I can never approve of Repellents; for though they may sometimes give great ease and satis∣faction, in point of their Pain, and in the Declination, or after Evacuations (a Me∣thod with some) may happen to be at∣tended with no sensibly ill consequences; and though the Astringents may seem properly to answer to the Weakness of the parts, yet if we consider the nature of the Nerves and Tendons, whose weakness it is that primarily occasions the Pain, we shall find, that Cold Repellents and Astringents

are very contrary to the nature of the Nerves, and consequently cannot be of such benefit in Arthritick cases as we ought to contrive. For Cold things are by all held to be injurious to the nature of the Spermatick parts. The Spermatick, exanguious, and Nervous parts are Cold in their Temper, and affected or hurt by Cold.* 1.4 And Galen gives this as one com∣mon Sign of distinguishing the temper of any part, that if it be offended by Cold things, it is Cold, if by Hot things, then it is Hot. And so Hippocrates says, that Cold is most offensive of any thing to the Bones, the Teeth, the Nerves, the Brain, and to the Medulla Spinalis, because those parts are Cold. But on the contrary Hot things are acceptable to them.* 1.5 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Wherefore I very much su∣spect even the affusion of Cold water upon the parts affected, which our Great Hippocrates does sometimes recommend in Gouts,* 1.6 and from him Vander Heydon in his not contemptible Discourse of those three not contemptible things, Whey, Cold water,* 1.7 and Vinegar. And Bathings with Milk, or the like, do seem to be alike improper, notwithstanding that a person

now and then may appear to have re∣ceived sufficient Benefit from them. And upon these grounds, I cannot but admire that so Learned and Eminent a man as Fernelius was, should find out no better, nor more proper an Anodyne, for such a person as the Marquess of Brandenburgh, than the mucilag. sem. althaea cydon.* 1.8 à ℥ ss. extract. in aq. stillat. Solan. & Plantag. à ℥iij. Addendo si lubet, acet. ℥j. to be ap∣plied, even at the beginning of the Fit, and before Purging.

As to the weakness of the Nerves in the Joynts, this chiefly depends upon an uni∣versal weakness of them, derived from the Brain, not as Fernelius maintains, in his Pathological considerations on the Gout,* 1.9 by bringing a Defluxion of thin phlegma∣tick humours from the outward parts of the Cranium, along under the Cutis down to the Joynts (which may rather be acci∣dental, and is not always perceived before the Fit) but by the universal weakness of the Spirits, from Procatarctick Causes, as shall more fully be explicated in the fol∣lowing discourse. In order therefore to take a right Indication of Topicks, we must restore the weakness of the Spirits, not by Cold Astringents, but by such things as shall Comfort and Cherish the Spirits, and

will that way Strengthen them Safely; and the humours which the Pain has drawn thither must be rather let out, not driven back, nor Stupified with Narco∣ticks.

And as for Narcoticks outwardly appli∣ed, or inwardly given, they must cer∣tainly Fix the humours in the parts af∣fected, and the Ease that the Patient for the present receives, can bear no propor∣tion to the inconveniencies that he must afterwards be liable unto, when the Gout shall hereby come to be Knotted, when those Salts which were fluid and moveable before, shall hereby come to Fix and settle, and the Disease grows to be in a manner Perpetual, which had some rea∣sonable Intermissions, before the Opiats were applied. Besides, I have sufficient∣ly shewed in the precedent Chapter, that Opiats are in their natural tendency inju∣rious to the Nerves, and for the reason that they are so injurious to the Pulse and Respiration, by diminishing and weak∣ning them, if not extinguishing their functions, they will be found to commu∣nicate very easily their hurtful, if not Per∣nicious effects, unto the Nerves.

Among the Ignorant Retailers of Phy∣sick, those silly Ignorant people, who for

want of something else to do, or because they could do nothing to purpose in their several Trades, and Employments, will needs be a trying their small Skills, some in one Disease, and some in another, in order to get a Penny, we have abun∣dance of ordinary Creatures that run about, one with an Oyl, a second with a Water, and a third with a Plaister for the Gout. And these shall give strange, and absurd assurances from their several Re∣ceipts; which all Physicians do know can never be rightly appropriated to all sorts of Gouts, any more than one sort of Purge to all Conplexions and Diseases.

As for the Oyl, it is to be remembred, that the Gout is chiefly occasioned from the weakness of the Nerves in general, and particularly in the Joynts. And this makes the Joynts so subject to receive Defluxi∣ons, when the body happens to be dis∣ordered. The Vitals being Strong, and the Limbs being rendred Weak, Nature like a Skilful Physician, throws the of∣fensive humours from within (the place of most danger) to the Outward parts, where the danger is less; and thus those parts are very subject to receive them, when men are Disposed to this Disease. And for the same reason it comes to pass,

that persons who have any Natural weak∣ness about them, whither it be in the Kidneys, the Glandules about their Throat, their Lungs, or in any other part, shall as Naturally receive into it the effects of any disorder, either by Intemperance, Colds, or the like, as those who have a weakness in the Joynts, do prove subject unto the Gout. Now the Parts being already weak, and the Joynts relaxed from their Primitive Tone, any Remedy which is of a Relaxing quality (as Oyls most plainly are) must of necessity do as much mis∣chief, by its additional Relaxation, as the Ingredients joyned to it can be conceived to do good.

As for the Water, if the Basis of it be a Water, it must needs be near as bad as the Oyl, being also of a softning emollient nature, and thereby tending towards the farther Weakning of the already enfeebled Joynts. I know how famous the Aqua Antipodagrica Rulandi, described in that excellent Treatise of Loselius de Podagrâ, and in his Secreta Spagyrica, Printed late∣ly Jenae; the Aqua Quercetani Antipoda∣grica, and others, have formerly been. But there's a great deal of difference be∣tween Waters of this, or any other kind, in the hands, and under the management

of such Able Physicians, and the Waters of a Woman, or an Ignorant Empirick, who know not how to suit them to their pro∣per uses, and who are continually subject to mistake, both in the quantities and the qualities of the Ingredients, which enter into them. One Water can be no more proper for all sorts of Gouts, than one Habit, and one kind of Diet, agree to all sorts of men. For there is a consi∣derable difference in Gouts, according to the different Complexions of men that are afflicted with it, according to the recency, or inveterateness of the Disease, and ac∣cording to the continual variations of na∣ture in the same person, insomuch that Good Authors have described a great many kinds of Medicines, both Outward, and In∣ward, to be interchanged, and altered, according to Discretion, as they are ob∣served to be Juvantia, or Laedentia, agree∣able or disagreeable, upon Particular oc∣casions. Nay the same Remedy has been observed to have admirable effects at one time, and to be insignificant at another, even in the same person.

