The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 1. Of Pain in the Joynts, called Arthritis, or the Gout.

ARthritis, or the Gout, is a pain in the Joynts which comes for the most part by fits, stirred up by an Influx of Humors into the said Joynts.

The parts pained are, Membranes, Tendons, Nerves, and al the Nervous parts that are neer the Joynts, which are stretched by the Humor which flows into them, or by their sharpness are pricked and twitched: but the Ligaments which spring out of the Bones, are void of sence. Now the Hu∣mors which cause the Gout, do seldom flow into the very Cavities of the Joynts, and that only in an old Gout, and where the Cavities are wider than ordinary, as it happens in an old Sciatica, in which somtimes the Thigh-bone fals out of its place, the Ligaments and other parts binding the Joynts to∣gether, being loosened, and then the Cavity of the Joynt is filled with a snotty kind of flegm, as we see in Hippocrates, Apor. 59. Sect. 6.

It is wont here to be demanded, why the Humors flowing into Nervous and Membranous Parts, and distending and twitching then, they should not cause a Convulsion. We answer, that the Parts affected in the Gout are cheifly Membranes, which being no instruments of motion, they cannot cause a Convulsion, though never so much stretched or twitched. And although the Tendons and Nerves ordained for motion should be likewise pained, yet do they not cause a Convulsion; because to make a Convulsion the Muscles must be drawn back to their Head, and that retraction ought to be made by a contraction of the nerves which are inserted into them; but when they are gone out from the muscles, or are come unto their extremity, though they be distended, yet can they not contract the Muscles.

Authors do commonly make four forts of Gouts, according to the diversity of the Joynts affected; Chiragra, or the Hand-Gout, when the Pain is in the Hands; Sciatica and Ischias when it is in the Hip. Gonagra when it is in the knees; and Podagra or the Foot-Gout when it is in the Feet. And the Pains of the other Joynts go under the common name of Arthritis: though Pareus have imposed proper names upon every one of them drawn from the Parts affected; calling the Pain in the Joynts of the Jaw-bone Syagonagram; in the Neck Trachelagram, in the Back-bone Rachysagram; in the Shoulder Homagram; in the Elbow Pechyagram. But these names have not been entertained by Practitioners. Therefore its sufficient to refer the Pains of those Parts to the general name of Ar∣thritis.

There are besides, other differences of the Gout; as that some Gouts are General, occupying all or most of the Joynts of the Body; others particular, residing only in some one Joynt: some are ingrafted and Hoeredetary from the Parents, others are adventitious caused by external Causes and Errors in Diet,

Now the Humours which breed the Gout, may have their Course not only into the Joynts but somtimes also into other Parts of the Body as the head, Teeth, sides, yea and the internal Parts as the Liver and Spleen and stir up divers Pains in these parts, which Pains are not to be termed the Gout, though they are Caused by the same matter which Causes the Gout.

Again all Pains seated in the Joynts merit not the name of Gouts for somtimes there are Swellings in the Joynts especially in the knees, from which Pains arise, occasioned by thick, flegmatick, and Melanchollick humors, which Pains continue very long, but are not to be reckoned among the Gouts, but have a distinct nature of their own. Which difference will more clearly appear by the different Characters of the Gout, which we shall describe in our Diagnosis thereof, that is in the Art of discerning the Gout from other Diseases by certain signes and tokens.

The next and immediate Cause of the Gout is a serous or wheyish Humor, either by its quantity stretching those sensible Parts which are about the Joynts, or by its sharpness twitching the same. That this matter is wheyish is hereby known, because thick Humors could not so easily flow into the Joints, and they would make a more Visible swelling in the Joynts, which is wont to be very little, yea in the begnning there appears no Swelling at all though there be a most bitrer Pain; add that the Tumor which is in the Gout, never comes to suppuration or ripens of matter, which often happens in other thicker Humors, if they have never so little Blood mingled with them, But in the Gout the Blood is drawn to the Joynts, as appeares by the Inflammation of the Parts; yet there never happens any suppuration or growing to a mattery Head, because Serosities or wheyish Humors rule the roast, and they hinder Suppuration.

But this wheyish Humor is seldom pure and sincere, but hath other Humors or their serosities and thinner Parts Joyned with it; whereupon great variety ari••es, according to the greater or lesser acrimony of the Humors mixed with the wheyish Humor, according to which the Pain is more or less; the Tumors is somtimes notably great and somtimes not visible; some are of a red colour, others yellow or white; in some the malady is soon ended, in others it continues long; somtimes a mighty and fervent heat possesses the Parts, otherwhiles little or none is discerned; somtimes hot things laid on do good, other whiles they do hurt and cold things help. Howbeit, it cannot be denied but that the wheyish Humor may of it self have more or less acrimony, according as it hath more or less Salt mixed with it: for seeing the serous or wheyish Humor, is wont to dissolve and drink up those heterogeneous salts, which are multiplied in the Body by reason of the multiplicity of meats we use (whence it is that all the serum or wheyish Humor in us is salt) according as this Humor is more or less salt, and according as the salts mixed there with have more or less sharpness, more or less Pain is wont to be caused.

And because in the Gout, as in every Fluxion, for things are considered, the matter flowing, the Part sending that matter, the Part receiving the same, and the waies by which the Fluxion is made; seeing we have spoke of the matter flowing, we are now to speak of the other four.

Touching the Part sending the Humor there is disagreement among Physitians. Fernelius would have all the material cause of the Gout (which he takes to be thin and flegmatick) to flow from the Head; not from the brain it self, (whose excrements are either voided by the nostrills, or flowing

through the palate, are driven to the mouth, throat, wesand or stomach) but from the external Parts of the Head, situate without the scull. For seeing very many veines derived from the exter∣nal Jugulars do run thither, he saies they do there lay down their thin and wheyish excrements, and seeing the Skin of the Head is thick and compact, and the Humors cannot easily breath through the same, in process of time they grow there to a quantity, and as he conceives from thence they flow through the surface of the Body, under the Skin, into the Joynts. But others do conceive, that the Head is the fountain of the flood of Gouty Humors, but they conceive those Humors flow from the inner Parts of the Head viz. From the Brain. Finally others there be that give sen∣tence, that these faulty Humors do flow from the bowells conteined in the lower ••elly, namely from the Liver, Splen, Womb and others, and also from the whol Body, through the Veins and Arterie•• into the Joynts. All which Opinions in my Judgment are Partly true and Partly fals. We Judg they are true in that, they say the Humors which cause the Gout do flow from the Head by the in∣ward and outward Parts, and from the Bowells and the whol Body by the Veins and Arteries: and fals we say they are, because they say that only the internal Parts of the Head, or only the external, or only the inferior Bowells do furnish the Gouty Humor. For seeing the whol Body is passable to and fro by Humors, all Parts of the Body may send their superfluities to the Joynts, if they be disposed to receive them. Now that disposition of the Joynts which makes them fit to receive a Fluxion of Humors (that I may take this occasion to open the condition of a receiving Part) is their weakness, either native from the Parents, or arising from other Preternatural Causes, which we shall speak of by and by. Seeing therefore it is established by Physitians as a most sure maxim, that the stronger Parts of the Body empty their excrements into the weaker, we may avouch that all the Parts aforesaid may discharge their excrements upon the Joynts, if they being weakned, cannot sufficiently resist the same. And that the Opinions aforesaid may be severally refuted: Fernelius indeed doth clearly enough demonstrate, that Humors collected without the Soul, do flow upon the surface of the body, and under the Skin creep into the Joynts, seeing somtimes the Pain begins in the Head, goes thence into the Neck, thence to the shoulders, and at length into the Joints. But that Humors do never flow from other places and Parts into the Joynts, he no waies proves, neither is any man able to prove after him. In like manner, they which say that such Fluxions come only from the brain, seem to contend against sense; Forasmuch as those Parts which compass the Joints about, do receive Veins and arteries, by which blood is brought unto them to nourish them withall, why may not also the wheyish Humor collected in the greater vessells be carried unto the same Parts by the same waies? Galen hath taught this precisely, in his Comments upon the Aphor. 10. Sect. 3 where he shews, that in the knobbs and Pains of the Joynts the profound Parts of the body are pur∣ged, the vitious Humors being driven from the principal Parts of the body into the Circumference. This is seen by the Feaver which is oftentimes raised in the beginning of the Gout; for it is caused by wheyish excrements conteined in the Veins, put into a commotion and working, when nature sees her self to expell the same, and seeing she cannot drive it all forth, she discharges the same into the weaker and ignobler Parts. Also the third Opinion, which Sennertus defends, is Void of reason, and is herein faulty, because it denies that Gouty defluxions do ever come from the brain. For seeing all Parts of the Body both inward and outward, do receive Fluxions from the Brain, how can the Joynts be free from them? And if Humors causing a Catarrh do often flow by the Veins and arteries, whence Rhewmatick Feavers daily arise; and the Humors conteined in the Veins and Arteries (as Sennertus himself affirms) do easily flow unto the Joynts, it is a clear demonstration, that a Fluxion is made from the brain into the Joynts. Also plentyful Pissing declares that Humors flow from the brain through the Veins, when the said Pissing is caused by some commotion of the brain by reason of long abiding in the Sun, or in a very cold air; for then the wheyish Humors conteined in the brain are agitated by those Procatarctick Causes, and driven into the Veins and Arteries, through which they flow unto the Kidney's and the Bladder, and thence comes so plentiful making of water.

