§. I DEsigning this Paper for the Instruction and Re­lief of my particular Friend, I shall only make such Observations, as directly tend to that Purpose; Passing by all Theories of the Distemper, as far as is consistent with giving the Reason of my [Page 2]Opinions. For after having laid down two Propositions (which will be found the Principles of my Reasoning through this Discourse) I proceed to the Observations themselves.

§. II Prop. 1. Of two Men having all o­ther Circumstances alike, as near as may be; Of the same Parents; Born Healthy; Of the same Stature, Complexion, Diet, Air, Exercise, &c. It seems to me impos­sible to assign a solid Reason, why the One shou'd be afflicted with the Gout, the O­ther be absolutely free from it, but this, That the ^* smallest Vessels of the Gouty Person must be in their natural ^† Confor­mation narrower and more ^‡ stiff, than those of the Other, who is free from the Gout, in respect of their common Stature and Size. For thereby the Crude and Gross Humours, which are confin'd, or pass with Pain, in the Gouty Person, will easi­ly flee off by Perspiration and the other Drains of the Body, in the Person free from the Gout.

§. III Prop. 2. The Cause of an acquir'd Gout in the first Person, or in those born of sound Parents, seems to me, to be the [Page 3]Abundance of Tartarous, Urinous, or o­ther Salts, introduc'd into the Blood by the Food. Salts seem neither to perish, nor to be begotten; but to be constant and incorruptible Parts of Animal and Vege­table Bodies. The Delicacy and Flavour of Flesh and Fish, is entirely owing to their abounding with a fine, soft, oyly, or urinous Salt, as is evident in Venison and Wild Fowl. Wines, of all kinds, have a grea­ter or lesser Quantity of Tartar in them: And other strong Liquors abound in their peculiar Salts, in Proportion to their Strength. Spirits are nothing but a great Quantity of Vegetable Salts crowded to­gether in a little Water and Oyl. These Salts receiv'd in abundance, but neither sufficiently broke by the Digestive Powers, nor driven out of the Habit by due Exer­cise; but by their Plenty and Nearness, u­niting in greater Clusters, must necessarily form Obstructions, and give Pain, when, by the Force of the Circulation, they are thrust through narrower and stiffer ^* small Vessels. Nothing either receiv'd or bred within the Body, besides these Salts, can account for this Difference.

§. IV Coroll. 1. Hence we may learn the Reason why, on the first Attacks of the Gout, in otherwise healthy People, the Humours generally fall on the Joints of the Limbs: Because, in the Joints, the smallest Vessels are more compress'd, by the larger Heads or Protuberancy of the Bones, and are thereby render'd narrower and more readily obstructed. These Obstructions fall on the Joints of the Limbs; because of the greater Length of these small Vessels, be­tween the Heart, the Origin of the Motion of all the Fluids, and these Joints; their other Extremity: Whereby the Quickness of the Circulation diminishing, Obstruc­tions are there more readily form'd.

§. V Coroll. 2. Hence likewise we may see the Reason, why the first Fits, of other­wise healthy Persons, Enrage and Remit once in Four and Twenty Hours. The ^* Ac­cess being at Sun-set, and the ^† Remission about Day-break. Why the whole Fit in such lasts about fourteen Days. And last­ly, why the particular Accesses and Re­missions, of Persons advanc'd in Years, and broken with the Gout, happen only once in fourteen Days. And why the whole [Page 5]Duration of the Fit is made up of several such Accesses and Remissions in equal Times. In the first Stages of the Gout, the Fluids being less Sizy and Glutinous, their Salts and Siziness are sooner broken and dissolv'd, by the Action of the Solids in the Circulation; and are thereby sooner brought into a Condition to be carry'd off by Perspiration; which makes an Access and a Remission. The greater Weight and Grossness of the Air (which hinders Perspiration) at Sun-set, beyond what it is at Day-break, together with the particu­lar Degree of Siziness, seems to determine the Times. The greater Degree of Sizi­ness in the Fluids, of People advanc'd in Years, and broken with the Gout, leng­thens out the Duration of these Accesses and Remissions. And the precise Period of fourteen Days, seems to arise from the special Nature of the Siziness of the Fluids; and its Resemblance to that of a Regular intermittent Fever. The whole Duration of whose Fits put together, Sydenham has observ'd already, to be equal to fourteen Days. But the particular Explication of all these Things, wou'd require more Room than can be allow'd them, in the Bounds [Page 6]I have prescrib'd to my self. My Friend, if he pleases, may consult Bellini on this Head.

