The London practice of physick, or, The whole practical part of Physick contained in the works of Dr. Willis faithfully made English, and printed together for the publick good.

CHAP. XIII. Instructions and Prescripts for curing the Gout.

AMong the Diseases of the Head and Genus nervosum, we justly rank also certain Affects which are wont chiefly to infest the Feet and Belly, to wit, the Gout and Colick. For we may con∣clude from the primary symptom, viz. Pain, that the Seats of both are in the nervous parts. I shall speak in the first place of the for mer.

The Gout most commonly is wont to arise about the Internodia of the Bones of the Feet; tho often it happens in the Joynts of the Hip, Knee, Elbow, Shoulder, Wrist, Ancle, and of other Parts.

The Fits of this Affect (which in a manner is always intermittent) either seize at random, or periodically; which ending sometimes soon∣er, sometimes later, good lucid Intervals ensue; presently, upon the first invasion, Pains for the most part arise without any swelling; tho afterward, about the height of the Disease, the Part affected often swells; the Pains about the beinning scarce yield to any Remedies, but are wont to be very much exasperated by Catharticks, and not presently to be driven away, or asswag'd by Topicks; the Fits most commonly seize on a sudden, and without a precious affect, tho sometimes it has a fore-running effervescence in the Blood, or a little Fever. The Disposition to this Disease sometimes is Hereditary, some∣times acquir'd through an ill Diet: the Occasions or Causes, which being wont to actuate the Disposition, raise the Arthritick Pains, are some violent alterations, or Passions inflicted on the Humours and Spi∣rits. Hence Surfeiting, immoderate drinking, especially of acid and thin Wines, Transpiration letted, Anger, immoderate Venery, Sad∣ness, also the Revolutions and great changes of the Year and Air, eve∣ry where bring Fits of this Disease: those that are obnoxious to this, are also in danger of being sometimes troubled with the Stone or Gra∣vel in the Kidneys, and on the contrary: moreover, the Gout increa∣sing gathers together every where about its chief Seats, to wit, the Joynts, a calculous matter, and there raises a tophous mass.

The Parts affected, upon the twitching of whose Fibres the Pains are raised, for the most part are the Periostia, or the Membranes co∣vering the heads of the Bones, also the Tendons, and haply the Liga∣ments there plac'd: but since the Pain in those Parts depends wholly on the solution of continuity, and this proceeds from a certain matter sticking in, or lying on those Bodies we must enquire, first, of what kind that morbifick matter is; secondly, whence it is brought thither, and thirdly, after what manner, by solving unity in them, it causes such periodical Fits of the Gout.

As to the morbifick matter, it seems in the first place that it is nei∣ther the Blood nor the nervous Juyce by themselves; nor also one sin∣gle Humour depos'd by either of them, but that in the chief Seat of this Disease many fermentative Juyces, and not easily miscible, meet; and then that from their contest and effervescency painful twitchings of the nervous Fibres arise.

Therefore a saline or tartarous matter, depos'd from the arterious Blood about the spaces betwixt the Bowels, is as it were the feminine Seed of this Disease; which nevertheless, tho heap'd together in a great plenty, is wholly unfruitful of it self, till the nervous Liquour growing turgid, sends acetous Recrements, falling from it, to the seat of

the former, which, as the masculine Seed, presently renders the other prolifick: for, in as much as those two particles, which are of a differ∣ing state and origine, meet, and mutually contest, they twitch the Fi∣bres of the Membranes and Tendons, and so cause the Fit of the Gout, the appeasing of which depends wholly on the mutuall subduing and dissipation of the sharp Particles of both kinds.

As to the evident causes for which the nutritive liquor, brought from the Blood to the Joynts, is too much stored with a fixt Salt, and by reason of which these Parts become over-ready and easie to receive what is disproportion'd to them, in regard they are various and ma∣nifold, we shall here briefly touch the chief of them.

1. And first, an hereditary disposition is wont to produce both the failures: for Gouty Persons for the most part engender Gouty Children; and this Disease, descending from Parents to Children, is wont to have in both not only the like fruit, and to be brought to a ripe∣ness about the same terms of age; but for the most part it fixes its first roots in the same members, and every where observes the like progress.