The next and immediate Internal Cause of the Gout hath hitherto bin sufficiently expounded; now let us proceed to the external and Procatarctick Causes or occasions thereof: which we may for clearness sake distinguish into three Tribes or Rankes, The first Tribe is of them which afford mat∣ter convenient to breed the Gout. The second is of those which do weaken and loosen the Joynts. The third is of them which promote the flux of the Morbifick Humor into the Joints.

To the first Tribe are referred al things which encrease raw and wheyish Humors, or any bad Hu∣mors whatsoever: as meates of gross substance hard to be digested, and such as afford many excre∣ments, frequent Gluttony and Drunkenness; immoderate Carnal Embracements; which is the reason that Gout is called the Daughter of Bacchus and Venus; Idleness and a sedentary life, and intermission of such exercises as men have been formerly accustomed unto; long sleep and unseasonable watching; intermission of such naturall and artificial Evacuations as men have been accustomed unto; fear, Sad∣ness and continual Care.

To the second Tribe are referred vehement motion and Labour; frequent use of carnall conjuncti∣on, especially of that which is celebrated standing; refrigeration and humectation of the Joints; frequent Bathing; Contusion, Luxation and Fracture of the Joints.

To the third Tribe are referred, Cold air squeezing out the Humors, and Heat melting, dissolving and agitating the said Humors and opening the secret Passages; meats of a servent and salt nature which attenuate the Humors; thin and strong Wine; Immoderate exercise, unbridled Lechery, ve∣hement anger and other immoderate passions of the Mind.

The Signs do either foretell the Gout at Hand, or declare the same to be present.

Signes of the Gout at Hand: a Sence in the Joints more exquisite and quick than ordinary so that the lightest thing will hurt them; as for example the hard sitting of a new Shoe, Long walking, a smal blow, or a light hitting against a stone, or some other hard thing. A Feaver commonly ushers in the Gout, which is caused by wheyish Humors and others conteined in the Veins and arteries, being disturbed and agitated, whiles nature endeavours to expell them to those less noble Parts. But the neerer approach of the Gout, and its beginning as it were, is signified by a stupidity, and sence of crawling Pismires in the Joynts, and a kind of unusual Heat felt in them.

The Gout is known to be present by an actual pain tormenting the Joynts, which commonly is attended with redness and swelling; which if it appear not at the very first; yet is it seen presently after. The pain doth usually seize upon the great Toe, especially on the left foot, and oftentimes it spreads it self from thence into other Joynts. The Feaver which comes before the pain, doth som∣times continue; and somtimes it goes not before, but comes together with the pain.

The Signs of the Causes are likewise to be considered: For although the Humor causing the Gout be principally wheyish, yet is it needful to know what other Humors are mixed therewith, that we may fit out Medicines thereunto.

And in the first place, Choller abounding with the wheyish Humor, is known by a vehement and cutting pain, a smal swelling, a reddish or palish color, great heat, and the Feaver intense and per∣severing in its state or height; thin Urine, yellow and riddish; cold things help, and hot things hurt.

Signs of flegm abounding with the Whey, are, a softish and somwhat loose swelling of the parts affected, which if a man press with his finger, there remains a pit; the pain is not so great, Urines are thick and troubled; Cold things hurt and hot things help; little or no heat is felt: the color is white, little differing from the Natural color of the part.

Signs of Melancholly abounding are, an obscure color of the part like Lead, deep pain, a thin and watry Urine, a weariness of the whol Body, and the temper thereof inclining to Melan∣cholly.

As for the Prognostick. The Gout is no dangerous Disease, but very troublesom by the vehe∣mency of pain, and of a very long continuance; so that for the most part it accompanies a Man du∣ring his life, to his old Age; yea, and it doth cause some to live long, because Nature at certain seasons drives unto the Joynts vitious Humors, which might cause other Diseases; and by so doing frees the nobler parts of the Body from bad Humors.

Yet doth it often fall out in weak bodies, or such as are decayed with Age, that when Nature can no longer expel such Humors as are collected in the inner parts of the Body, deadly Diseases do there∣upon arise; as most sharp Feavers, Inflamations of the Bowels, Apoplexies, Convulsion, Phren∣zies, Difficulty of Breathing, and inability to breath, unless sitting upright, Pantings of the Heart, and other most grievous Infirmities.

Although a Disposition rooted in the Bowels tending to breed Goutish Humors, and Natural weakness of the Joynts cannot be perfectly taken away; yet may the Invasions of the Gout be very much retarded, and kept off; so that some only by abstaining from Wine, others by usual Purges frequently repeated, have kept themselves for many yeers free from the Assaults of this Disease.

Hippocrates in the Second Book of Predictions, affirms, That many Gouty persons may be cured, distinguishing them from such as cannot be cured, in these words: Touching the Gout, this I say; All that are aged, or have stony knots about their Joynts, or live miserably, being costive, cannot be cured by Art of Man that I know of. Such are well cured by a Dysentery, when it seizes upon them; and by other fluxions of Humors to the inferior parts. But he that is yong, and hath no stony know about his Joynts, and lives accurately, being inclined to labor, and having a belly well inclined to stool; this man having a skilful Physitian may be cured.

An hereditary Gout may well be accounted incurable.

If the Veins of Gouty persons do swel with black blood, their Gout leaves them; out of Avicen∣na. Because the Humors which were wont to flow into the Joynts, are derived to the external parts of the Skin.

If the Gout, being accustomed to return at certain seasons, shal not return, it portends grievous, and oftentimes deadly Diseases, unless the Morbifick matter by a diligent prevention shal be taken a∣way.

For if through weakness of Nature, the matter which is gathered together within, shall not be expelled, it breeds the greatest and most dangerous Diseases imaginable.