Lastly as for the Plaister, I'le grant it may be an Excellent one, as there are For∣mulae enough of some few Good, and many more Bad, and that this Plaister may be

sometimes accommodated to very good purpose in one sort of Gout; but when an Ideot comes to manage it, who can no more distinguish in reality between Gouts, than a Blind man between Colours, who uses his Plaister at random, as a Game∣ster throws the Dice, it must certainly happen to do as much hurt sometimes, as it may happen to do good at others. And therefore what a Blessed condition must those Gentlemen be in, who in such tick∣lish points as neither themselves, nor their Quacks can possibly understand, will run the hazard of a Plaisters, doing either Good or Hurt, as meer Chance directs it! I have often observed the very Form of Plaister, though an Excellent sort, the very Form, I say, of Plaister, notoriously to disagree with this Disease. The Form of Cataplasm is much more likely to an∣swer an intention throughly, and safely, than any other that I know of; it may be impregnated with proper Medicines more Strongly, or Mildly, as the Physician judges it most convenient, and as the Case appears before him.

When proper Topicks, not Cold or Hot, according as the Gout is supposed to be either Hot or Cold, but Milder or Stronger; more or less Searching and Evaporative;

and more or less Temperate in respect of Heat; and more or less Strengthning, not by a Cold Astringency, but by a Comforta∣ble, Nervous, and invigorating way of Strengthning, according to the weakness of the Parts, the duration of the Disease, and the frequency or fewness of Paroxisms: when, I say, Topicks thus proper have taken away the Pain, and thereby brought the Fit into a Sudden Declination, Inward Remedies may then as Safely and as Ef∣fectually be used, as if the Patient had, to his great Prejudice in divers respects, waited the Cessation from Pain, or Decli∣nation of the Disease, for divers weeks, according to the Course of Nature. Before the Declination is obtained, one way or other, Catharticks or the like, cannot be so Safely administred, although here and there an instance may be brought in de∣fence of them. And though Solenander,* 1.10 a very good Author, does allow of Ca∣tharticks, even at the beginning of the Fit, while the Pain is raging; and Bayrus, one well acquainted with the Gout, main∣tains the same opinion, yet most Authors, and Experienced Patients are of another mind, and will not allow them so soon, by reason of ill accidents which do, or may often happen from that untimely admini∣stration

of Catharticks. For whilst the Pain is much predominant, it is not an Easie Purge that will work at all, and Lenitives are generally granted to be more hurtful than beneficial in any sort of Arthritis, and if the Purge be of a Vehe∣ment kind, and should happen not to work, or to work but little (which often happens, when exhibited in dolorifick Distempers) the Symptomatick Feaver must needs be attended with additional danger, the Choler burn, or fret more violently, and the Thirst grow more in∣tense. In Vehement Pains we know that an ordinary Dose of Opium shall have no operation at all, nay that it is sometimes requisite to give such a quantity of it, as would certainly Poyson the same man in Health and Ease, and yet at that time, un∣der the circumstance of Vehement Pain, it might have a Good, at least no Bad effect.

* 1.11Bayrus gives us a very famous History of himself, how by the use of his Caryo∣costinum, an Excellent Purging Electuary, when he was brought so low with the Gout, that he could move neither Hand nor Foot, nor any part of his whole body, besides the Tongue, yet upon taking half an ounce of the said Electuary, after it

had given him but four or five Stools; he found himself so mightily relieved, that he was able to go of himself to and from his place of Ease, and could take a walk freely into his Study, although upon the first operation of it, he was fain to be carried, or lifted upon the Stool by no less than four men. Nay the very next day he was perfectly freed from his Di∣stemper, which you may read more at large in his own Words, and was a just reason for his high Commendations of the Caryocostinum,* 1.12 to be Electuarium mi∣rabile ad auferendum dolores Juncturarum, subito solvens sine molestia, ignitum calo∣rem extinguens, & contemperans membra pa∣tientis in tantum, ut à sella redeat ad locum proprium sine alterius auxilio. Bayrus does not arrogate to himself the intire inven∣tion of the Caryocostinum; he acknow∣ledges that the Species of it, in form of a Cathartick Powder, were mentioned by Galen,* 1.13 only he thought it convenient to alter the Form of it, from a Powder into an Electuary, with a Syrup made of Honey, and White-wine. Our Dispensatory re∣tains it under the name that Bayrus gave to it, Caryocostinum, making it up with a triple quantity of Mel Rosatum, omitting the White-wine. But Daniel Horstius, I

know not upon what grounds,* 1.14 calls it Electuarium Caryocostinum Horatii A••ge∣nii, described after the same manner as by Bayrus, But if we can have such ex∣cellent effects from it, as Bayrus asserts, both upon his own Experience, and what he found in others, it is no great matter to us, who was the Author of it in part, or in whole.