2. But nevertheless, the Arthritical disposition, without an original taint, is often caused by reason of an ill dyet, and errours in the six nonnatural things; for those who being given to feasting and good fellowship, delight themselves in eating and drinking much and dis∣orderly, and especially if they feed on salt and sumptuous provisions, and drink, Wine plentifully, easily contract this Disease. For by this means none but an indigested Chyle, and such as is endowed with wild and unmeet Particles is prepared in the Viscera; moreover, after much drinking of Wine, Salt dregs and heterogeneous filth, which otherwise would stay in the first passages, being too much exalted, are conveyed into the Blood: To which irregularities in Dyet, if a sedentary Life, Idleness, and much sleeping are joyned, so that neither the superfluities exhale, nor the saline Impurities are blown off by exercise that they do not subside about the Joints; certainly a great store of this Alchalisate seed will be sown for produ∣cing this Disease of the Joynts.

The weakness and Arthritick disposition of the Joints is not only hereditary, but is frequently caused on several occasions; the falling down of the morbifick matter often brings it: for if by chance it happens that the firs fit of the Gout be in this or that Part, the pec∣cant humour will afterward more readily fall on that member; and in a short time will make there, as it were, its nest, where it will con∣tinually lodge its brood: Moreover, solution of Continuity also, or an injury hapning to some Joint by cold or moisture, a wound or luxati∣on often cause a Gouty disposition.

The evident Causes, which in respect of the Nervous Liquor, cause Fits of the Gout, either pervert the particles and Portions

into an acetous nature, or being before degenerated, stir them to fluxious.

1. Many acid Liquors and small Wines ought to be avoided, and ex∣perience teaches us that Cyder and stale Beer ought of all things to be shunn'd by Arthritical persons, for those kinds of drinks do not only bring into act the latent cause of the Disease, but by filling the Brain and Nerves with a great many acetous particles, they contribute to its fuel, and encrease the morbifick matter.

2. Immoderate or unseasonable exercise of the Body, Violent pas∣sions, immoderate Venery, and a disorderly Diet, and likewise what∣soever things greatly trouble or exagitate the Spirits and Humours, and consequently raise fluxions of the nervous Juice, or of its Recre∣ments cause Arthritick pains.

3. Solemn Evacuations supprest, also an admittance of cold and moi∣sture, forasmuch as by this means the Blood, and consequently the Nervous Liquor fall into effervescencies and fluxions, bring fits of that Disease.

4. For the same reason changes of the places of aboad, also the revolutions of the year are wont to bring pains of the Gout, that it is become a Proverb, that Couty persons carry their Almanack in thier Bones, and from their pains draw most certain prognosticks of the seasons; for as often as a moist constitution of the year, and South or North Winds, or Snows are at hand, they are wont to predict those things from the accesses of their pains. Moreover, at each quarter of the year, especially Spring and Fall, they are more sorely tormented; wherefore the Aequinoxes are always religiously observ'd by them: The reason of these things partly consists in this, that in∣sensible transpiration is variously altered by reason of the changes of the air and of the year; for which reason, the Effluvia, which were wont to transpire, being restrain'd, ferment the Blood and Ner∣vous humour, and easily stir them to Arthritick flucions. Moreover, the humours of our Bodies, as the Juices of Vegetables, and other natural or artificial liquors, diversly ferment according to the changes of the seasons, and fall into various states, sometimes of fixation, sometimes of volatility, sometimes of flowing.

The chief differences of this Disease are taken from the places af∣fected, and therefore they are made, as it were, the distinct species of the same, viz. to wit, the Hand Gout, the Hip Gout, the Knee Gout, the Foot Gout: Mean while, pains usually rais'd in any other Members, go by the common name of the Gout: Whether the Tooth-ach, the pain in the Loins, and pains of other Parts ought to be referr'd to this, I have not now leisure to enquire.