§. VI Coroll. 3. Hence we may discover the Reason of the common Observation, that Gouty Persons are People of good Natural Parts, large Feeders, and long­liv'd: Because the Fibres of the smallest Vessels, being more stiff and springy than ordinary, The Circulation is brisker, more full and free: Whereby the ^* Natural Fun­ctions are more readily and regularly per­form'd; and therein the best Health and truest Sensations consist: Strong Health requires liberal Supplies; and both toge­ther lengthen our Life.

§. VII Coroll. 4. From these also, we may discover what a Fit of the Gout is, to wit, An Effort of Nature, to throw off this A­bundance of Salts, through more stiff and narrow ^† Strainers. Salts of all Kinds are more or less ^‡ Burning: The Urinous most of all, as is evident from Spanish Flies, and that unextinguishable Substance, call'd the Phospheros, so readily and plen­tifully to be had from Human Urine. [Page 7](The Reason of which may be from their pointed Figure, piercing more readily, by its being besmear'd with a light Oyl: Or from their greater attractive Force; or from some other Quality, not yet, or per­haps never to be discovered.) What is certain is this, That Persons of a large Appetite, as Gouty Persons generally are, feeding plentifully of Flesh and Fish, and drinking liberally of generous Wines, or other strong Liquors, and using, either too little, or too much Exercise, must necessa­rily overstock their Blood with these fix'd and incorruptible Parts of Animal and Vegetable Bodies; which in their Nature being Hard and Burning, can't fail, first, to raise a Tumult and Fever; and then to give violent Pain, as they are driven out of the Habit, through more stiff and nar­row small Vessels, by the Force of the Circulation: So that a Fit of the Gout may be consider'd, as a Crisis of a putrid Fever, wherein the noxious Humour is thrown upon some of the Muscles or Joints of the Body.

§. VIII Coroll. 5. Hence we may discover the Vanity of the Pretenders to a certain and universal Remedy for the Gout. For [Page 8]unless a Remedy could be found, which at once cou'd change and new-mould the solid Parts of Human Bodies; alter the Nature and Qualities of Animal and Ve­getable Bodies; and destroy Parts, that are in their own Nature fix'd and perma­nent, it is impossible it shou'd be certain and universal; and how possible such a Remedy is, I leave every one to judge.

§. IX Coroll. 6. Hence it is evident, there can be only two direct Ways of Treating the Gout, with any Prospect of Success. The one is, by stretching and widening the Capacities of the small Vessels, and ^* re­laxing their Fibres. The other is, by les­sening the Quantity of the Salts introduc'd into the Fluids by the Food; these being the two Antidotes or Opposites to the two fundamental Causes of acquir'd Gouts.

§. X Here it may be convenient to take notice of the Difference between heredita­ry and acquir'd Gouts. The latter is pro­duc'd in a Person, otherwise sound, from Ignorance or Negligence of the exact Rules of living. For tho' there be a na­tural Configuration of Parts, that disposes one Man more than another to the Gout; [Page 9]yet there might be a Method of Diet or­der'd, which should prevent it. The for­mer is a ^* Taint (compounded perhaps of Scurvy, Stone and Pox) transmitted to the Patient with the Principles of Life, together with a Disposition in this Taint, to unite it self to any Malignity, introduc'd into the Habit, through Excesses.

§. XI Coroll. Hence we may observe the Necessity of a much more strict and careful Management, in hereditary Gouts, than what is necessary in acquir'd ones. In the first, the Gouty Humour is ingrain'd and transubstantiated into the Solids, and other Principles of Life, and impossible to be rooted out by human Art and In­dustry: The most that can be done is, to lessen and relieve the Symptoms. Where­as in acquir'd Gouts, the noxious Humour being more confin'd to the Fluids, a pro­per Diet, due Exercise, and a few well-chosen Remedies, may go a great way; if not to a perfect Cure, yet to make Life tolerably easy under them.