But now as for Bayrus his case, there is no such wonder that this Purge, or even a Purge in general should prove so Safe to him at that time, or that he from thence should take occasion of urging the benefit of Purging at any time of the Fit. For he had no Acute Pains in one or two Parts more remarkably, but his Pain, and Dis∣ease together, were in a manner equally dispersed all over his body. And when the Gout comes once to this Extremity, they seldom feel much Pain to complain of in one certain place, and consequently Pain was not capable of hindering, or much retarding the operation of a Purge, as it may be apt to do in other kind of Fits; so that for reason it work'd as well with him, cum 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, as it would have done upon a less or another occasi∣on. Wherefore it will not follow from this Famous Story, (what I asserted at

first) that Purging about the Beginning, or in the heighth of the Fit (while the Pain is very Acute) is a safe and com∣mendable Method. But bring the Dis∣ease into a Declination, that is truly, take away the Pain, let it be done in an hour or two, or in longer time, and there ought to be no farther dispute, but Proper and Judicious Evacuations may be as Beneficial, as if the Declination had been tediously expected, for divers long weeks, accor∣ding to the Course of Nature.

And as for Bleeding, although in Youn∣ger persons, who are more than ordina∣rily addicted, or accustomed to a Glass of Wine, and in the First Fits, where there is a plain Plethora, and the Defluxion falls violently like a Torrent, it may some∣times be a Proper Preparative to other Medicines, yet this can only prove a Re∣vulsion from the Parts affected, and it may qualifie the Heat and Ebullition of the Bloud, but must still leave the Parts (if other Methods succeed not) in a fu∣ture weakness, or disposition to this Dis∣ease. Bleeding, where proper, may al∣lay the present Symptom or Paroxism, but is apt rather to impair the tone or strength of the Nerves, than to take away their imbecillity. The Eyes, and the

Optick Nerves are very sensibly weakned by Venesection, the very day that it is performed, and though in Younger peo∣ple that weakness is soon enough repaired again, yet it plainly shews that in all Diseases which proceed especially from a weakness of the Nerves, this Remedy ought to be used with very great cau∣tion, and not without some Necessity, on account of the Feaver, or Inflamation.

In Elder persons, or in Habituated Gouts, the use of the Lancet is almost as much to be dreaded, as a Dagger stuck to the Heart. The loss, and inconve∣nience of one single Bleeding shall per∣haps never be made up again as long as the person lives.* 1.15 Solenander, a Sober and Good Author, reckons up two persons that he knew, who upon unadvised, or unfortunate Bleeding in the Fit, did one grow quite Paralytick, and lost the use of his Arm afterwards, and t'other made his Gout Knotted by that means. And Examples of that kind are not rare. Galen indeed advises Bleeding Spring and Fall, as a Preservative against the Gout. But they must be very Young, and Sanguine, and they must not have suffered the Gout long, to whom that Remedy can be safe and Good.

Emeticks indeed are a Noble Remedy, both by way of Preservative, and some∣times before the Fit is over. One Vomit shall oftentimes do more than divers Purges, as making a Strong Revulsion from the Parts affected; as clearing the Stomach (the depravation of whose Fun∣ctions is a main original cause) of those humours which pervert its Chylification; as also freeing the Principal Parts adja∣cent to the Stomach, which do all by Consent unburthen themselves thither, during the operation of the Vomit; and lastly as wonderfully freeing the Head, and the Nerves of Phlegmatick, or Serous matter for defluxions. And in many Ce∣phalick Distempers, where the Nerves, or even the origine of the Nerves are threat∣ned, every body knows that little is to be done without Emeticks, and that very strange things may be done with their help. It is an Eradicative Remedy, and I wish it were as easie to bear, and as easie to perswade unto, when Proper, as it is Excellent in its kind. The Great Effects from Vomits made the Chymists even Mad in their use, and because some Stubborn Chronical Diseases did beyond ex∣pectation yield unto their Vehement Anti∣monial and Mercurial Emeticks, they would

needs be using the same, in Infirm per∣sons, and in Mild Diseases; and so the Credit they one while got, when they were rightly appropriated, they soon lost again by Apparent Miscarriages under their improper Administrations. For let ignorant men say what they will, and defend it with a Face of Brass, we and our Posterity shall always find it true, that only Extream Diseases require Extream Remedies, that Great Remedies are to be accommodated to Great Diseases, and so Mild to Mild. He that will think other∣wise, let him try Beef and Pork to Infants, and Milk to Plow-men, and Labourers. For there is certainly as much difference be∣tween Medicines to strong and weak Dis∣eases, as between Aliments to Men and Children. I have spoken more to the Matter of Emeticks before, in the Chapter of Vitriol, and elsewhere; and the small∣ness of this Treatise will not admit that variety which this Particular Disease de∣serves.

Sudorificks may in some have a proper and good place, and in Phlegmatick na∣tures, and Phlegmatick Gouts, may serve to consume any remaining superfluous humours about the internodia, where sufficient Topicks have not been used.

† 1.16 Cardan would make us believe that he had done mighty things in Arthritick Diseases with the Decoctum ex Ligno cum Betonicâ, adding but the Pilulae ex Her∣modactylis; and * 1.17 Platerus runs very much upon the same strain. But though these Sudorificks may seem to finish compleatly the Cure of the Paroxism; yet they will be found to do but little towards a future Prevention of the Disease.

The Cure of the Gout is truly, and chiefly, if not only Prophylactick. And he that is once subject to this weakness of the Joynts, and Nerves, and when he finds himself hearty and stout, bids defi∣ance to all Physical Care, and refrains now and then Medicè vivere, will as Certainly again Miserè vivere, and fall into the same woful condition he was in before, sooner or later, according to his course of life, and the prevalency of the former weakness, as the Tide ebbs and flows, or the Laws of Nature are Fix'd and Certain. Man's body is always in a fluxibility and motion, and either a good or ill habit is ever gain∣ing ground upon him. Neque enim in humano corpore quicquam quiescit,* 1.18 sed si non in melius proficiant, necesse est ut in dete∣rius prolabantur. And therefore none of us have reason to think our selves too

secure; for when we are in the greatest Athletick vigour, then commonly we are in greatest danger. 'Tis easie enough (through the Blessing of God) to Prevent Dangers, if we look to it in good time; but when once Diseases have gotten a strong hold upon us, and fundamentally altered our Tempers, we must be contented to run greater troubles, and uncertainties too, than could before have entred into our thoughts.