A long continued Gout very often joyns to it s Scurvy, and some Scorbutick affects so plainly counterfeit the Gout, that they cannot easily be distinguish'd: The reason of the former is both a like Dyscra∣sy

of the Blood, in both affects depending on the fixt Salt; and likewise that the Scorbutical disposition easily comes upon Gouty persons; for that keeping long to their Bed or a Chair, they use no exercise. Secondly, the Scorbutick affects which initate the Gout, are a Rheu∣matism, and the Arthritis vaga Scorbutica, concerning which we have written in our Tract of the Scurvy.

The Gout has so near a Relation to the Stone in the Reyne, that both affects, as tho they were of the same Origine, most common∣ly concur: for scarce any Person is troubled with that Disease, but he is found obnoxious to this; Moreover an inveterate Gout is wont to cause strong concretions in the Joints, such as the Nephritick Disease in the Reins: hence I think it very likely that the ach in the Reins ar∣rises from a like, or wholly the same cause which we have assign'd for the Gout to wit, that the Salino-fixt-matter depos'd by the Blood in the Reins ferments with the acid humour often sent thither by the Ner∣vous Ductus's; and that therefore Nephritick Pains are frequently caused; and that afterward the Stone is form'd by both matters coagulated af∣ter fermenting.

As to the Prognostick of the Gout, every man knows it to be a Di∣sease that is safe enough, but extreamly difficult to be cured. 1. As to the former, this Disease is not only void of danger as to it self, but is a prevention against most other Diseases: for gouty Persons by reason of a saline-fixt Discrasy of the Blood are not obnoxious to Fevers; More∣over they live for the most part free from other affects of the Head or Viscera, in as much as the Recrements both of the Blood and Ner∣vous Juice are continually depos'd in the Joynts. 2. But as to the way of its cure, it is so diffcult, that for the removal of the Procatarxis of the Disease there is requir'd both a most perfect amendment of the two Humours, viz. of the Blood and Nervous Juice, to wit, that they en∣gender not any Saline-fixt, or acid Particles, and likewise a Restituti∣on of the weakned Joints (neither of which can ever easily be done) to which may be added, that the conjunct cause of this Disease lies in parts very remote, where the Vertues of no Medicine reach.

Sometimes it happens by reason of the fluxions of the Arthritick matter being supprest or struck back, that one while gripes of the Belly or Viscera of the Abdomen, another while a Dyspnaea, Asthma, or other affects of the Brest, and sometimes also that the Apolexy, and other sleepy or convulsive Diseases are raised; from which things being observ∣ed, it will be obvious to object, that the Minera of the Gout is not such as we even now describedit, because its saline part, in regard it is the same which is appointed for the nourishment of the Joints, cannot be driven thence, or convey'd, or depos'd elsewhere: when as to the other part, to wit, the acid Seminium deposed in its usual place, it seems that that can∣not easily be driven back, and being supprest by it self, or in its Passage, or convey'd elsewhere, that it will not much hurt any part; but it may

easily be replyed to this, that the acetous Portion of the Arthritick matter flowing in the Ductus's of the Nerves may be repelled or stopt, and that being discharged on other parts, it often causes very sore Diseases, and indeed the nervous Liquour and its Recrements, since they consist of Particles that are very subtle and active, upon any small let or repulse are driven into divers sorts of sallies and fluxions; More∣over, when those grow turgid about the noble parts, or within the Ductus's of the Nerves, or meet with Particles of other Humours of ano∣ther kind, and ferment with them, they cause various affects either in∣ducing pain, or convulsive: and often, in as much as Particles of a dif∣fering nature are coagulated together, Tumours, sometimes Strummous, sometimes Cancrous, or otherwise malignant arise.

Whilst I was writing these things, I was called to a renowned Ma∣tron, who formerly having been very obnoxious to the Gout, after that she had been ill of late for about three Months of a very great weakness of the Stomack with an Anorexia, a Nauseousness, and almost a continual Vomiting, at length I know not on what occasion, falling into frequent Swoonings, a little after she was often troubled with a Vertigo, with a failing of Memory, and sometimes with a slight De∣lirium, and when she had continued so for many dayes, and in the means while being free from the Gout, and having a good Stomack, she eat Broath twice or thrice, and flesh once a day with an Appetite, and disgested it without trouble; this was a plain sign that the Recre∣ments of the Nervous Humour which formerly were wont to fall by the spinal Nerves into the feet, to the seat of the Gout, afterward being deposed by the Nerves of the Par vagum and Intercostale in the Ven∣tricle, raised continual Troubles in it, which at last partly restagnating in the Brain, and partly being conveyed into the Nerves of the Heart, were followed by those affects of the Leipothymia, Vertigo, and Deli∣rium.