§. XII Of all those things that a Gouty Person can safely undertake for his Health, wisely manag'd Exercise, seems that alone, [Page 10]which can best answer one part of the first Intention, viz. The widening the Ca­pacities of the small Vessels. Labour or Exercise assists the Gouty three different ways: First, as it increases the ^* Motion of the Parts of the Fluids among them­selves; so that their Salts, by their ^† strik­ing one against another, are broken and made less, that they may pass more rea­dily through the small Vessels. Secondly, as it adds a new and foreign Force to the Blood, and thereby promotes its Circula­tion from the Heart through the small Vessels; driving some of the grosser Parts of the Fluids through them; which in the ordinary Course of the Circulation wou'dn't pass so freely; and thereby opening their Obstructions and enlarging their Capaci­ties. Thirdly, as it increases the natural Perspiration; the Action of the Muscles in Labour and Exercise, and the Spring of the Solids by their multiply'd Efforts, squeez­ing the Strainers of all their Contents. But to make Labour and Exercise as useful as they may be, two Cautions must be added to them: First, that they be not too violent, in respect of the Patient. For [Page 11]too violent Exercise will, necessarily, either spend the Spirits, whereby the Digestions and Circulation will be impair'd; and so a regular Gout be brought into an irregu­lar one: Or by shaking all the Gouty Salts at once upon the Extremities, a regular Fit will be forc'd out; which, in less vi­olent Exercise, might have been spent by Perspiration. Secondly, that Moderation in eating and drinking be join'd to it; For commonly Gouty Persons are large Feeders; and Exercise emptying the Stomach, the Guts and small Vessels, if the Appetite be satis­fy'd to its craving, the Evil is rather in­creas'd than diminish'd thereby.

§. XIII There be two direct Ways of less­ening the Quantity of the Salts, which produce the Gout. The first is, by a total Abstinence from, or a great Abstemious­ness in Flesh, Fish and strong Liquors, which introduce those Salts into human Fluids: But this Course is never to be undertaken, but with great Caution, and in the last Extremity: For these two Rea­sons; First, because an entire Vegetable Diet weakens all the digestive Powers, and all the Functions of Life; impoverishes [Page 12]the whole Mass of the Fluids; impairs the Strength, and dispirits the Man: And thereby necessarily begets the worst kind of Hysterical and Hypocondriacal Disor­ders, and all their black and dismal Con­sequences (at least till the Body has been long accustom'd to it) which is a Disease far worse than the Gout it self: And to which the Gout only brings the Patient, in its last and fatal Stages. Secondly, be­cause this Diet, once enter'd upon, is ne­ver after to be chang'd, under the Dan­ger of certain Death, or the most violent enraging of all the Gouty Symptoms. For a Vegetable Diet, as has been just now hinted, weakening the Digestive Powers, and all the Functions of Life, &c. the Patient can never after be brought to bear with a free way of living, without the Hazard of certain Death, or a violent en­raging of the Gouty Symptoms; as is too plain from many ^* fatal Instances. If a­ny Diet is ever to be try'd in the Gout, it is to be order'd in Cornaro's Method; that is, by living on the white Foods; eating Flesh and Fish of the lightest Digestion, and drinking generous, unmix'd Wines, both [Page 13]of them in small, and constantly equal Quantities; in Weight and Measure; un­der the Craving of the Appetite, and proportion'd for the mere Support of Life.

§. XIV The other direct way of banish­ing the Salts out of the Habit is by Evacuati­ons. Sydenham, otherwise a most accu­rate Observer of Nature, and a most ju­dicious Practitioner, has been the Occa­sion, I think, of a great Mistake in the Management of the Gout; by forbidding almost all Evacuations, either in the Fit, or in the Intervals, for fear of weakening the Constitution. There are two Seasons, to wit, Spring and Fall, when the Peri­odical Fits of regular Gouts commonly hap­pen; which I consider as Cardinal and Critical Discharges, under general and me­chanical Influences, for purifying the Blood, and discharging the Gouty Salts: In which, Nature is no more to be dis­turb'd in its Operations (I mean as to pur­ging, for even then a gentle, slow, con­stant and uniform Perspiration and Breath­ing Sweat may be promoted, not only safe­ly, but with great Advantage) than in the Monthly Purgations of the Sex. But in light, flying Touches of the Gout, out [Page 14]of these Seasons; and in the Intervals of the Fits, gentle, warm, stomachick Purgers will be an excellent Remedy to send these a going, to lessen the Fits, and lengthen the Intervals. A Person out of the Pain and Inflammation of the Fits, and in their Intervals (except his natural Disposition to breed another Fit) is, to all Intentions of Medicines, the same as a well Person. And all Medicines levell'd against other Diseases incident to human Bodies, may be as safely administer'd to a Gouty (re­gard being had to his particular Constitu­tion) as to any other Person. Wherefore, the general and direct Methods of relieving the Gout, are, In the Fits, a gentle, uni­form, continu'd Perspiration and Breath­ing Sweat. In the Intervals, Labour or Exercise, and gentle, Stomachick Purgers.