The Prophylaxis of the Gout must be so managed, as to divert Defluxions from falling on the Joynts, by a timely care. According as the Distemper has gained, either by its inveterateness, or else by the frequency of Paroxisms, or by their Ʋni∣versal affection of the parts (for I have known in some, near every Joynt in their body Sensibly affected, even in the first Fit, and not only a Toe, or an Instep) I say according to those, or the like cir∣cumstances, Ʋniversal Evacuations must be more often, or seldom administred; and oftner at first, afterwards more sel∣dom, until at last Spring and Fall, or even one of them may be a sufficient Pre∣servative. Among Evacuations, Emeticks will claim the first, and chiefest place; neither always need we have recourse

unto the Strong ones; there are as many Degrees of them, and some in a manner as Mild, as of the Catharticks; but where violent prejudices are taken against all the Kind of Emeticks, we ought not to force them too much, but rather make up the good we might have expected from them, by a more frequent administration of Proper Catharticks. The Dutch have a Natural, and Endemial aversion to all Emeticks, and if some of ours have a Spo∣radical Antipathy to them, we ought in prudence to avoid obtruding them with a Magisterial command, as much as we should this or that sort of Aliment, to which they have a Strong and Uncon∣troulable aversion.

All Authors do lay a great, if not an Absolute stress upon Nervous Medicines inwardly taken, and continued daily for a long time, no less than a Year or two together, in order to Prevent, or Cure the Gout compleatly. Aetius an old,* 1.19 but no bad Author, recommends several Ele∣ctuaries of this nature, to be taken for a year together: his Antidotus ex Hyperico, Antidotus Anastasii, and Doari Episcopi, all three appointed for a full year; his Tetrapharmacum, otherwise called Myste∣rium, for a short one, and Philagrius his

long one, &c. Our Modern Practicers keep rather to the pulvis fol. chamaepit. salv. beton. and the like.* 1.20 Platerus tells us of an Antient Gentleman of 70 years of age, who had been Arthritick for di∣vers years, and by the use of Betony alone, taken several ways, as in Conserve, infused in Wine, boiled with his Meat, &c. Cured himself so perfectly of his Gout, that he lived afterwards to 80 years, and free from it. And in my opinion it was a pretty Cure, and such as deserves not to be pass'd by in silence. But notwithstanding that Nervous Medicines inwardly taken for a long time be very Rational, and of∣tentimes Ʋseful at the long run, if other care goes along with them, yet it may be considered, that by reason of the Heat which attends Nervous Plants, and the other Hot Aromaticks and Spices, which are commonly added to the Recipe to make it appear with greater lustre to the eye, whither or no they may not in length of time have the effect of Wine immode∣rately drank. Wine in its self Soberly used, is perhaps the greatest Cordial in nature, and consequently a little of it may be as good for the Nerves, as Cor∣dials are thought primarily to be for the Heart; but if men cannot forbear over∣charging

their body with heavy loads of that Spirituous Liquor, or if once there grows a Thirst which nothing but Wine can quench, it will prove a Poyson in∣stead of a Cordial, and by degrees burn, and consume the necessary Principles of life. And thus even Nervous Remedies imprudently, or over long used, may ('tis more than possible) with their attending Heat so fret and Inflame the Bloud, that the disorders from the very Remedy, upon this account, may in some occasion or ac∣celerate an unexpected Fit.

Wherefore Evacuations, suitable to the temper of every person, or as the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, the present circumstances of Particulars do require, do seem in my conception to claim a just precedence to Alterative Ner∣vous Remedies, and will do abundantly more alone towards the Prevention of the Gout, than any Nervous Medicines can without Evacuations. The great use, and exceeding benefit of Evacuations, was not only Indicated, but Demonstrated, by the Natural Crises which have often de∣termined Feavers, sometimes Critical Hae∣morrhagies at the Nose, at the Haemor∣rhoids, and by the Menses, at other times by Diarrhaeas, Vomitings, profuse Sweats, and Discharges by Ʋrine. Evacuations

in Diseases have thus as Naturally been Indicated, as one Contrary has been by another. Indeed a due order both of Evacuations and Alteratives, is the part of a Good Physician, and if either Chymistry, or any fond whimsical Fancy does insti∣gate a man to be at defiance with Bleeding in general, or with Purgations either up∣wards or downwards, as if they might altogether be spared, and other Remedies would do better without them, these men, let their pretences be never so Chy∣mical, ought as strictly to be Banished from the Province of Physick, as a no∣torious Traytor from a well-governed State.

And now I have thus spoken to some of the most Material circumstances re∣lating both to the Cure of the Paroxism, and the future Prevention of it, it may not be amiss to obviate one great Error, about the Cause of the Gout. Authors with one consent, and people in general, have favoured the Opinion, that immo∣derate or unseasonable Bacchus and Venus, are the only Legitimate, and Necessary Parents of the Gout, where it is not He∣reditary. The Greek Poets have sung aloud, that the Gout is the Daughter of Bacchus and Venus, that the Gout is a

Luxurious Goddess, and esteemed 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, a hater of Poverty, and Poor peo∣ple. And it was a pertinent Apologue to this purpose, which Mouffet relates,* 1.21 of a Spider and the Gouts taking a small Jour∣ney together: That at night the Spider hapning to take her lodging in a Rich mans house, was quickly driven away, and spoiled in her weaving Cobwebs, that the Gour hapning to take up in a poor mans Cottage, was almost starved with his Brown Bread and Herbs; that meeting the next day again, they agreed to change their Quarters, each complain∣ing very much of their former Landlords, that the Spider was kindly entertained, and unmolested by the Poor, and the Gout upon coming to the Rich, Luxurious person, and falling at his Feet, was pre∣sently welcomed with Downy Pillows, rich Tapistrys, and all imaginable care and tenderness; the Kitchin grew Hot, the Table spread with all manner of Dain∣ties, and the best Wines that were to be had, went merrily about, &c.

Neither were Poets, and Merry men only of this opinion, but even our most Judicious Hippocrates hath Aphoristically dictated the same.* 1.22 One of his Aphorisms is 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.