The Theraputick method suggests three primary Indications, where∣of the first being curatory, is used only in the Fits, for the appeasing, or sooner putting an end to the Pains: The second being preservato∣ry, and appointed for the intervals of the accesses, endeavours to re∣move the Procatarxis of the Disease, so that the invasions of the Pains may return but seldomj, or more mildely, or not at all. The third be∣ing vital, orders by what kind of dyet, and with what Remedies, the strength may be supported among the said Tortures, and Life, notwith∣standing the frequent and almost continually troublesome oppressions of the Disease, may be prolong'd, and withall reinvigorated.

The first indication, viz. the appeasing of the Pains, contains these two cheif intents: viz. That the Solution of Continuity be taken away, and in the mean while that the irritation or excandescency of the Fi∣bres, or of the Spirits abounding in them, be allayed.

1. To take away the Solution of Continuity in the places affected, both the fluxions of the Humours which are apt to tend thither ought to be stop'd, and the Minera already there sticking ought to be discuss'd or dissipated, and its Particles be restrained from their mutual Efferves∣cencies. For these ends evacuating and altering Remedies, and both of them, as well inward as outward, are appointed: we shall-set down certain select Forms and wayes of Administration of these in or∣der.

Blooding in a new Gout, or which is not very inveterate, and especial∣ly in a hot constitution, being used about the beginning of the Disease, often gives relief: but in an habitual Difease, also in a cold tempera∣ment, and in old Age, it is wont to do more hurt than Good, in as much as it depresses the vigour of the Blood and Spirits, which are not too exorbitant, without a diminution of the morbifick matter.

Concerning Purging about the beginning of the Disease, the thing is very much controverted, whilst some Physicians religiously abstain from all Purging, before the declination, or end of the Fit; and others on the contrary constantly give strong Purges about the beginnings of the Disease: the reason of the difference seems chiefly to lye in this, viz. that in some gouty Persons, who are yet firm in the Constitution and Tone of the Humours and the containing Vessels; and whose Joynts are not yet weakned, as often as the Blood and Nervous Liquour are troubled by a medicine, their Superfluities and Recrements are not presently precipitated into the Minera of the Disease, but yielding to the Medicine irritating and stirring them, they are drawn from the Mouths of the Arteries into the Cavities of the Intestines; and mean while the emptied Vessels withdraw or drink up again a part of the morbifick matter. but on the contrary, in tender and weakned con∣stitutions, upon the gentlest commotion of a Medicine, the Recrements of both humours fall into the Place troubled with the Gout. To those therefore with whom purging agrees, it ought to be ordered with a strong and exagitating Medicine: for this purpose are vulgarly famous the Electuary Caryocostinum, Syrup of Buckthorn, compound Powder of Her∣modacts, Pilul. ex duobus, Pil. Rhasis; which, if we may believe the Au∣thour, will make such as are not able to goe, presently to walk about.

Take of the best Aloes half an ounce, red Roses two Scruples, Hermodacts pill'd a dram and a half, Diagridium a dram, Honey of Roses what suf∣fises, make Pills. Rodericus a Fonseca wonderfully extolls the roots of black Hellebore, and amongst other things, an Apple with the Fibres of it stuck in it to half a dram, rosted under the Embers and eaten.

Take Calomelanos a Scruple, Rosm of Jalap three grains, or of Scammony three grains, Oyle of Cloves a drop, Balsam of Peru what suffises: make three or four Pills for one dose.

In purging, what Solenander prescribes happily may be of some mo∣ment; viz. by putting a Plaister, or some other defensive Medicine on the place, to hinder the falling of the humour to it.