§. XV The Secondary or less direct Me­thods of relieving the Gout, are principal­ly these two, First, Dilution, by proper Liquors. Secondly, Strengthners of the Instruments of the Digestion. Nothing is more likely to thin the Blood, to dissolve and break the Salts, and keep them at a distance from running into Clusters, than proper Diluters; as we see in Fevers, [Page 15]Rheumatisms, and other inflammatory Distempers. For this Reason, among o­thers, it is, that Bath and German Spaw Waters, and all other Mineral Chalybeat Waters; Dwarf-Elder Tea; Trifoil Tea; light, quick, Green Tea; small spicy Bit­ters on Water, and such like, drunk free­ly, Blood warm, on an empty Stomach, become so useful in Intervals of the Gout. Water is the universal Dissolvent of Salts of all sorts; and being replenish'd with the spicy, bitter and active Parts of other Bodies, it strengthens the Stomach, and Bowels; breaks and dissolves the Salts; cleanses the insides of the Vessels from the foulness that constantly adheres to them, and carries it out of the Body, by increas'd Perspiration and Urine.

§. XVI Strengthners of the Instruments of Digestion, are an excellent Remedy in the Intervals of the Gout. If the Digestions be true and good; the Parts of the Chyle be made sufficiently small, and the Circu­lation be full and compleat (all which are the common Effects of Stomachick Medi­cines) the Salts will be less; the Obstruc­tions of the small Vessels fewer, and the Impurities of the Fluids will more easily [Page 16]pass by Perspiration, and the other Drains of the Body; and so the Fits of the Gout become more easy, and less frequent. A­mong all the Strengthners of the Dige­stions, I wou'd recommend a strong Infu­sion of the Jesuit's Bark, in generous Cla­ret, as being the coolest Bitter, the most powerful Strengthner of relax'd Fibres in the Instruments of Digestion; and the greatest Antidote of the urinous Salts, es­pecially if join'd with Chalybeats, and some Qualifiers of its mawkish and nauseous Taste. The Bark has the same Effect on the Coats and Fibres of the Vessels, that Oak Bark has on raw Leather; and the same Effects on the Fluids to prevent their Coagulation; and to render them uniform, that the Testaceous Powders have on Vi­negar, or as they have on Milk, to pre­vent its Curdling: But more especially, as it produces such Wonders on the Solids and Fluids in intermittent Fevers; to the State and Condition of both which, the So­lids and Fluids of Gouty Persons bear so near a Resemblance, as has been observ'd in Coroll. 2. Wherever the Bark is pro­per, I recommend the Glans Quercina, or Acorn, as of the same Class of Medicines, [Page 17]and in some Cases of Relaxation exceeding the other. It is cool and easily digested. But they do best united. All bitter and spicy Medicines have more or less of the same Quality; but heat the Body more, and brace the Fibres less.

§. XVII Mercury, by its Weight, and its constantly forming it self in little Spheres (or perhaps from its greater attractive Force) throughout all its possible Divisions, seems to offer fairest, of any internal Me­dicine, for breaking the Gouty Salts; for relaxing the Fibres; and enlarging the Ca­pacities of the small Vessels. And the Fact is, that by a full and free Salivation Gouty People have been freed from all its Symptoms for several Years. But it is al­so Matter of Fact, and Experience, that a full and free Salivation does so break, rend and tear all the smallest, tenderest and fi­nest Vessels and Fibres, that the Body be­comes in a worse State, in respect of the future Fits, than it would have been in se­veral Years Time, under the common Symptoms. For tho' a Salivation may o­pen all the Obstructions of the small Ves­sels; cleanse their insides from the Foul­ness that cleaves to them; purify the Blood, [Page 18]and break its saline Impurities; yet by its great Weight, and the excessive Force it adds to the Blood, rending and tearing the finest Vessels and Fibres; when the Gouty Person comes to his former Diet, and the other Circumstances of Living; and the Fluids become thereby loaded with their Salts, they stick more obstinately to the Joints, than if the Parts had been sub­du'd and broken by regular Fits of the Gout. So that a Salivation, tho' it banish the Fits for some Time, yet when the Blood is replenish'd again with Gouty Salts, the Habit is reduc'd to a worse Condition, in respect of the future Fits, than if they had never been interrupted: And, indeed, it is observable, that after a full, or repeat­ed Salivation, the Man is seldom or ever the same, as to the Quickness of Sensa­tion; or the Usage of the most beautiful animal Faculties. But there is an absolute Necessity of having recourse to Mercurial Vomits and Purges, when the Gout be­comes fixt to, and permanent in a Place, as also when it is dispersed all over the Habit, like a Rheumatism. These active Medicines must first render the Humours fluid, which Gum Guajac with Diaphore­tick [Page 19] Antimony persisted in will afterwards carry off. I come now to consider the Gouty Person under two different Circum­stances. First, under a regular Fit. And, Secondly, in the Intervals.