That a Youth never has the Gout before the use of Venery:* 1.23 and another is, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. That Eunuchs are never troubled with the Gout:* 1.24 and a third, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. That a Woman never has the Gout, before her Menses have left her. After a word to these Aphorisms, I shall speak to the Rationality of the thing.* 1.25 Hippocrates makes a difference between the Morbus articularis, and the Podagra; and grants that even Youths and Eunuchs, may be subject to the Dolor articulorum, before Venery, though not to the Podagra. For in the end of Feavers, Defluxions do some∣times fall upon the Joynts, either by rea∣son of the moisture and relaxation of the Ligaments of the Bones (the humours flowing to them, and a Dry Cough accom∣panying it) or by reason of the exanguious macilent condition of the Junctures after Feavers; and therefore Oxen, about the end of Winter, when they grow to be very Lean, are apt to slip the Bones in the Joynts. And thus to this sort of Ar∣thritis, the Dolor articulorum, which is made per modum Puris corrumpentis, (ne∣ver so the Podagra) even Youths and Evnuchs are subject as well as others.* 1.26 And Brassavolus relates how Alphonsus

Tasso, or Dassonius, and Claudius Rango∣nus, two very fine Youths, were troubled with the Gout at fifteen years old, in his time and knowledge. Hollerius says upon the same Aphorism, that he knew some at ten years of age troubled with it.* 1.27 Brassa∣volus also tells us, that he saw at Venice an Eunuch Turk, forty years old, afflicted with it. And relations of Women are less rare.

To all which we answer, that Hippo∣crates must mean the Podagra, which so much differs from the Dolor articulorum; and Cardan excellently well defends the truth of these Aphorisms,* 1.28 against the mis∣interpretation of Galen, and other Com∣mentators, by allowing that they may, and are sometimes subject to the latter, but never properly to the former. I re∣member one Contemporary at Winchester School, who was very Arthritick, and whose case might probably be the same with Tasso, and Raengonus. If we will understand a sentence in a large sence, which is meant only in a strict sence, we may easily enough find a flaw in the truth of it. And this seems to me to be a much more genuine interpretation, than to say I can't tell what, that the time Hippo∣crates lived in, was so exceeding Temperate

and Abstemious above ours. I don't doubt but they knew the taste of a Glass of Wine as well as our times, and as few of them were Women-haters as now. We may talk of Golden Ages, and Iron Ages, to comply with the humours of some men, whose temper inclines them to dis∣like and censure every body, and every thing that they see, and to admire all that is dead and gone; but upon the best reflection that I can make, I am very well perswaded, that there ever was, is, and ever will be a Golden Age, in respect of some Particular persons, whose Virtues do preserve the very Being of the World, and an Iron Age in respect of others, I fear much the generality, whose Vices would overwhelm the Order of the World; and bring a sudden dissolution upon it, if the first did not uphold it, by a powerful hand.

As for Eunuchs being now sometimes troubled with the Gout, notwithstanding Hippocrates his assertion to the contrary, we must know, that in all probability our Master did mean such Eunuchs only, as either were born without any Necessaries for Coition, or were intirely deprived of them soon after they were born, as is now the manner of the Turks, and not

concerning those Eunuchs, who were de∣prived only of their Testicles, but had their Virga, and Scrotum remaining, upon which sort Martial was a little pleasant in his time, in that jocular Distich:

Cur tantum Eunuchos habeat tua Gellia, quaeris Pannice? vult—Gellia, non parere.

And if they are still capable of doing in private such feats of activity, as gave occasion to the Grand Seignor to make a through Exection of their Generative Prin∣ciples, and besides can swill a Glass as freely as those who are not Castrated, nay and can impair the tone of their Spirits upon other accounts, what should hinder them from becoming Arthritick as well as others? There are four things requisite to breed the Gout, according to the opi∣nion of the Antients; an imbecillity of the Joynts, an expansion, or dilatation of the Veins about them, Crude matter to flow that way, and an impelling principle, chiefly a Flatus. Now if a young lusty Fellow happens to be made an Eunuch only in Martial's sence, after he has sufficiently known what's what, and thereby, as well as other ways, weakned the Natural

strength of the Joynts, and dilated the Veins about them, certainly he is after∣wards capable of disordering his body with Intemperance, thereby furnishing Crude indigested matter, and Wine will provide him with an Impelling Prin∣ciple.

The third Aphorism will likewise hold true, if we consider it a little attentively. No Woman is ever known to have the Gout, before her Menses have left her; 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 is the word, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 does not only signifie derelinquo, leaving abso∣lutely, and for good and all, but also de∣sum, and deficio, to be wanting, and de∣fective. So Xenophon takes the word when he says,* 1.29 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. And so the Sun and Moon are said 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, deliquium pati, and there's a great deal of difference between an Eclipse, and a Natural incapacity of ever shining again. And thus it is true, that a Woman is never known to get the Gout, before her Menses 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, have been wanting or defective to her, either in quantity or quality. This therefore seems to me to be a much more proper Inter∣pretation of that Aphorism, than to say, that the Women were all Saints in Hippo∣crates

his days, and that they are now-a-days all Beasts, and for that reason are now subject to the Gout more than for∣merly. Women were always Women, as well as Men Men. Wherefore I shall still have the same honour for Hippocra∣tes his Judgment, in these Aphorisms, as well as his others. And I think it is bet∣ter thus to understand his meaning, than to suppose him to be an Ideot in these Sentences, who is accounted an Oracle in the rest. A wise man may be mistaken in his Notions, as well as a Fool, but he would be very unwise, who would Deter∣mine so Positively notorious untruths in Matter of Fact, as those three Aphorisms commonly misunderstood must insinuate. An Aphorism is a final and well-weighed determination of a matter, in few words; it is the result of long Experience, and a Wise man can never be so Ridiculous, as to lay down for a Rule, and a Conclusive Rule, what every half-witted body must needs know to be False, and this in Matter of Fact.