Vomiting, with those with whom it uses to be safe and easie, does well also in this Disease; for which end the Emetick Tartar of Mynsicht, Sulphur of Antimony, its Flowers, Mercurius Vitae, Vinum Emeticum, Gutta Gamba may be given.

Moreover, in a Fit of the Gout, Powder of Stones, Bones, and Shells, and also of smart Vegetables do good, which being said to be the Anti∣dotes of this Disease, subdue all Particles, and fermenting with them, mortifie them as it were, and at length being subjugated, send them forth by Urine, or sweat.

Take compound Powder of Crabs Claws two drams, Ivory, Roots of bastard Dittany, Roots of male Peony of each a dram, Lignum Aloes, yellow Saunders of each half a dram, make a Powder, let it be taken from half a dram to a dram, either by it self in a Spoonful of red Poppey water, drinking after it six Spoonfuls of the same, or let it be made into a Bolus, or Pills with Venice Treacle, or Venice Turpentine what suffises; the dose is a dram twice a day, drinking after it of the distilled water beneath prescri∣bed, two or three ounces. Or,

Take of the same Powder six drams, conserve of Clove-gilliflowers and Betony Flowers of each an ounce and a half, Diascordium two drams, Syrup of Maeconium what suffises, make an Electuary, the dose is a dram, to two drams Evening and Morning.

Mean while that these things are done for withdrawing elsewhere the morbifick Matter which would flow into the places affected, or for sending it forth, let altering and qualifying Medicines likewise have their turns, which may appease the Turgescencies of the Blood and Nervous Juice, and stop the fluxions of the Recrements falling from them; for this end a thin diet, and a drinking of Water (if it be pro∣per) being ordered, let Emulsions, Juleps, Apozemes of mild things and Anodines be prescribed.

As to what concerns the other Scopes of curing, viz. the discussion of the Minera sticking in the Parts, and the mitigating the excandes∣cencies of the Fibres and Spirits; we must insist first on this latter, without the performance of which we cannot answer the other intent: for this end therefore it is expedient to use both outward things, viz. Topicks of various kinds, and inward things, viz. Hypnoticks.

There being a vast number of Topicks, they either being only Ano∣dines, have regard to the Pain it self; or levelling at this, together with the Tumour, they are either Repercussives, or Resolvents and Discussers; there are various Forms and Wayes of Administrations of every kind of these: but those of cheifest use are wont to be Fomen∣tations, Cataplasms and Plaisters; we shall set down some of the most noted of these, and first Anodyne Applications, which moderate the Fibres

and appease the Spirits by a certain soothing: for this use, a Cataplasm of Milk and Crum of Bread, or of those things with the poúndings of the Leaves and Roots of Mallows and Althea, and the like, are every where in common Practice with the Vulgar.

Others commend a Cataplasm of fresh Cow-dung applyed warm.

Take Water of Night-shade, or of the Spawn of Frogs, of each six ounces, Saccharum Saturni a dram, mix them, let linnen Cloaths dipt in this be applyed warm.

Take of red Lead three ounces, distilled Vinegar two pounds, digest them for many dayes: let either this Liquour by it self, or a Water drawn from it by distillation be used for a Fomentation.

Also a distilled water made of the Tincture of Verdigrease distilled in Vi∣negar, often appeases Pains.

I was told by a Gentleman often troubled with a severe Gout, that he, in the cruel Tortures of that Disease, had always present ease from a Fomentation with a Water distilled from the contents of a Bullocks paunch newly killed.

Against extream Tortures of the Gout outward Narcoticks sometimes ought to be used.

Take Leaves of Henbane, and Hemlock of each three Handfuls, let them be put into boyling Water, and as soon as they grow tender, let them be taken forth; to which, being bruised, add Powder of the Flowers of Cam∣momil about two drams, the yolk of one Egg, make a Cataplasm. Or,

Take Tincture of Saffron made in Spirit of Wine four ounces, Camphire and Opium of each a dram, let there be a close and warm digestion till they are dissolved; let the part that pains be anointed with this Liquour: there are innumerable Medicines of this kind every where to be found in Books of Physick, and are every where wont to be prescribed by every vulgar Person; which likewise may suffice for fulfilling the other intent, to wit, the repercussion of the Humours, if at any time it seems to be indicated.