§. XVIII 1. On the first Attack of the Fit, especially while the Fever, that ushers it in, remains, Dilution is the only Reme­dy. Fine, clear, old small Beer, with a little old Mountain, or Madera Wine; Water boil'd with a few Spicy Seeds, mix'd with these Wines: Water Gruel with some Wine, or Hartshorn-Drink with Cin­namon; and little or no Flesh Meat, will succeed best during all the Time of the Fever. After the Fit is distinctly form'd, the milder Cordial and Stomachick Medi­cines, which promote a gentle Breathing Sweat (I mean in the more compounded and tedious Fits of the Gout, chiefly in Persons advanc'd in Years) such as Gascoin Powder, Goa Stone, Bezoar; Sir Walter Rawleigh's Cordial, Diascordium, Con­fection of Alkermes, and the like, wash'd down with clear Blood-warm Sack-whey; in every Draught of which ten or fifteen Drops of Spirit of Hartshorn has been first pour'd; with Flannel on the Parts, and [Page 20]much lying a Bed; such a Method, and such Medicines, I say, will best forward the Fit. Towards the Decline, the Stron­ger, Warmer, Spicy and Stomachick Me­dicines; such as Serpentary Root, Casa­munair, Zedoary, old Venice Treacle, E­lectuarium de Ovo, and such like; with a few Grains of Camphir, and Salt of Vipers; and a good Stomach Bitter on Wine to wash them down, will finish this Affair, streng­then the Bowels, and prevent the Recoil of the Gouty Humour on them. And here it may be taken Notice of, that as the Fe­ver, that ushers in the Gout, is, so will the Fit be: If the Fever is short and sharp, the Fit will be so likewise, in regular Gouts: If it be feeble, long and lingering, the Fit will be such also. In the Manage­ment of the foregoing Method and Medi­cines, two Cautions are to be minded: First, That during the whole Fit, Li­quors may be more freely and safely in­dulg'd, than solid Foods. For Repletion from solid Foods, in a Fit of the Gout, might be of fatal Consequence, by ren­dering a regular Fit of the Gout irregular: Whereas Fluids will certainly pass, either by Perspiration, Sweating, or Urine. Se­condly, [Page 21]The Cordial Medicines are always to be regulated, by their Lightness on, and Agreeableness to the Stomach of the Patient; (for whatever makes him sick, will more or less draw in the Gouty Hu­mour on the Stomach) and by their not rendering him more hot and restless, than the Gout it self wou'd naturally make him: For if they produce an agreeable Sensation on the Stomach, and do not inflame, they will necessarily procure Coolness and Quiet.

§. XIX Here it may be considered, whe­ther Opiats may be safely given in a Fit of the Gout, to procure Rest, and alleviate Pain. In the general, it is the safest side, not to administer any kind of Opiats in the Fits; because they constantly pall the Ap­petite, and leave a Nauseating, and per­haps a Reaching on the Stomach, the readiest way to bring the Gout there. But in Extremities, when the Patient has been many Days without Rest, and the Pain becomes intolerable, all other Means fail­ing, or equally Dangerous, Opiats may be so qualify'd, and their mischievous Effects so bridled, by joining spicy, nervous and [Page 22]Stomach Medicines to them, that they may become an excellent Remedy. Thus liquid Laudanum, with Tincture of Castor, of Snakeweed, of Diambra, of Saffron, Sal Volatile, Compound Spirit of Laven­der, Hysterick Water, and some agreea­ble simple Water; some of these mix'd in a due Proportion, and proper Dose, will not only procure Rest, and ease Pain, but answer all the other Intentions in the Cure of a Fit of the Gout. Thus also, London Laudanum, with old Venice Treacle, or Mythridate, Serpentary Root, and unscen­ted Species of Diambra made into a Bo­lus, with any agreeable Syrup, and cau­tion'd, as before, will produce the same Effect.

§. XX As soon as the Pain is almost gone, and the Swelling and Weakness only re­main, nothing will more quicken and fi­nish the Cure, and strengthen the wea­ken'd Parts, than gentle, warm, stoma­chick and spicy Purgers, dos'd and repeat­ed according to the Strength of the Pa­tient; by carrying out of the Habit, the more gross and unperspirable Remains of the Gouty Humour. This premis'd, espe­cially after long and severe Fits, which [Page 23]have impair'd the Strength, and wasted the Muscular Flesh; I should advise Asses Milk with Pearl, half a Pint, or a Pint, in the Morning early, and five or six a Clock in the Afternoon; to lengthen out the Morning Sleep, to pulp up the ex­hausted Muscles, to cool and refresh the parch'd Fibres, and keep the Body solu­ble; which Asses Milk commonly does. And to keep up the Appetite, which the Milk commonly palls, and to prevent its too cooling Effects on the Stomach, a light Bitter made of Gentian, Cinnamon, and Orange Peel only, the last double of the other two, infus'd in Sherry or White Wine, and taken two Hours before Meals, may be us'd most conveniently. This Course might be continued for two or three Weeks: After which I shou'd or­der a Course of Bath or German Spaw Waters, with Steel, riding, a light White­food Diet, and generous Wines drunk temperately.