Whosoever they bee that have the Gout within the space of forty daies the Inflammation is allaied, and they are freed. Hippocrates in the 49. Aphorism of the fifth Book or Section. For in such Parts as have little Natural heat, the matter offending requires a long time before it can be discust. Howbeit this period of Hippocrates is not certain and perpetual; for some are healed sooner, and some later; which depends upon the quantity, thickness, or rebellion of the Morbifick causes; the strength or weakness of the Parts affected and the obedience of the Patients in Point of keeping the Diet, and using the Medicaments appointed for them.

The Cure of all Gouts consists herein, viz. That the flux of Humors into the Joints may be staied, that which allready is come in and abides in the Joints may be removed, and that the Pain may in the mean while (if it be sharp) be abated; all which may be performed by the following Me∣dicaments.

And in the first place, Letting of Blood will be very convenient, if there be no want of Blood in the Patient, and if flegm do not abound; because the Blood is agitated by the motion of the Humors flowing into the Joints, and does as it were boil, and is by Pain drawn into the Part affected: wherefore it is necessary to draw the same back, into that Part of the Body which is opposite to the Part affected: and therefore if the right Arm be Diseased, a Vein must be opened in the left; if the right Foot be Pained a Vein must be opened in the right Arm; and if the left Foot in the left Arm. And Blood is to be taken away at the first beginning of the Disease, and as much as needs must be taken at one time, if the Patients stength will bear it: if not, it must be done at severall times, till the plenitude of Blood be sufficiently diminished.

One thing we must allwaies remember, that copious Blood-letting in such as can bear it easily, does exceedingly shorten the Disease, if it be done at the beginning of the Disease, at least by Piece∣meal, drawing now a little and then a little.

Also Purging must be used at the beginning of the Disease, as soon as may be: for so both that Humor which is influx and is ready to flow, will be drawn from the way to the Joints and be brought unto the Gutts. But in this purgation two things are worthy of observation, being frequently noted by Solenander a famous practitioner.

The first is, that this Purgation be not made by some mild lenitive Medicaments, whereby the Humors are rather stirred than Evacuated, and are precipitated into the Joints, whereupon a more greivous Pain and swelling is wont to follow such purges; but with some strong purgative, which may force out the stirred Humor and turn the cause there of from the Joints. The other is, that the Medicaments being given, the Joints above the Knees and elbows, be Plastered with some defensative, by which the Humor which is put in motion by the Medicine may be intercepted, so that it may not so much nor so forcibly fall down into the Joints.

To which intent let an Oyntment be made of Bole, Pome-Granate Rinds, Balaustians, Roots of Bistort and Tormentill, red Roses with the white of an Egg, and Vinegar; which being spread upon snipps of cloath as broad as ones Hand and indifferent long, let them be wrapped about the Parts aforesaid. If these simples be not to be had at present, wet them only with Vineger and water and let them lie on at least an whol day. If the Fluxion be vehement, use a liniment of Bole, Dragons Blood, the white of an Egg and Oyl of Roses made with Oyl of unripe olives: or at first use it without Oyl adding a small quantity of the Oyl aforesaid or of Ʋnguentum Comitissae, least grow∣ing dry and hard it cause Pain.

And for to procure such a purgation as we have spoken of, let the skillful Physitian prescribe a Medicament fitted to the Nature of the Patient and such Humors as are redundant in his Body: or some of those Specifick Purgations which we shall propound in our Doctrine of Preservation from the Gout.

Vomiting is likewise profitable in this Case, for such as are easie to vomit; because it brings out the evil Humors by a shorter way, and so there is no such fear least they should rush into the Part affected. But gentle Vomits are to be used, which do only evacuate those Parts which are near the stomach. For if they be vehement, and draw Humors out of the Veins, they may precipitate the said Humors unto the Joynts. Then after vomitings, purgation must be procured downwards; yea and if one purgation will not serve turn, it must be repeated.

After sufficient Purgation, it will be very good to procure sweat; for so the wheyish matter wil be discussed by the habit of the Body. But, seeing when the Gout gives its first Onset, there happens a kind of boiling and working of the Blood, and commonly there is a Feaver, hot sudoroficks will not be convenient, but only such as are temperate; amongst which Sennertus commends Harts-Horn, either crude, or prepared without burning, either alone, or with Carduus Water; as likewise Antimonium Diaphoreticum. In an old Gout without a Feaver, a Decoction of China Salsa Parilla ar Sassafras may be given, qualified with coolling Herbs, as Cichory, Endive, Sorrel and

Or after the Sweat is wiped off, it may suffice to give the Patient Chicken-Broth, altered with the Herbs aforesaid.

Martinus Rulandus did use this following Sweating Medicine with happy success:

Take Tops of Centaury two handfuls: Asarum Roots two ounces: Boyl them in ten pints of Water to five pints, and strain the Liquor. Give the Patient eight ounces of this Liquor hot, in the morning some daies together; and let him sweat upon it.

But Forestus commends the Roots of the greater Burdock; because it cuts, discusseth, and pro∣vokes both Sweat and Urine. And he reports that a certain Gouty person that kept his bed, and could not stir a Limb, drank hot Beer in which the great Burdock Root had been boyled; after the drinking whereof, when the Physitians could do him no good with all their Medicines, he piss'd a great deal of white Matter like Milk, and was freed from his pains.

Hercules Saxonia puts a great many Loaves hot out of the Oven round about the Patients Body, by which means Sweat is plentifully procured, and the pains removed.

Also a Decoction of Elder, Bay-leaves, Sage, Rosemary, and such like Herbs wil do much good, the Patient receiving the vapor of this Decoction in a sweating Tub, which wil make the sweat to come lustily.

Also the Waters of Natural hot Baths do provoke sweat, and do readily discuss the Matter contai∣ned in the Joynts. And therefore when the sick are not able to go unto them, their Water is wont to be brought unto them and heated in a Caldron for them to bath in. Erastus in his 15. Counsel, prefers this above al others, for easing the pains, but he boyls so much Salt in the Water, as gives it an evidently brackish tast.

In the beginning of the Fluxion of Gouty Humors, in the spaces free from Purgations, such things must be given as stop the Flux, which have been propounded by me in the Cure of an hot Catarrh; especially Juleps of Waters, or Decoctions and Syrups which do cool and thicken.

Yea, and the truth is, We are somtimes compelled to use Narcotick or Stupefactive Medicaments; for they both stop the flux of Humors, and they mitigate the rage of the pains. Of these sort of Me∣dicines new Venice Treacle is most convenient, which may often be repeated without danger from half a dram to a dram. Unto which may profitably be added, a little Bole-Armoniack to stop the flux of Humors. Howbeit, instead of Treacle, Laudanum Opiatum, and other Narcoticks, may conve∣niently be substituted.

After due Evacuations have been celebrated, and other things given inwardly which respect the antecedent Cause, we must proceed unto local Applications, such as mitigate the pain, and dis∣cuss the contingent Cause: Which are not presently to be used before the universal Remedies afore∣said have been first applied; for otherwise they are wont to do more hurt than good. For either the Matter which Nature intended to drive into the Joynts, is driven back into the inner parts of the Body, whereby grievous Symptomes are raised; or it is forced into the Joynts, and the pain is ex∣asperated; or the part is effeminated, and made lax, and so the fluxion is encreased.

Which Cautions being commonly neglected, and external things untimely and heedlesly applyed; the Patients receive commonly more hurt than good thereby. And those external Medicines do ei∣ther respect the pain alone, or the Cause likewise of the pain, viz. The Humor which hath took its course into the part, and caused both the pain and Swelling.