As to what regards resolvent, and discussing Topicks, such are not required, which only open the Pores, that the Serum may evaporate, and the Blood may be restored to Circulation, as in a Phlegmon or Aede∣ma, but whose saline Particles being destinated for strongly assaulting the saline Particles of the Arthritick Minera, may either draw them forth by laying hold of them, or, by precipitating them, keep them from their Pain, causing Effervescencies: wherefore, in this Disease, when Fomentations, or Cataplasms of Chammomil, Mallows, Marshmallows, Linseed, and Faenugreek seeds do little or no good, nay often much offend the nervous parts by relaxing them, the Dissolutions, or Stilla∣titious Liquours of Sal Armoniack, Sea-salt, Nitre, Vitriol, quick Lime and the like; which in other Humours and Pains are always offensive are wont to prove very beneficial.

Of these kinds of Liquours to be applyed to the part pained in Fits of the Gout, several are prescribed by Quercitan, Crollius, Hartman, and other Chymists; which since other famous Physicians, upon fre∣quent tryals have approved off, we conclude them to have given relief for the foresaid reason.

I need not repeat here the forms of these; as I could suggest many other Preparations of the same sort, I shall here only add one or two.

Take Salt of Tartar and Armoniack powdred of each two ounces, dissolve them in four pounds of Rain-water or Fountain-water: let it be used luke∣warm with Linnen-Cloaths dipt in them.

Take spirit of Vitriol not rectified a pound, Sea-salt calcin'd and powdred a pound, mix them, and distill them in a Glass Retort with a sand heat; there will come forth a pure spirit of Salt, to wit, which being driven from its seat by the distilled Liquor of the Vitriol, and leaving to it its possession, will easily dscend: to the Caput mortuum pour Spirit of Wine two pounds, make a close and warm digestion, adding of Camphire two drams, let it be applyed warm to the part grieved with Linnen Cloaths.

Take filings of Iron, Flowers of Sal Armoniack of each six ounces, mix them by boyling them together, let it be distilled in a Glass Retort till the Flow∣ers are sublimed: to the caput mortuum bruis'd pour spirit of Wine, digest, and keep it for use.

I have heard that some for appeasing Pains of the Gout, put the foot affected in a bag fill'd with Sea-salt calcin'd and powdred, from which they still expect a certain and quick relief.

In the declination of the Fit, to strengthen the part, and to discuss the remainder of the morbifick matter, Plaisters are usefully applyed, which nevertheless do not all agree indifferently with all Persons; but with these more hot, with othérs less hot, tho with most those are wont to be most efficacious, in which are red Lead, Litharge, Mercury, and other mineral or saline things, we use chiefly a Plaister of red Lead, Cerusse, and Soap boyled with Oyle, or take the red Lead Plaister two parts, Paracelsus's Playster one part, mix them and spread them on Leather.

Inward Remedies to be used against Pains of the Gout, are in a manner only Narcoticks, which ought to be given in a cruel and long continued Pain. Of these we most commend Preparations of Opium, with Salt of Tartar or its Tincture. Moreover, for this use Paracelsus's or the London Laudanum, Pilul. de Styrace, de Cynoglosso, Syrup of Meco∣nium, Venice Treacle and Diascordium are wont to prove beneficial.

The second indication called preservatory, has respect to the remo∣val of the Procatarctick Causes of the Gout; so that the Fits of the Gout may molest with invasions more seldom, and less, or not at all. For this end evacuating, altering, and corroborating Remedies, together with an exact sorm of Dyet are prescribed to be used out of the Fits.