§. XXI It is in the Intervals of the Fits that any thing great or probable is to be undertaken for the Relief or Cure of the Gouty. The Methods, both general and particular, I have touch'd upon. I come [Page 24]now to recommend some special Medi­cines, which have been found useful in this Case. It is certain that great Absti­nence from Flesh, Fish, and Wines, would prevent the Fluids from being overloaded with Gouty Salts. It is also certain, that if the Food be carried out before it is di­gested, it will be pretty near the same Thing, as if the Quantity carry'd out, had not been taken down. Now if a Medicine can be found, that without weakening the Stomach and Bowels, shall carry off the greater part of the Food, before it is quite robb'd of its Salts, it can't fail to be of great Use in the Inter­vals of the Gout. For this Purpose, I wou'd recommend fine Rhubarb, taken regular­ly once, twice, or oftner a Week, in such a Dose, as to procure two or three Mo­tions: For these Reasons, First, Because it is an excellent Stomach Bitter, as is e­vident from its Taste, and from the sharp Appetite it gives those that take it fre­quently. Secondly, Because it is one of the noblest Astringents hitherto known, as is evident from its Cure of Fluxes, and intestine Haemorrhages; and from the Tightness it leaves on the Bowels. Third­ly, [Page 25]Because it requires neither Diet, nor keeping warm, nor any other particular Management; and yet taken frequently and regularly, it will carry off any Pro­portion of the Food one pleases; and so reduce the Dier, as near as needs be, to Cornaro's, which, in Article XIII, has been shewn to be of so excellent Use in the Gout. I knew a Noble Lord, of great Worth, and much Gout, who, by taking from the Hands of a Quack, a Dram of Rhubarb, ting'd with Cochineal to disguise it, every Morning for the Space of six Weeks, liv'd in Health for four Years after, with­out any Symptom of it.

§. XXII It is worth here taking Notice, that all the Preparations of this Medicine serve only to spoil it. And that it is best taken in a spoonful of Soup, or any other agreeable Liquor, immediately before Din­ner, or chew'd in a Morning fasting. But to those to whom its Mawkishness is nau­seous, I would recommend this Form. Take Gentian and Zedoary of each a Dram, Serpentary Root, and unscented Species of Diambra, of each half a Dram. Cochineal and Saffron of each a Scruple; Orange Peel an Ounce: infuse in a Quart of Moun­tain [Page 26]in a warm place twenty four Hours, strain, and to the Liquor add three Ounces of the best Rhubarb; Salt of Wormwood a Dram and half: set in a warm Sand heat twelve Hours; and then strain a second time. Of this four Spoonfuls every Night, or e­very other Night, as occasion requir'd, I have found an excellent Remedy in this and other Chronical Cases. Where no Preparations of Rhubarb will agree with the Constitution, as there are many such, then Elixir Salutis, Tincture of Hiera Pi­cra; a Solution of Gum Guajac, or the Scot­tish Pills, might take place; but that all the preparations of Aloes are apt to throw out both Gout and Piles. However in this matter there is great Variety; out of which every one may fit themselves with what is most agreeable to their own Con­stitution; which if they use regularly and frequently, they cannot fail to prevent violent Fits of the Gout, and perhaps most other, both Acute and Chronical Distem­pers.