Such things as mitigate pain, are very necessary in this case, because the extremity thereof weakens the Patient, and draws the Humors to the parts affected. Furthermore, by the use of Anodines, the parts are relaxed, and the Humor which before did flow into the more deep parts about the Joynt, is diffused to the more ambient parts and external. Whence it is that the pains of the Gout are most vehement before the part swels; but after it is swollen they are mitigated. Now there are many A∣nodine, or Pain-charming Medicaments propounded by Authors to be applied to those parts which are troubled with the Gout. But the chief are these which follow:

Luke-warm Milk applied to the part affected, by wetting Linnen Cloaths therein, and laying them on, doth asswage the pain; as also if the part be sprinkled and bedewed therewith, especially when it comes fresh from the Dug; which Amatus Lusitanus doth very much commend, in the 41. Cure of his sixt Century, in these words: One mightily tormented with the Gout, caused a shee Goat to be brought into his Chamber, and her Milk to be milked out upon his pained Joynt; by which he perceived the pains evidently lessened. And there is good reason for it: For Milk newly milked, doth asswage, mitigate, and lessen pains. It is a Medicine commonly used by the Great Turk: by you who seek Profit and Honor, highly to be prized.

Of Milk likewise is made the Cataplasm of white Bread Crums boyled therein, adding the Yolks of Eggs, and a little Saffron.

Also the Leaves of Henbane, or Violets, are boyled in Milk, or in Vinegar and Water, and profi∣tably laid upon the part affected.

Also a Cataplasm is made of the Pap of Marsh-mallow Roots mingled with Milk.

Also a Cataplasm is made of the Pulp of Cassia alone, or mingled with Oyl of Roses, or the fol∣lowing Ingredients:

Take Crums of white Bread boyled in Milk, half a pound: Pulp of Cassia three ounces. Make them into a Pultiss. Or,

Take the Pulp of Cassia four ounces: new Venice Treacle half an ounce: Barley and Oaten meal, of each three ounces: the Crum of white Bread four ounces: Cows Milk two or three pints▪ Boyl all into the form of a Pultiss, which apply warm to the parts pained. If you shall add half an ounce, or an ounce of Vitriol calcined and finely poudered, you will make it far more ex∣cellent.

In the beginning of the Gout, which seizes only the great Toe, lay on this following:

Take two whites of Eggs: a little Salt beaten to Pouder: a few drops of Vinegar of Roses. Mix all, and apply it upon Tow, or course Flax to the part affected.

Other Cataplasms are likewise made of greatest efficacy, compounded on this manner:

Take Water of white Mullein, and of Fern Root and Branch, of each half a pint: calcined Vitriol exquisitely poudered, one ounce and an half: Meal four ounces: Saffron two drams. Make all into a Pultiss.

Take Mallows, leaves and Roots, as much as you please, Boyl them in a new Earthen Vessel, with equal parts of Wine and Vinegar, till a third part be consumed; then ad as much course Rye Bran as will make it into a Pultiss; which being well wrought together and spread upon a Linnen Cloth, let it be applied to the parts pained, as hot as the Patient can endure it. Solenander doth exceedingly commend this Pultiss.

Forestus relates that a Cataplasm made of Duck-weed and Chamomel Flowers boyled in Milk, adding a little Barley Meal, wil do miracles.

Montagnana affirms this following to be most excellent in extream pains.

Take the Yolks of ten Eggs; beat them in a Frying Pan with half a pound of Oyl of Roses. Let them boyl gently till they grow thick, adding two drams of Saffron; and lay it on hot.

In the beginning of the Flux, many lay on a Cataplasm of Salt and Soot, wrought into a Body with whites of Eggs.

Or of two ounces of Chamomel Flowers: red Rose Leaves one ounce and an half: Mullein flow∣ers half an ounce: Pouder them, and boyl them in sweet Milk to the stiffness of a Pultiss, adding three or four Yolks of Egs.

Or of Barley Meal, and Bean Meal, of each one handful: Flowers of Chamomel and Roses, of each half a handful: Mullein Water, and Willow Water, or Plantane Water and Wine, of each as much as shal suffice. Incorporate all together in form of a Pultiss.

Also divers Fomentations may be made to be applied to the place affected, after this man∣ner:

Take of the Leaves of Mullein six pounds: red Wine a Quart. Beat the Leaves and st••ep them in the Wine for three daies. Distil them, and bathe and foment the parts affected therewit•• warm, with Linnen Cloaths dipped therein. Or,

Take Flowers of Mullein as much as you please; fill a glass Bottle therewith, and stop the mouth, and set it in the Sun; for so they will turn to Liquor, which being applied to the part affected, with Linnen, mitigates the pain.

Salsaturni, that is, Salt of Lead dissolved in subtil Spirit of Wine, easeth pains wonderfully.

Frog-spawn-Water stilled in May, applied to the parts pained, doth wonderfully asswage the pains, and tempers the Inflamation and redness of the part. These following Simples may profitably be mingled therewith.

Take Frog-spawn-Water, Water of Tapsus Barbatus, or of Mullein, and of Fern, of each one pound and an half. Infuse therein Lapis tutiae, and Litharge of Gold, of each two ounces: Vi∣triol calcined, and Allum, of each one ounce. Foment the pained Parts herewith warm.

An Infusion of Litharge made in Vinegar, the Vinegar being a little evaporated, till it grow swee∣tish, doth much good to an hot Gout.

Oyl of Calves Feet is excellent to allay the pains of the Gout, and it is thus prepared:

Let the Calves Feet be beaten, and the Bones broken, then boyl them all to a Pap. Take the Oyl which swims on the top of the Water, mingle it with Aqua vitae, and Salt, and therewith bath or a∣noint the parts pained.

Also Oyls and Fats are by many used. But seeing the Inflamation which befals those Members which are troubled with the Gout, doth draw very neer the Nature of an Erysipelas, or red fiery swel∣ling, oftentimes those fat things may do more hurt than good; for by stopping the pores, they may keep in the Humor, and so encrease the pain.

According as Sennertus makes relation of a man troubled with the Gout, who found great good by very new Sheeps-milk Cheese laid upon the pained part: for as soon as the Cheese being heated by

the pained part, began to melt and shed its Butter, the pains were encreased. Yet in some Bodies, Oyl of Roses, and such like, may do good, especially mixed with other Medicaments; because accor∣ding to the different Natures of Mens Bodies, several things do good to several persons. And there∣fore we must be furnished with a mighty company of Medicaments, that upon al occasions we may have change; because there is scarce any one so effectual, as to do good to al that are troubled. Take these following for an Example or Pattern.

Take Crum of the whitest Manchet half a pound: Boyl it in new Milk to the consistence of a Pultiss; then ad of the Mucilage of Marsh-mallow seeds two ounces: Meal of Line seed and Fe∣nugreek seed, of each two drams: Flowers of Chamomel, and of Melilot poudered, of each one ounce: Saffron one dram: Oyl of Roses one ounce: Mix all into a Cataplasm.

Or to the Cataplasm of white Bread Crum before described, Oyl of Roses may be added.

Also Liniments and Oyntments are wont to be made to mitigate pain.

Take Yolks of Eggs two or three: dissolve them with Oyl of Roses, or Violets, or Wine, and apply them luke-warm.

Balsamum Saturni prepared with Oyl of Roses or Violets, allaies pain most effectually.

Take Ceruss two ounces; dissolve it in Endive Water and a little Vinegar make thereof a Li∣quid Oyntment.

Of the said Ceruss is made a Plaister of great efficacy which may be laid on in the beginning of the Disease, even whiles the Tumor and Inflamation is present. Its composition is thus.