1. Therefore Gouty persons ought to Purge solemnly Spring and Fall. and it will be convenient then to give a Vomit, if nothing in∣dicates the contrary, and afterward to repeat it sometimes by inter∣vals. Those who have a strong Stomach and Praecordia may take Mi∣neral Emeticks, prepar'd of Antimony and Mercury: Those who are of a more tender constitution, after having eaten slippery food, may take Wine of Squills, or Salt of Vitriol with Whey: Afterward, the Sto∣mach being filled with warm Water, or plain Posset-drink, or with the leaves of Carduus boyled in it, let a Vomiting be raised twice or thrice, or oftner. For Purging to be used also frequently at fit intervals of time, the forms of Purges above prescribed may be proper enough. Or,

Take threads of black Hellebore cleansed an ounce, lignum aloes, Cloves, of each two drams, being bruised, pour to them of Spirit of Wine not recti∣fied, two pounds; let there by a close and warm digestion for many days; the dose is two or three spoonfuls in the morning twice or thrice a week, and let Vomiting and Purging always be begun before the Equinoxes, lest haply the fit, hapning first, may prevent the course of Physick. Blooding, or opening of the hemorrhoid Vessels are sometimes pro∣per Spring and Fall to Persons of a hot temperament and a sharp Blood; Cauteries made in the Arms and near the Shoulder-blades are useful in a manner to all that are obnoxious to this Disease.

Moreover, altering Remedies, call'd by the Ancients the Antidotes of the Gout, are of excellent use, and being taken sor a long time, together with an exact governance as to the six nonnatural things, often give great relief: In this rank, Medicines endow'd with a Volatile Salt, or a Balsamick Sulphur; to wit, inasmuch as these exalt the fixt Salt, and those reduce the acetous, are accounted the chief; again, bitter and astringent things, as the Herbs Germander, Groundpine, Centory, Roots of Gentian, and Birthwort, &c. (since they are approv'd of by expe∣rience in this Disease) seem to be profitable for this reason that they help the offices of Concoction and Chylification, and keep the saline faeculencies from being carried into the Blood. Let us set down cer∣tain forms of each of these.

Take Powder of Groundpine six dram; Crabs-eyes two drams, Venice Turpentine what suffices, make small Pills, let three or four be taken in the evening and morning for thirty or firty days; drinking after it of the fol∣lowing distill'd Water two or three ounces.

Take leaves of Cypress, Firr, Misteltoe growing on Apple-trees, of each six handfuls; Roots of Avens, the great Burr-dock of each a pound, the outward rinds of ten Oranges and six Limons; Nutmegs, Mace, of each an ounce, being all slic'd and bruis'd, pour to them of fresh Milk seven pounds, Malaga Sack a pound, let them be distilled according to art; let the whole liquor be mixt.

Or let a plain Water be prepared of the leaves of the great Burr-dock, cohobating it twice or thrice on fresh leaves.

Take Powder of the Seeds of the great Burr-dock six drams, Crabs∣eyes two drams, Nutmegs half a dram, Balsamum Capivii what suffices, make a mass, and let it be made into little Pills, let four be taken in the evening and morning for many dayes.

Take Tincture of Antimony an ounce, the Dose is twenty drops to twenty five in the evening and early in the morning, with three ounces of the wa∣ter even now describ'd.

To poor People I use to prescribe after this manner. Take powder of the leaves of Sage half a pound, Crabs-eyes, Saccharum Crystallinum of each two ounces: mix them, let it be kept in a glass, let a spoonful be taken twice a day with a draught of the decoction of the leaves of Sage, or of the roots of the great Bur-dock.

Or, let Dornorellus his powder be prescribed to be taken after the same manner.

Take powder of the leaves of Germander, Ground-pine, the lesser Cento∣ry, Marjoram, Sage, Betony, roots of Gentian, round Birth-wort, of each an ounce, Sugar a pound, mix them, make a powder.

Or the Powder of Johannes Anglicus, called by him Saracenicus.

Take powder of the Leaves of Ground-pine an ounce, of the Bones of Mans∣foot burnt two drams, Licorice three drams, mix them.

For ordinary drink let a Bochet be prepared of Sarsaparilla, Saunders, Lignum Rhodium, shavings of Ivory and Harts-horn, &c. Or, let a small Ale be prepar'd for a Vessel of four Gallons: in which instead of Hops let the leaves of Germander and Ground-pinē be boyl'd: and after it has wrought, put into it of the leaves of dry'd Sage four handfuls, Sassafras two ounces, Roots of Avens eightounces.