§. XXIII Next to Rhubarb, and all Cir­cumstances consider'd, even far before it, I would recommend Sulphur, as one of the best Remedies in the Intervals of [Page 27]the Gout. It is but in little Use at pre­sent in Physick, except in the Itch, and the Piles; and yet in the whole Extent of the Materia Medica, I know not a more safe and more active Medicine. Its won­derful Efficacy, and particular manner of Operating in these common Cases, might, I think, have encourag'd its Trial in o­ther Chronical Cases, especially consider­ing the Facility of its Working, and the little Trouble it gives in taking it. Its principal Qualities are these. 1. The Parts of Sulphur, and those of Light and Fire, act mutually upon one another, more powerfully than those of other Bodies. It is to their Sulphur that Bodies owe re­flecting and refracting Virtues; from whence its Inflammability proceeds. ^* The Particles of Sulphurous Bodies receive and retain those of Light and Fire, more strong­ly than any other Bodies: And the Rays of Light and Particles of Fire, separate, move and turn the Parts of Sulphurous Bo­dies into Fire and Flame. 2. The Parts of Sulphurous Bodies are very small, even smaller than those of Water it self, where­by [Page 28]it comes to pass that they will enter those small Vessels, where Water it self (our best and most universal Diluent) can't come; this is evident from hence, that Water will not dissolve Sulphur, and that no Moisture will stick to fat Substan­ces, or the Feathers of Water Fowl: As also from its cure of all cutaneous Foul­ness; which it cou'd never effectuate but by entering all those smallest Vessels, which scarce any other Medicine can en­ter. And lastly, by its dissolving the sizy Juices of the smallest internal Glands, when obstructed; particularly those of the Lungs, Mesentery and Rectum; as in the humorous Asthma, Scrophula and Piles. 3. Sulphurous Bodies will readily unite with, and destroy the Effects of all Saline Parti­cles, but especially those of the acid kind. And in this their great Energy seems to consist. Sulphur yields the most piercing, active, and agreeable Acid in the World; such as Spirit of Sulphur, Gas of Sulphur, and the like. 4. The fat and oily Parts of Sulphur, like other fat and unctuous Bodies, are the lightest, the most cohe­rent, and the most springy of all Bodies. These two last Qualities are most manifest [Page 29]from the artificial Sulphur made of Oyl of Turpentine and Spirit of Vitriol (the strongest Glew, and the most penetrating Acid) duly digested and carefully manag'd, which in all respects is the same with na­tural Sulphur. ‘No Body denies (says Tournefort in his Voyage to the Levant, Pag. 122. Part I. English Edit.) that Sulphur is only a fat Substance, fix'd by an acid Spirit: The Sulphur which is artificially made, and the Analysis of common Sulphur, put this Truth out of all Dispute. For the Sea Water be­ing fat by the Oil of the Sea Fish conti­nually corrupting there, and bitter and saltish from its saline Rocks, produces in proper Nests natural Sulphur.’ And Sir Isaac Newton says, in his last Edition of his Opticks, pag. 359. ‘By dissolv­ing Flower of Brimstone in Oil of Tur­pentine, and distilling the Solution, it is found, that Sulphur is compos'd of an inflammable thick Oil, or fat Bitu­men, an acid Salt, a very thick Earth, and a little Metal: The three first were found not much unequal to one ano­ther; the fourth in so small a Quantity, as scarce to be worth the considering.’ [Page 30]Join all these Qualities together, and you have one of the most admirable Remedies in the World, for all Intentions in the Cure of the Gout: By its agreeable Taste and Lightness on the Stomach, (especial­ly when wash'd down with any milky Ve­hicle) its Tenacity, Ropiness and Elasti­city; the smallness of its Parts; their Ef­ficacy in destroying the Mischief of all sa­line Particles, with their natural Warmth, join'd to the Activity of its acid Salt, (making it a kind of natural Soap) it en­ters the small Vessels, where no other Diluent, hitherto known, can come; cleanses their insides from the Foulness that sticks to them; imbibes and retains all the Gouty Salts, and carries them out of the Body by Perspiration; softens, smooths and relaxes the parch'd and stif­fen'd Fibres; and by leaving some of its oily Parts on their Surfaces, sheaths and defends them from the Points of the Salts afterwards introduc'd. And the Fact is, from repeated Trials I can recommend Sulphur, as a most powerful Remedy in the Intervals of the Gout. For I have known half a Dram of powder'd Sulphur, or Flowers of Brimstone, taken regularly [Page 31]twice a Day in a Spoonful of Milk, pre­vent the Fit for many Years; and lessen both its Pain and Duration when it hap­pen'd: For it mov'd the Body gently once or twice a Day. I have in my Possession Testimonies under the Hands of some treated and tended by my self; and of o­thers of undoubted Credit, witnessing to the great Success of this Medicine in the Intervals of the Gout. Nothing hither­to discover'd, I believe, equals it obsti­nately persisted in.