Take Common Oyl one pound, Wine a pint and an half: Boyl them till half the Wine be consumed. Then ad a pound of Ceruss finely Poudered and two drams of Camphire. Boyl them to the Con∣sistence of an Emplaister. When there is great Inflamation, Vinegar must be used instead of Wine. Spread this plaister upon Linnen Cloathes that it may the more commodiously be wrapped about the Parts affected.

A Living whelp laid to the pained Part, doth very much asswage the pain.

When the pain rages extreamly we may have recourse to Narcoticks; howbeit they must not lie long upon the Part, because they are adverse unto the naturall heat and to the nerves.

Take Henbane Leaves two Handfuls: Nightshade and Housleek of each one Handful. Garden Poppy-Head one pugil, Mandrak Roots one ounce. Chamomel Flowers and violet Flowers of each one pugil, make a Decoction in Water or Milk with which let the Part be bathed.

Beat the residue after the Liquor is strained out, and add of the Flower of Lin-Seed one ounce and an half. Wheat meal two ounces: Oyl of chamomel three ounces: and make a Pultis. Or,

Take Spirit of Wine somwhat Yellow by infusion of Saffron four ounces: camphire one scruple: Boyl them a little, then dissolve therein, one dram of Opium: With that Liquor let the pained Part be bathed: It is a safe and most effectual Medicine.

Green Tobacco Leaves beaten and laid on do ease the Gout, and are said to be of a stupefactive Nature.

As for the Efficient Cause of the pain, to the Humor flowing into the Part repelling Medicaments must be opposed; and to that which is allready in, deriving and resolving Medicaments must be ap∣plied.

Howbeit repelling Medicines are disallowed in this Case, especially alone and without the com∣mixture of other things. For if they shal wholly stop the influx of the matter into the Parts affected, it is to be Feared least they retiring to the inward Parts, should cause dangerous diseases, unless they happen to be translated to some other Joynt. Again the Humor which hath already flowed into the Part, is the more driven inward, by which means, the Pains become more violent. But yet, if in the beginning of the Gout there be a great afflux of Humors especially hot ones, which threatens sharp Pains to follow, it will be convenient in some measure to repress the same, by applying repellers, not alone, but mixed with such things as mitigate Pain, after universal and sufficient Evacuations. For then such things as do overmuch relax, do help forward the afflux of Humors. And therefore, we may ad unto the foresaid cataplasmes and other remedies Plantane, Lettice, Purslane, Housleek and such like as also a little Vineger. As for example.

Take Barley Meal three ounces: Boyl it in Water and Vineger, add two Yolks of Eggs, Saffron twenty grains: Make all into a Pultis. Or,

Take Red Roses an Handful: Barley and Fenugreek Meal of each one ounce: Red Sanders one dram and an half: Chamomel Flowers one pugil: when they are Boyled and beaten, add two Yolks of Eggs, Vineger four ounces: Oyl of Roses as much as shall suffice; make all into a Pultis.

Among remedies which derive the Humor from the Part affected are Horse-Leeches, after suf∣ficient Evacuation applied thereunto: for then they do much good, especially when the Veins in the Part affected, do seem distended and swelling with Blood.

Now resolving Medicaments are wont to be used in divers forms as of Waters, Oyls, Unguents, Balsoms, Fomentations, Fumigations, Cataplasmes, Plaisters and the like, compounded after this manner.

Take Vitriol white and green, of each one ounce: camphire two drams: aqua vitae and white Wine, of each one pint: Mix them and apply them with cloathes dipped in them. Or,

Slake Lime in Urine, purifie the Liquor and foment the Pained place therewith It is likewise good if it be done with Vineger and Lime.

Martinus Rulandus in the Centuries of his Cures, doth mightily cry up his Gout-quelling Water, but never describes the same. But Libavius, Petreus and others suppose it was thus made.

Take Fountain Water a Pint, Aqua fortis half an ounce: Sublimate one dram: Boyl them a quarter of an hour. Wet linnen cloaths in this Liquor and apply them luke-warm to the Part af∣fected.

Quercetanus in his Pharmacopoeia propounds these following.

Take Pickle of salt, and the Ʋrin of a Boy of each Equal Parts. Still them and Wet Linnen Cloathes in the Water and apply to the place affected, often changing the cloathes for fresh ones.

Take Green Elder Leaves and flowers of each one pound: beat them and steep them in Aqua vitae for two or three daies: still them in a Glass or Copper vessel, till they be dry.

Take Spirit of Wine rectified two pounds: of the finest honey one pound. Distill them in Balneo Vaporoso: So you shall still two Liquors; The first is watrish; The second much stronger, and Sulphureous, which you shall keep by it self. To the remaining materialls add an ounce and an half of whol Oriental saffron: Venice turpentine two ounces: Castoreum six drams: Tartar calcined till it be white, half a pound; dissolved salt an ounce: Phlegm of vitriol not separate from its spirit four ounces, Lie made of Vinetree-Ashes two pound: steep them together twenty four hours. Then still them til they become dry: keep the Liquor which comes likewise by it self. To the Dreggs remaining pour on the former Water which you kept: Steep them and still them. Lastly put all the distilled Waters together and distill them in Balneo Vaporoso.

Quercetanus saies, That this Water is of wondrous efficacy, and that it was communicated unto him by a certain most famous German, as a special guift, affirming, that this was the very Water of Rulandus. And he averred that he had seen the rare effects thereof in easing the Pains of the Gout, if Linnen cloathes being moderately warmed and dipped therein, be applied to the Part af∣fected,

The same Quercetanus in his Councel touching the Gout, doth brag that he reserves to himself his Gout-quelling Water, as a Master-peice for such an old soldier as himself to boast of which he saies is made of plain Fountaine Water, wherein he doth divers times quench certain Metallick sub∣stances, which are wont to be taken inwardly when rightly prepared: whose spirits being impressed into the foresaid Water, do contribute thereunto the power of penetrating unto the Roots of the Disease, and of truly resolving the Tartarous, stony matters, with the salts, which are combined in the Joynts, from whence such intollerable Pains do arise.

Peradventure this that follows it not unlike it, nor a whit inferior in Virtue.

Take Ʋnslaked Lime four pound: Slak it in River-water as much as you please, and let it stand in a Wine Cellar three daies, that the Salt may be better extracted out of the Chalk or Lime. Af∣terward let them Boyl a little and strain the Liquor through an Hippocras Bag. In twenty pints: of the strained Liquor, quench seven or nine times; first Plates of steel red hot; & then Plates of Cop∣per red hot; and thirdly to the quantity of ten ounces of Vitriol calcined till it be white; fourthly Antimony melted in a Crucible to half a pound; fifthly Litharge or Ceruse heated in a Crucible, half a pound; white Precipitate once washed and no more one ounce and an half. Brassburnt and finely Poudered, half an ounce: After the quenching of these mineralls, let the water stand still in a Wine Cellar, the space of ten daies. Afterward, Boyl it a little, and strain it through an Hippocras Bag. In this Water being hot, doubled cloathes must de dipt and frequently applied to the Gouty Part.