Among altering things, a Milk Dyet does not claim the last Place; viz. that the Patient use no other Dyet for three or four Months; Morn∣ing and Evening let him drink Milk as it comes from the Cow; about Noon let him Eat of it boyl'd with White-bread, Barley, or Oatmeal. I have known some who by this kind of Dyet have found great Relief; and that others have been much worse after the use of Milk, and the Gout being not cured, to have contracted great Obstructions of the Vis∣cera and a Cacochymia. Therefore, let not that Method rashly be entred upon without the advice, and careful observation of a prudent Physi∣cian whether it agrees or not.

Not long since, it grew a vulgar Custom for Gouty Persons to drink every Morning their own Urine, which I remember to have done good to some: The reason of which relief seems of be, that the Saline latex of the Urine, passing again through the Blood, carried with it the Salino-fixt Particles, which were wont before to be convey'd to the Joynts: Wherefore this Method, if at any time it give ease in the Gout, for the most part it encreases the Nephritick affect.

A very learned and Pious man, the Glory both of our Nation and of Learning, D. D. H. H. having lived for many years greatly obnoxi∣ous

to frequent fits of Pains, Vomiting, and pissing Blood, at length, upon the constant use of the following Remedies, becoming almost free from the Nephritick affect, he liv'd above seven years without any very great Fit of it. The Method of Cure which a certain Gentleman had taught him, without any Physick, was thus, Abstaining from Wine and Cyder, he drank for ordinary Drink a small Ale made of Oaten Malt; Moreover, once a week he took in the Morning a draught of the same Ale to about half a pound, with three spoonfuls of the Pow∣der of Ossa Senelorum dissolv'd in it: by the use of these things seem∣ing to have bid farewel to the Disease of the Stone within four Months, he presently begun to be troubled with the Gout, and was often infested with severe Fits of it during all the time of his being free from the Stone; and at length, upon every little occasion, he became so obnoxi∣ous to them, that if presently after Eating he any way exercis'd his Body or Mind, viz. either by walking or study, he certainly expected in∣vasions of the Pains; the reason of which was, that the Blood being saturated to a fulness with Salino-fixt Particles, and the Nervous Li∣quor with Acetous, when, upon a fresh supply of Nutritive Juice, they were stir'd and grew turgid, presently they deposed their Super∣fluities, viz. the morbifick matter of both kinds in the Joynts, as be∣ing very weak.

Therefore that Venerable Person, being tired with so srequent and almost continual a Torture, by the Advice of a certain Friend drank his own Urine every Morning, by the use of which, within a Month or two he was tormented somewhat less with his Pains of the Gout, but by an ill change the Nephritick affect begun to come upon him again; for he was often affected with a Pain about the Loins, with a Vomiting, and Dysuria, which being not to be overcome by any Remedies, caus'd the Death of the Renowned Person after about a Fortnight.

The Body being opened, all the Viscera excepting the Reins ap∣peared very sound and firm, but the right Kidney seem'd to have been almost consum'd long before, there remaining only a little heap of Glands, all the Vessels and the Ureter growing together, and being wholly stop'd, that no Urine had pass'd there for a long time; The left Kidney being large enough, contain'd a great heap of Gravel-Stones within it's Cavity and Ductus's. Moreover, a round, hard, and whitish little Stone being fallen about three Inches deep into the Ureter, and there sticking, had wholly stop'd the Passage of the Urine, the Membrane of the Ureter, where the Stone stuck, was become so thick and callous, and consequently without Pain, that it could not be stirred thence by any means upward or downward.

It seem'd in this Case, that whereas the Coagulative Particles of the Blood and Nervous Juice, viz. Salino-fixt, and Acetous first meeting together in the Reins, had long caused the Nephritick affect; afterward, by the use of that abovesaid Powder the Saline being still

sent into the habit of the Body, and not readily convey'd forth, heap∣ed together a Seminium for the Gout in the Joynts, the Reins in the mean time being almost free: but at length, when by drinking his own Water the Saline-miner a was brought back to the Reins, the Disease of the Joynts was changed into a fatal Nephritis.