And now for the Rationality of that vulgar opinion, that Wine, and Women, are the adequate, and most general Cause of the Gout, it is very Censorious, un∣charitable, injurious, and improbable, I

do not doubt but it is in some the True, and main Cause, but in abundance of others has a very small, if any share in its production. Whatsoever is capable of weakning, and impairing the tone of the Animal Spirits, will claim properly a title to its Generation. A Sedentary life full of Study, and deep thoughtfulness, in persons who feed high, and Digest ill, by reason of a continual and unseasonable application of the mind, shall cause it in Sober persons, who drink but little Wine, and use little or no Venery; sometimes too much Exercise, as well as in others too little, shall weaken the Spirits and Joynts; the continual use of a Coach, and disuse of Legs, I do very believe is a more Gene∣ral Cause, than can be easily imagined. We may further observe, that many So∣ber, Temperate, and eminently Virtuous persons, upon whom Malice its self can hardly fix a Suspition of Debauchery, shall miserably labour under this Disease, when∣as thousands of the rankest Libertines in nature, who never deny themselves any sort of Sensuality, do escape all their lives free from being Arthritick. Nay of those who are afflicted with it, sometimes the most Temperate, Regular, and Abstemious men shall happen to fare the worst; and

I have known some upon the stricted ob∣servance of Diet, fall suddenly into a Pit, and the same as soon recover again upon taking a little Liberty. So that there can be no adequate Cause of this Distemper, but this: whatsoever is capable of weakning, and impoverishing, or afterwards of disor∣dering and irritating the Animal Spirits, in persons disposed to this Disease, whi∣ther it be by an Hereditary Necessity, or by a Luxurious, or Sedentary, or sometimes Laborious course of life.

In point of Diet, that Aphorism of Hip∣pocrates ought to be well remembred, and especially in Arthritick cases. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, &c.* 1.30 That Sick people are apt to do themselves injury, by following too spare a Diet, and this is the more inju∣rious to them. For whatsoever Error is committed, is more considerable under a spare Diet, than under a liberal, and there∣fore very strict rules herein are of dangerous consequence to those that are in Health, be∣cause they suffer the more from it. And for this reason a most exact, and slender Diet is generally more dangerous, than that which is stronger and fuller than it should be. Thus the wise man. Notwithstanding which advice, the generality of Physicians have been apt to debar Arthritick persons more

than is really requisite in point of Diet. And they have thought they have had good Authority for it. For Authors on this subject have recorded divers instances of persons desperately afflicted with the Gout, who by reason of Poverty, Impri∣sonment, a forced or voluntary abstinence from Wine, and the use of Women, have been as it were Miraculously Cured of it, to the astonishment of all who knew them. Porphyry tells us of Rogatianus a Senator of Rome,* 1.31 who upon hearing Plotinus a Platonick Philosopher, grew to an absolute contempt of the things of the World, for∣sook all his Honours, dismiss'd his Ser∣vants, and spent his time in Philosophical entertainments, and eat but once a day, and that very sparingly. And it seems by this change of life, he that by reason of the Gout could not go one step, but was at first carried every where in his Chair, got strength to his Legs again, and also recovered the use of his Hands, as well as ever, who before was absolutely dis∣abled.* 1.32 Franciscus Alexander of Vercellae, a Town in Piedmont, relates the Story of a Rich Gentleman there, who being pri∣vately surprized, and cast into Prison, and there living on the Bread and Water of Affliction, recovered so strangely of the

Gout (that he had been troubled with 'till fifty years old) that when the Castle he was kept in was taken by the French, he had lost his Distemper quite, and could walk without a Staff, who before could not so much as walk with it.* 1.33 Trincavelli∣us relates of an old Physician at Venice, who had been exceedingly troubled with the Gout, that for five years he debarr'd himself from drinking so much as a drop of Wine, and by this means quite freed himself of his Distemper to a Decrepit old age, and even to his Death. And many places do ring of Hydropotae, or Water-drinkers, who by that means have got rid of their several sorts of Arthritis. Guainerius speaks of several Ʋxorious people,* 1.34 who had been forced to keep their Bed the greatest part of their time through the violence of their Gout, and upon burying their Wives, were very sel∣dom afterwards attacked by it, and when a Fit did come, they were very quickly rid of it.

To the substance of all which Stories I shall make some Answer, and shew, that notwithstanding these Relations, Diet is no adaequate, or certain Cure of the Gout, that though Temperance be good in all men, and especially in this Distemper, yet

we ought to be very Cautious how we re∣commend it too strictly to persons who have habitually, and a long time indulged themselves to greater Liberties than they ought to take; that it must needs be a matter of more than ordinary conse∣quence for a man to grow exceeding re∣gular, nice, and scrupulous, in eating or drinking many Innocent, and accustomed things, who had always used himself to a free Scope, and could or would never debar himself from indulging to the Di∣ctates of his Appetite. For Sudden Alter∣ations from things Accustomed to the con∣trary Extream, though to the better, ought carefully to be avoided.

It is to be observed, that of those who labour under this Disease, the generality, if not all, are men of great Sense and Brains, and their Spirits are much, if not always employed in very intense thinking. And if Fools do chance to come by it, as well as Wise men, it is to be imputed to their Foolish Extravagancies, whereof some will exhaust, and impair the Spirits, as much as Immoderate Studies, and long fixedness of thoughts. But I dare appeal to any man, who has known the World, whither it be not exceeding rare to meet a man of weak, or very ordinary intellectuals,

much afflicted with this Disease. Now the Animal Spirits, which more imme∣diately perform the functions of Reason, being in these thoughtful men upon very constant and hard Duty, do call in to their assistance those Spirits, whose part is pro∣perly designed to help the business of Di∣gestion. So that the Stomach finding its self destitute of those necessary helps which it uses to receive in order to Regu∣lar Concoction, can therefore do its work only by halfs, and so heaps up Crude and indigested humours in the body, which Na∣ture finding at last to grow very offensive, and threatning to attack the main Forts of Life, the Vital parts, does in great kindness to them, throw them off upon the Outward. We know that an Error in the first Concoction, cannot be rectified in the second or third. Let but the Spring of a Watch flag in its due force, and though the Wheels and other parts be never so curiously and exactly wrought, yet the Watch can never go right, because all the rest depends upon the first-Elastick motion of the Spring. And thus the Stomach being the main Spring of Digestion, and upon whose regular, or irregular functi∣ons, do absolutely depend all the subse∣quent acts of Sangnification in the Blood,