Among Fomentations easie to make, that is commended, which is made of Salt Ammoniack seven times sublimed, and fitly dissolved in Wine or Water. or of the Urin of a young man in good health, Boyled till half be consumed and laid on with Raggs;

Solenander Writes in his 24. Counsel, Section the 4. That a certain Gouty old man was wont to make himself this Medicine. When the swelling and Pain was great and the place red, he took Salt, the Urin of a Boy and Vinegar. In these being mingled together, he Wet a Linnen cloath and squeesed it and laid it on, this he did divers times and so the Pain was much abated,

As we said before, that Anodine or Pain-quelling Oyls did little good in the Gout, the same must here be said of resolving Oyls, beeause they close the pores of the skin and so hinder the freedom of transpiration and encrease the heat, neither can they by reason of their clammy substance peirce into the innermost Parts of the Joint, so to temper and resolve the Salt, sharp and Tartarous Humors which lurk in them, Yet if the foresaid Oyls shall be Distilled in a Retort, they will become very fit for this use, because they will be very searching and no waies clammy. Among these the most ex∣cellent are Oyl of Cheiry, Saint Johns Wort and of the Yolks of Eggs, which being mixed together▪

and stilled by a retort, are very profitable to ease Pain and to discuss the Cause thereof.

Also Mathiolus his Oyl of Scorpions stilled after the manner aforesaid, is most excellent.

Oyl of Wax is likewise effectual to the same purpose.

But Oyl of Mans Bones made after the same manner that Oyl of Tiles is made, is preferred before all others, and commended not only by the Chymists, but also by the Dogmatical Doctors, as Crato, Platerus, and others. The manner of making it is this: Mans Bones fresh and unburied, are broken and burnt, and cast into old Oyl: afterward, they being full of the Oyl, are beaten and cast into a Retort, and so by the force of the fire, an Oyl is drawn out.

Where Mans Bones are not to be had, the Bones of other Animals may serve the turn.

This following wil also be very good:

Take Mastich, Frankinsence, Mirrh, Ammoniacum, Opopanax, Bdellium, Mummy, of each two ounces: Vitriol one pound: Honey two pound: Tartar one ounce and an half: Spirit of Wine four pound. Distil out of all an Oyl, with which let the pained part be anointed with a feather.

To ease the pain, and to resolve the Matter of the Gout, a Liquor made of Snails is likewise com∣mended, which is thus compounded:

Put an handful of Snails into an Hippocras Bag, and cast upon them an handful of common Salt; upon the Salt, a handful of Dwarf-Elder, or Danewort seeds very finely poudered: And so one Lay after another of Snails, Salt, and Seeds, until you have made four or five Lay's of every one in parti∣cular. Let the Bag hang in a moist Celler; and after a few daies there will drop a slippery Liquor and fat; which set in the Sun for four daies, and then smear the place affected therewith.

A resolving Unguent may be made after this manner:

Take Chamepitys, common Wormwood, and Rosemary tops, of each a handful: Chamomel flowers, Melilot flowers, and Rose Leaves, of each one pugil: Oyl and Wine, of each half a pound: Let them boyl till the Wine be consumed: the Liquor being strained, add thereto as much Wax as shall suffice to make it into an Oyntment. Let the Part affected be anointed herewith warm; with∣in twenty four hours the Part doth swell, and the pain ceaseth.

Also divers Pultisses resolving and easing pain, may be made. The principal are these:

Take Wheaten Bran a pound: Salt one ounce: Soap as much as shall suffice. Boyl all into a Cataplasm, or Pultiss. Or,

Take Bean Meal half a pound: Boyl it in a sufficient quantity of Wine, adding thereto a little Aqua vitae and Butter. Make it into a Pultiss. Or

The Leaves of Dwarf-Elder, or Tree-Elder being beaten, may be applied; or they may be fryed with Butter in a Frying-Pan like a Pan-cake.

Briony Root bruised with Aqua vitae, is also very effectual.

Also some commend Aron, Cuckoo-pintle, or Priests-pintle Roots, being mingled with Cow-dung.

This following is commended by Solenander, because it resolves without any great heating, ea∣seth the pain, and strengthens the Joynts. And it may be safely applied after the beginning of the fit, about the fift day of the Disease.

Take Pouder of red Roses two ounces: Mastich one ounce: Camphire half a dram: Barley meal half a pound. Boyl all in white Wine, evermore stirring the same, till it come to be thick, and lay it on warm.

Emplasters are likwise wont to be of great use in this Case. The chief are these which follow.

Take Frankincese, Mummy, Colophony, of each one ounce: Mastich, Mirrh, white Coral, of each half an ounce: Mans Fat six drams: Gum Ammoniacum, and Bdellium dissolved in Vine∣gar, of each three Drams: Turpentine half an ounce: Oyl of Foxes, and of Roses, of each as much as shall suffice to make all into a Plaister.

Take Florentine Orice Roots, and Hermodactils poudered, of each six drams: Emplastrum Oxycroceum, & de Mucilaginibus, of each two ounces: Rozin of Pine one ounce. Melt them to∣gether, adding Oyl of worms as much as shall suffice, and make thereof a Plaister.

Emplastrum Diapalma, or Diacalciteos, is very much used, both alone, or with Camphire added thereunto, after this manner:

Take of the Rowl of Diapalma Plaister half a pound: Camphire two drams. Mix them toge∣ther, and apply them to the parts affected.

Or in Form of a Cerecloth.

Take of the Rowl of Diacalciteos Plaister half a pound: Plaister of Sulphur an ounce: Sto∣rax and Benzoin, of each half an ounce: Tacamahacca two ounces: Oyl of St. Johns wort, and Worms, of each an ounce: Liquid Storax an ounce and an half: New Wax, as much as shall suf∣fice. Melt all together, and dip your cloth therein, twice or thrice, make it smooth and dry, and keep it for your use.

But yet the same Plaister mingled with these things following, ought to be reckoned amongst the most excellent Medicines for the Gout.

Take Diacalciteos Plaister dissolved in harsh red Wine, and boyled till the Wine be consumed, one pound: Myrtles, red Roses, Mastich, Tartar of red Wine poudered, of each two drams: Chame∣pitys, or Ground-pine, and right sweet Chamomel poudered, of each half a dram. Make of all a Plaister, to be applied after the swelling is much abated.

And at last, in a very old and setled pain, especially from a cold Cause, some lay Vesicatories to raise Blisters upon the parts affected. Sennertus makes mention of them, but so as that Anodines be mixed with them. But the most wise Varandaeus, my Master, did with happy success use the common Vesicatory Plaister, which is kept in our Shops, simply, and by it self without any mixture; wherewith he cured a great and rebellious Swelling upon the Knee, when other Physitians had in vain used many Purgations, a Sudorofick Diet-Drink, and many External Medi∣cines.

In the use of all the fore-recited Medicaments, this one thing is diligently to be noted, That we must take our hints from such things as we find do help or harm the Patient: forasmuch as the Na∣tures of Men are divers, their Complexions divers, and divers kinds of Excrements are bred in several Men, whence it is that the same Diseases do extreamly differ in several persons: therefore what pro∣fits one man, doth another no good at all; which often comes to pass in curing the Gout. And for this Cause, every Practitioner must have an abundance of Medicines, that when one hath been appli∣ed in vain, he may use another and another, making alwaies choyce of such as a rational Method shall most approve of.

When the Gout becomes stony and knotty, it is extreamly hard to cure, especially if it be of long standing. But new knobs may with Emollient and Resolving Foments, Unguents, and Plaisters, be dissolved. The most Specifick or Appropriate, are these which follow.

Galen exceedingly commends a Plaister compounded of old strong Cheese, made into a Plaister with the Decoction of a poudered Sows pestle or Leg.

Others boyl poudered Sows Legs, till they come to a slimy substance or Gelly. Afterwards they mingle therewith two parts of old Cheese, pouder of Water-cresses one part, and so make a Plaister thereof. Or,

Take Juyce of Tobacco three ounces: yellow Wax two ounces: Rozin of the Line-tree an ounce and an half: Turpentine one ounce: Oyl of Chamomel as much as shall suffice. Make all into a soft Cerate or Plaister. Or,

Take of those Eastern Berries, which the French call Coques de Levant, and Mirrh, of each half a pound. Pouder them, and mix them together with strong Vinegar into the form of a Cata∣plasm.