and Assimilation in all the parts of the body, if the Spirits at due times are not sufficiently relaxed from intense Medita∣tion, and the Stomach assisted with as many of them as are requisite to the first Concoction, or Chylyfication, there is like to be a most natural inlet to such Diseases as the Constitution of the body inclines to, and particularly the Gout in those whose other circumstances do concur towards its production. Hence therefore it is that the most Eminent and Ʋseful men in all Professions, and in all Stations in the World, are so subject to the Gout more than others. A continual hurry of business does fill their heads, they are neither before, af∣ter, nor even at their Meals sufficiently disingaged from Serious Thoughts; their Industry and Application does commonly provide them with great plenty and va∣riety of Food; they Eat well, and Digest ill, for the reason aforesaid; their Spirits with continual exercise, and fatigue, are as much tired, and therefore weakned, as Arms or Legs can be on other occasions, where there is not sufficient intermission. And therefore the having the Gout is very often a Good Sign, a Sign of Sense and Rea∣son, a Sign of Industry, and a mans mind∣ing his business, as well as sometimes it

is a Bad Sign, a Sign of Irregularities, and previous loosness in some respects.

Now though this may in all probabi∣lity be a more general Procatarctick Cause, than others, yet no Author, that I know of, has made any words about it. They have all in general gone in a stream, and assigned the more Popular Causes menti∣oned before. Sir Theodore Mayern indeed, who has written a short but judicious Trea∣tise of this Disease, makes the Stomach (not the Head, or Liver) to be the pri∣mary Fountain from whence those De∣fluxions are derived to the Joynts. And therefore Diaeteticks are in his opinion a main instrument in the Cure. The Sto∣mach is doubtless first of all affected, and it very often comes to be so, by reason of the Spirits being too much employed in the Brain. For whither Wine, or Wo∣men, or Corporeal, or Mental Exercise of the Spirits do weaken their natural crasis, it is certain that they are weakned, and being so, the Nervous Parts must on that account be as subject to receive morbid impressions, as Infirmities and Weaknesses in other parts do likewise become at∣tractive. But that a very Spare Diet is the most proper course to restore the strength of the Spirits, or to prevent dis∣orders

from falling on the Joynts, I can∣not but very much question. For let im∣moderate Venery, or any other immoderate exercise, or consumption of the Spirits take place, and we shall find a strict Absti∣nence repair them again but slowly. There∣fore the true Prophylactick Cure of the Gout must be so adapted to most people, as to let them live in great measure as they did before, and not to make a Baby of a man of Sense, and feed him with no∣thing but Milk and Spoon-meats. Crato, an Eminent and Learned Physician, was yet no wiser than to observe,* 1.35 that Capons flesh is very injurious unto, and ought mightily to be avoided by Gouty people. Whereas if he had lived out of the Courts of Princes, where Capons are a Dish which comes under every days Animadversion, he would have found, or might as well have observed, that Mutton, and Veal, and any thing else that is taken for Nou∣rishment, is apt sometimes, as well as Capons, to disagree with Arthritick crazy bodies. It is easie enough to misobserve, that the present Diet, let it be what it will, was a previous cause of the Paroxism. Though there is no doubt, but gross, hard to be concocted, Saline, and too Fermen∣tative Food, is always more in fault, to

a vitiated Stomach, than a clean, easie, agreeable, and Digestive sort of Aliment.

Now as to the Stories before-menti∣oned, in vindication of the power of Diet, I answer to the first, that of the Roman Platonist; that he had separated himself from business, and had reduced his mind into a Philosophical Tranquillity, that his Animal Spirits finding ease from their hard labours, could now be more intent in contributing their assistance to the functions of the Stomach, and upon this new remission of them from conti∣nual and tiresome Cogitations, they could very well help the Stomach to perform ex∣ceeding well its Duty in elaborating or digesting the one Meal a day, much better than it could before frequent Meals, when their strength was enervated. The conse∣quence of which change of life was natu∣rally enough a change of Temper, a change from Sickness to Health. To the second, that of the Savoyard in Prison; that though the Imprisonment might at first be attended with a great consternation of mind, yet in some time it grew easie enough; and we may find abundance of Prisoners, after a little inurement to that unhappy life, grow very well contented in the condition which they find can't be

help'd; that there no multiplicity of Af∣fairs, no cross disappointments in business, could wrack or distract his mind, so that Bread and Water, or any other ordinary Diet, sparingly allowed, could not choose but be well-digested, and so his Natural strength being recovered, was a necessary means to the strengthning his Animal. To the third, that of the Gouty Physician; that if the loving a Glass of Wine too much, had been a main Cause of his Gout, he did very well in drinking a glass less than perhaps he needed. For after Sixty was no such proper time for him to re∣nounce Wine indispensably. Wine im∣moderately, or unseasonably used, is re∣markably injurious to the Nerves, and in general to bodies subject to Crudities and indigestion, is rather a hurtful vehicle of them, than a Cordial any ways beneficial. The benefit of Water to those that are Ar∣thritick, cannot be enough recommended. And yet to such whose Brains are conti∣nually travelling with important business, there is no absolute necessity of debarring one Glass of Sack now and then.* 1.36 Sole∣nander considered well, when upon re∣flecting how hurtful Wine is to the Nerves, he says, Non tamen ego proptereà cuilibet temperamento, cuilibet constitutioni, aetati,