Gum Ammoniacum dissolved in Vinegar, doth powerfully soften.

Rulandus anoints those hard Swellings in the morning, at noon, and in the Evening with Oyl or Balsom of Sulphur hot, and then he laies on a Plaister hot, of Emplastrum Diasulphu∣ris.

But this Plaister following, is your rare Plaister, because besides easing the pain, it draws the grit∣ty, stnoy substance out of the Joynts likewise.

Take Roman Vitriol one pound: Roch Allum half a pound: Salt four ounces. Calcine all these together in a Crucible or Earthen pot, letting it to steem so long till the spirits shall begin to go away. Which when you perceive by their smel to rise, leave presently your calcining, and let all cool, and then pouder them.

Take of this Pouder, and Barley Meal, of each a like quantity; mingle them with Wine Lees to the form of a Pultiss, which spread upon a rag as thick as a knife, and apply to the place affected. When it is dried, dissolve it again with Lees of Wine, and apply it again, until in the first place the pain be discussed; and in the next place, until all the stony substances be consumed out of the knobbed and knotted Joynts. In the mean while it fals out often that the Skin will break, which need not affright us; for either afterwards the Ʋlcers close of their own accord, or at least by lay∣ing Wax upon them in manner of a Plaister, they are closed up, the Joynts having regained their motion with activity.

Finally, If the Gout be very exceeding old, and perfectly knotted, by the preceding Cure a miti∣gation of pain is to be hoped, but the stony substances wil hardly give way; therefore with a gen∣tle Caustick the Skin is to be opened, and then the stones are to be taken away with a drawing Plai∣ster of Gums.

The Cure of the Gout when present, is performed by the Remedies aforesaid. But because this Disease is wont to return by fits, especially in the Spring and Fall, we must now shew the way to prevent the same. Which Prevention ought to aim at the hindering of any Gouty Matter, like to fall into the Joynts, from gathering in the Body; or if any be collected, that it may be carried away.

And finally that the Joynts may not be so disposed to receive the Humor which flows unto them. The collection of Matter will be hindred, by an excellent Diet, and by Medicines rectifying the distempers of the Bowels. The Matter collected will be carried away by Evacuating Medicaments. And the Joynts will not so easily receive if they be fortified with corroborating Medicaments.

As for the Matter of Diet, although in this Case it be of very great, yea greatest moment, yet the Nature of this work will not give me leave to describe the same.

I shall only speak of the Patients Drink so as to say, that Wine is extream hurtful to all Gouty Persons, and many have recovered only by abstaining therefrom. Yet if the Patient in regard of some other Infirmity cannot wholly abstain from Wine, let him drink weak Wine, or well allaied with Water. Hollerius instead of Wine commends thin Metheglin viz. Of forty or forty eight Parts of Water to one of Honey. Yet this suites not with such as abound with bitter-choller and those that are dry and thirsty.

This following Diet drink suits all Natures, and hath done much good to very many persons.

Take Salsa parilla Roots two ounces: Liquorish one ounce: Cinnamon and Annise Seeds half an ounce: Make all into a very sine Pouder. Of this Pouder mix one spoonful with so much smal Beer or ale as the Patient is wont to drink at a Meal. Brew them together out of one Pot into an∣other three or four times. Then strain the Liquor for the Patients ordinary drink. Doing the like for every Meal.

And as for Evacuations, Bleeding must be first practised especially in the spring and fall, in such as abound with Blood and whose Blood is wont to work and ferment or be very hot.

But Purgation is not only to be used spring and fall, but four times in a yeer, yea and every month in every Cacochimical Body that is which abounds much with evil Humors. To which purpose ma∣ny forms of Purgations are handed to and fro, of a special property for this Disease. These that follow are the chief, which are so to be used by the discreet Physitian, as that he must make many changes, both in respect of the materials and the Dose, according to the various Constitutions of the Patients,

Take Senna clensed, Turbith, Hermodactiles and Pouder of a Mans Skull that hath never been in the Earth of each one dram: Diagridium half a dram: Make all into a Pouder of which give one dram: at a time, in Groundpine Water, or in Broth. Or,

Take Salsa parilla one ounce: Senna six drams: Turbith, Hermodactiles, Jalap, Mechoacan of each half an ounce: Agarick Trochiscated two drams: Diagridium and Cinnamon of each half a dram: Make all into a Pouder. Steep a dram thereof in white Wine all night, in the Mor∣ning let the Patient drink Pouder and Wine.

Electuarium Caryocostinum is by Petrus Bagerus exceedingly commended, and is approved by al Practitioners, and it is described in the London Dispensatory in Folio 111. and in that of Bauderon. It is given to half an ounce: But in hot Constitutions it may do harm.

Rhasis Commends his Pils so far as to say, that they can make such as are fain to Ride, to go on Foot again. Thus they are made.

Take Aloes of the best half an ounce: Red Roses two scruples: Hermodactiles white and pur∣ged from their outmost Skin or shel, one dram and an half: Diagridium one dram: With Water of Ground-Pine and honey of Roses make all into a Mass of Pils. the dose one dram.

These also are good which follow.

Take Aloes, Hermodactiles of each half an ounce: Groundpine, or Chamepitys two drams: Chamaedris or Germander, Stcoehados of each one dram: Saint Johns Wort Seeds, half a dram: With Ʋenice Turpentine make a Mass of Pils, which because they Purge little may be given the of∣tener.

Also Evacuation by Vomit is very good for Prevention if the Patient can bear it well; which is declared by Alsaharavius a famous Physitian in these words. A Vomit is better than a purg to Root out such ill Humors of a gross Nature as are below the Knee even to the Foot; as in the Knee-Gout, Sciatica and such like.

Now Vomiting may be procured every Month two daies together because the second day drives out the Reliques of the first. And some have observed that vomiting is more successful than ordinary when is in a Sign that chews the Cud, such as the Bul & the Goat or Capricorn. It is good to Vomit the Moon after Supper the Patient having eaten divers Meats, Fat, sharp of Salt or Spice &c. and others in great Quantity, and afterward rubbing his stomach and putting his finger into his throat. And if that will not do, he must take a Vomit, especially of Asarum and Broom Boiled together and the De∣coction drunk, which are otherwise good in the Cure of the Gout,

That Evacuation likewise which is made by sweat, Purges the Blood from wheyish excrements, and draws out the antecedent Cause of the Gout. To this Purpose a Sudorofick Diet drink may be ordered for the Patient Spring and Fall, of a Decoction of Salsaparilla, China, Sassasras, or of Guaiacum, as the temper of the Patient shall advise,

But some late Physitians have brought into use, a Decoction which carrieth away the Matter meerly by invisible Transpiration through the Pores of the Skin, without any sweat at all, which hath done a world of good. Its Composition and use is thus:

Take Sarsaparilla, Crude Antimony, Nut-shels, of each six ounces: China Root one ounce: A little Brasil Wood: Water nine pints: Boyl them to four pints and an half. Let the Antimony and Nutshels be poudered and tied in a cloth, which must be so hanged in the pot that it touch not the bottom. Let him take a good draught of the strained Liquor, on mornings three hours before dinner; in the afternoon four hours after dinner, and three hours after supper, for fifteen daies together. Bleeding and universal Purgation being premised.

Of the Grounds remaining in the Strainer with like quantity of Water, may be made a Diet¦Drink for ordinary use instead of Beer. Boyl the Water half away, and ad Coriander and Liquoris as much as shall suffice to give it a good smack.

To prevent the Gout, and to root the same out of the Bowels, some Practitioners commend the use of Gout-quellers given an whol yeer together, whereby they avouch many have been perfectly cured. Among many of their Receipts, this is the Principal.

Take Salsaparilla four ounces: St. Johns-wort seeds, Groundpine, and Germander Leaves, of each three ounces: round Birthwort six drams: Angelica three drams: Cinnamon three drams: Cloves four scruples: Saffron two scruples. Let all be finely poudered and incorporated with Spanish Honey clarified as much as shall suffice. Make all into an Electuary, which let the Pati∣ent use a yeer together, taking every day in the Spring, Fall, and Winter, one dram and an half; in the Summer only one dram. Let the Patient forbear to take it in the Dog-daies. Let him whol∣ly abstain from Wine and Lechery.

Peradventure the Decoction of Germander may be of the Nature of the Gout-quelling Medica∣ments our Practitioners talk of; which was therefore commended to the Emperor Charls the Fifth exceedingly by the Physitians of Genoa; and Solenander doth testifie, That very many who drank this Medicine threescore daies together, were perfectly cured. The Composition of this Decoction is thus:

Take Germander gathered when it flowers, and well preserved, one handful: Ripe Wine not ve∣ry strong, nor very smal, three pints: Boyl them in a double vessel five hours. Let the Patient take a draught of the strained Wine, and compose himself to sweat. This is to be done after the Patient hath been purged.

And it is here to be noted touching those hot Medicines, that they are not only unprofitable for hot Constitutions, but they cause such Resolutions of Humors or Joynts, or other inconveniences, as can never be cured, and therefore they must be given with great Caution.

Peradventure this following Electuary may be used with more safety and success, which doth purge the Body by little and little from all superfluities without heating the same.

Take Senna half an ounce: Turbith, Hermodactils, of each six drams: Lignum Guajacum, Sassapbras, and Salsaparilla, of each half an ounce: China Roots one ounce and an half: Ne∣phritick Wood two ounces: the three Sanders, of each one ounce: Annis Seed two drams: Ho∣ney very well clarified fourteen ounces: make all into an Electuary. The Dose is one dram every day in the whol yeer, except the Dog-daies.

Among the common People, some hold it for a great Preservative from the Gout, to swallow three Cloves of Garlick whol every morning for a month together. For they heat and strengthen the Sto∣mach, without heating the Liver, or other Bowels; for they are voided forth with the Excrements whol, but boyled and wrapped in clammy Flegm, which they bring from the Stomach and Guts.

In the Gout proceeding of Chollerick Humors, Waters of Medicinal Wels, which are Acid, Vitrio∣late, and cooling, such as that of Tunbridg in Kent, Blackbois not far from Lewes in Sussex, one in the Parish of Sandherst in Kent, do very much good. So that by the use of such Waters, some per∣sons have been for a long time freed from the Gout.

To the same purpose Hippocrates commends in his Book of Diseases, the use of Asses Milk, which Experience shews hath done good to many Gouty persons.

And in a word, All things which are good against an hot distemper of the Liver, and to strengthen that Bowel, wil be good in this Case, as they are described before in the Cure of the hot distemper of the Liver.

But if a wheyish Humor flowing from the Brain be Cause of this Disease, as most commonly falls out, the greatest care must be had of the Brain; viz. That its distemper may be corrected, and that the Humors bred therein may be derived and discussed. To which intents; Issues, Vesica∣tories, Medicines to be drawn up into the Nose, Masticatories, Pouders, Spiced Caps, will be very serviceable; and other Remedies propounded in the Cure of Diseases of the Brain.

The last Point of Prevention, is to strengthen the Joynts that they may not so easily receive the the Humor flowing in. Yet it is to be noted, that strengthening Medicaments, are not only Vain but hurtfull also, unless the antecedent Cause, and the Humor ready to flow into the Part, be carefully removed by the foresaid Medicaments. Otherwise those strengtheners, either are not able to hinder the influx of the Humors into the Joynt: or if they do hinder the same, the Humors retire to the more noble Parts of the Body and raise much worse Diseases.

Among the principal strengtheners the pressings of Grapes viz. their Seeds &c. are reckoned, which discuss the reliques of the Morbisick Matter by their actual heat, and by their astringency, do very much strengthen the Parts. Duretus upon Hollerius doth thus commend them. But the use of Ʋine-Grape Kernells doth exceedingly profit in the time of Ʋintage. If the pressings of the Grapes be brought out of the Wine Press into a Barn and being covered with Blankets do there grow hot. In them let the Patient thrust his Feet, Legs, Thighs, Arms, or his whol Body. I have tried it (saith he) an hundred times, there is no better thing under the Cope of Heaven.

And Solenander in his Counsel 21. Sect. 4. Doth give the foresaid Medicine this commendation. But among the best and safest remedies, (which do also strengthen the Parts affected, and do cherish the innate heat,) is this to be reckoned, and diligently once every yeer (for oftner it cannot) to be practiced, viz. That in Ʋintage time, the Feet and hands affected, be whelmed in pressings of Grapes hot from the press, or made hot with warm Wine, every Morning for fifteen daies. And I could name a worthy Personage, to whom I have communicated this Medicament, and received from him a very considerable Gratuity; therefore who could not go at all, and by this Medicine and Gods Blessing, he was restored. And by how much the Grapes are riper, by so much the more good, will the pressings do in this Case.

Sulphureous and Nitrous bathes such as the Balerucane in France, do not only discuss the Matter of the Gour, by provoking sweat, as was said before; but also by strengthning the Joynts, they do much conduce to the Prevention thereof; as also being used by way of Embrocation, that is the Head being wet therewith or it being pumped upon the Heat, Cotton wet therein be at last laid on and made fast. The mire of the said Bathes applied to the weak Parts, doth likewise strengthen them.

Where the benefit of Natural bathes cannot be had, the Feet may be washed and other Parts Fo∣mented, with a Decoction of nerve Herbs, some astringents being added thereto, as Balaustians, Mirtill. Cypress Nutts, Allum, and Salt, with Iron-quenched Water and red Wine.

Also Oyntments are commended, being frequently used, made after this manner.

Take Oyl of Mirtles or Roses two ounces: Salt two drams: Mix them and make a Lini∣ment. Or,

Take Oyl of unripe Olives Oyl of Mastick one ounce: Salt fried in a pan two drams: Bole Armoniack three drams: Dragons Blood, Hipocistis, Frankinsence, Mastich, of each one dram and an half: Let each Particular be first finely Poudered by it self, then with the Oyls mix them into the form of an Oyntment.

The Plaister called Emplastrum Diapalma is very good to strengthen the Joynts: and its useful in all Gouts whatever the Humor be which offends. and Solenander writes in Counsel 25. Sect. 4. that he hath known some, who had wont to be often troubled with the Gout, and by the continual use of this Plaister, with frequent purges taken at certain distances of time, they were freed from those Pains for five years together. And this Plaister doth not daub and foul, doth not raise Itch or Pim∣ples, nor is it troublesome by its smel or any other evil quality. And it is fitted to the shape of the member. When the Feet are troubled shoes are made of thin Leather which being smeared with this plaister are put upon the Feet. The like spread with this Plaster may be applied to the Wrists and other Parts. But the truth is the same Plaster boy led in Wine and mingled with Pouder of Myrtles, Roses, Tartar, Chamepitis or Groundpine and Chamomel, so as we described before in the Curation, is much better for the same uses. And we have seen Gouty persons, who contiually wore such a Plaister upon their Feet and Wrists, with most happy success.