consuetudini, suadere auderem, nec utile pu∣tarem, omnimodam vini abstinentiam. As for that Physician, we have not so very full an account of his case, as might re∣quire a more punctual Answer. His for∣bearance of Wine, and use of Water alone, might be no more the True and Compleat Cause of his losing the Gout,* 1.37 than the eating of Honey might be the only true cause of Pollio the Roman's living to above a hundred years old, as it seems he af∣firmed to Augustus, when he was asked the question. To the last, the case of Ʋxorious Peoples finding so much relief upon surviving their Wives, that the be∣ing Ʋxorious, or keeping truly and con∣stantly to their Wives, is a very unlikely means to procure the Gout, though when once it is Confirm'd upon a man, a small excess even of that kind, shall help very much to promote it, and so that Adjutant Cause being removed, the Disease may abate in its force; that the greatest Ran∣gers and Libertines in Town do often es∣cape the Gout, being rather subject to Venerial than Arthritick Diseases; that Women, as Wine, immoderately and un∣seasonably used, by enervating the Ani∣mal strength, do sometimes, but not al∣ways, cause the Gout; and that when

they do it, it is not so much in Sots, and Silly People, as in men that can be at other times over-thoughtful, serious, and melan∣cholick.

Now we cannot deny but Diet is of great concern in so considerable a Chro∣nick Distemper, and especially to those persons who think fit to quit themselves of their Physician, so soon as they are got a little rid of their Paroxisin, or those who over-wisely leave all to the Course of Nature. Seasonable and proper Eva∣cuations carefully followed at certain times, will leave the less necessity, perhaps none at all, of being Curious in this re∣spect.

Before I dismiss this subject, I cannot but speak one word to the Milk Diet, that being oftentimes the Last Refuge, and having gained greater Fame than any other. Some indeed have had the good Fortune to receive benefit from it, or to think so at least, for a time; and the re∣commendation of this Diet, in some par∣ticular cases by Eminent and Worthy Phy∣sicians, where they have had sufficient Experience of the Idiosyncrasia, or pecu∣liar Tempers of their Patients, has en∣couraged some others to venture upon it of their own head, and they have paid

dearly for their Rashness, by its absolute disagreement. For Milk is a contrary to those men, whose Habit of body is Acid, and Melancholick, (and Thoughtful men are very apt to degenerate into that State) and as contrary to such who have inured themselves to the constant service of Bac∣chus, as Beef and Pork to the Stomach of a little Infant. These mens Stomachs shall sowre and curdle Milk, as certainly as Vinegar or other Acids, when set over the fire. Besides it is very unnatural, and he∣terogeneous to make Children of Men, and to accommodate the proper Diet of the one to the other, unless it be upon some par∣ticular occasions weighed and deliberated with the utmost care and nicety, and with the Advice of some Good Physician. And in this case the Aphorism of Hippocrates, respecting Diet, that was mentioned be∣fore, ought well to be remembred.

Thus I have been longer than I inten∣ded, upon this Disease, and I hope some Hints may not be altogether Ʋseless. If I have been guilty of the common Infir∣mity that attends Mankind, and have No∣tion'd it wrong, I shall be always ready to hearken to better Counsel. Though upon these Principles, such as they are, I could Magnifie my self, if it were proper, in

Particular Performances, and could both as to the Fit demonstrate Experimentally how Suddenly and Safely the Pain can be, and has been quite removed beyond Ex∣pectation, and the consequential Cure made easie and soon dispatch'd; and as to the Preservative part, could sufficiently evince how by Proper and Suitable Evacuations, the Gout, though confirmed by abundance of Fits, and many years continuance, yet may very well be kept off from time to time, untill the Nerves have regained their pristine strength, and the Habit of body altered into a better State. But I shall forbear.

Notes

• * 1.1

  Lib. 2. Sect. 84.
• * 1.2

  Hortulo ge∣niali pag. mihi 170.
• * 1.3

  De Rat. cu∣rand. par∣tic. hum. corp. affect. lib. 12. c. 1.
• * 1.4

  In Arte parvâ, sive Arte Medi∣cin. cap. 59.
• * 1.5

  Aphor. Sect. v. n. xviij.
• * 1.6

  Aphor. Sect. v. n. xxv.
• * 1.7

  Synopsis Discursu∣um, &c.
• * 1.8

  Consil. 14.
• * 1.9

  Patholog. lib. vj. cap, xviij.
• * 1.10

  Consil. Me∣dicin. Sect. 4. Cons. 24. & 25.
• * 1.11

  Prax. Med. l. 18. c. 1.
• * 1.12

  Ibid.
• * 1.13

  2. ad Glanc. cap. de Po∣dagr. cal.
• * 1.14

  Pharmacop. Galen. Chym. Ca∣thol. l. 11. de Elect. & consec. li∣quid.
• * 1.15

  Consil. Me∣dicin. Sect. 4. Cons. 24, 25.
• † 1.16

  De Curat. admirand. Cur. xv.
• * 1.17

  Observ. l. 2 in habitûs corp. dolore.
• * 1.18

  Cardan de Curat. ad∣mirand. Cur. xvi.
• * 1.19

  Tetrabibl. 3. Serm. 4. cap. 47.
• * 1.20

  Observat. l. 2. in ha∣bit. corp. dolore.
• * 1.21

  Theatr. in∣sect. lib. 11. cap. 13.
• * 1.22

  Aphor. Sect. 6. n. 30.
• * 1.23

  Ibid. Aph. 28.
• * 1.24

  29.
• * 1.25

  Lib. de affectionib.
• * 1.26

  Ad Aphor. 30. lib. 6.
• * 1.27

  Ad Aphor. 28.
• * 1.28

  In Aphor. praedict.
• * 1.29

  In Oecon.
• * 1.30

  Sect. 1. num. v.
• * 1.31

  In vitâ Plotini.
• * 1.32

  In Appollinis radio primo in descript. elect. Dia∣corall.
• * 1.33

  De rat. er∣rand. par∣tic. hum. corp. morb. l. 12. c. 2.
• * 1.34

  De aegri∣tud. jun∣ctur. c. 27.
• * 1.35

  Consil. 246.
• * 1.36

  Consil. Me∣dicin. Sict. 4. Cons. 24.
• * 1.37

  Plin. se∣cund. Na∣tur. Hist. l. 22. c. 24.