§. XXIV Especially if to these be added plentiful Dilution by some Blood-warm Infusion of a spicy and diuretick Plant in Water, so as to provoke a gentle Brea­thing Sweat, and pass freely by Urine. Thus large Draughts of Sage, Dwarf-El­der, Buckbean, or Green Tea; but espe­cially of weak Whey made on old Moun­tain, drunk Blood warm, and on an empty Stomach, and join'd to any of the now mention'd Medicines, will be of great Ad­vantage in the Intervals of the Gout; by diluting and breaking its Salts, and car­rying them off by Perspiration and Urine. And certainly Roselli's Drops, (perhaps the Tinctura Metallorum somehow alter'd) [Page 32]which were said to work gently by Stool and Sweat, in the Hands of a prudent and knowing Physician, had been an admira­ble Remedy, as answering both the Inten­tions mention'd, in the Intervals of the Fits; and even in the Fits themselves, it had not been without its Use (always except­ing the Vernal and Autumnal regular Fits) had he dealt with recent Gouts, and firm Constitutions only. That which I wou'd particularly recommend here, is, a weak Decoction of the BARK of Sarsa Root (in the BARK the Virtues of the Plants chiefly consist: For being replenish'd with most part of, if not all the Juice-circulat­ing Vessels, it contains all its Salts and most active Parts; and being Spungy and Tender, it is thereby more easily digested: And where Roots are most in Use, the Bark of the Root is more eminently use­ful, for the Reasons assign'd: As also because, towards the End of the Autumn, when Roots are gather'd, the Cold has already driven the Juices into their Bark. And this may be one Reason why the fa­mous Pox-Doctor succeeds in some Cases, when mismanag'd Mercurial Treatments have fail'd: His Diet-Drink chiefly con­sists [Page 33]of a Decoction of the Bark of this Root: His Pill is Mercurial, perhaps the Arcanum Corallinum, or Panacaea, and these two persisted in for so long a Time, must necessarily sweeten the tainted Juices, and expel the entangled and grosser Mer­curial Parts, which clustering together, cou'd not perform the Circulation, but were retain'd within the Habit, by for­mer mismanag'd Salivations, and thereby render'd ineffectual to the Cure; especial­ly, if to these be added, the low and star­ving Diet he prescribes. For I have heard of a famous Sea-Commander, who effect­ually cur'd the first Stages of Venereal Di­stempers by living twenty Days on Water Gruel only, in which a little Cream of Tartar had been first dissolv'd; (and high­er Degrees of the same by the like Diet continu'd twice the Time;) with a little Milk, drunk freely Blood warm every Morning, which I have known wonder­fully relieve Gouty Persons, when drunk all the Winter between the Cardinal Fits. And even Cow's Milk warm, taken for Breakfast and Supper, has been of great Service to those Gouty Persons who drink [Page 34]not much Wine; for those who drink Wine freely, have too hot and sour Sto­machs to deal in Milk.

§. XXV Even drinking freely of light, clear Spring Water after full Meals, and indulging in strong Liquors, will be found of great Use in the Intervals of the Gout. It is well known that warm Water alone, drunk in a Morning fasting freely, and at Meals, from its Heat, its Dilution, and cleansing Qualities, has been a sovereign Remedy in restoring decay'd Appetites, and strengthning weak Digestions, when other more pompous Medicines have fail'd. Low­er very justly observes, that Persons that have drunk beyond the Rules of Tempe­rance, may be much reliev'd from the ill Effects of it, by exposing themselves to the free Air, to cool the Blood, and to force off the Liquors by Urine. I'm of Opinion, were there neither Sin nor Shame in it, as there are eminently both, a Gouty Person ought to avoid Intemperance, as he wou'd avoid the Bite of a Snake or mad Dog. But since such Accidents do hap­pen, let the Gouty Person, after the Ex­cess either in Meat or Drink, swill down as much fair Water as his Stomach will [Page 35]bear, before he go to bed; whereby he'll reap these Advantages: First, Either the Contents of the Stomach will be thrown upwards, and he freed from a great part of the Load. Or, Secondly, Both Meat and Drink will be much dilu­ted; and the Labour and Expence of Spi­rits in Digestion much sav'd. And Third­ly, the Gouty Salts will thereby be dissolv'd and distanc'd from one another; and so be more readily carry'd off by the free Perspiration, Sweating and Urine which ensue.

§. XXVI But beyond all other Things, a well order'd Course of Bath Waters, with Chalybeats and warm Bitters, and a frequent and regular Use of Stomach Pur­gers will be found to succeed best in Gouty, as well as other Chronical Cases. The Learn'd have been divided, and much perplex'd about the Heat of Bath Waters. I have always endeavour'd to account to my self for it, from the common Experi­ment of mixing filings of Steel, and Pow­der of Sulphur, working them into a Paste with Water, and putting them in a Cellar, under a Cock, dropping Water slowly and regularly; the Paste will ferment to [Page 36]such a degree, that the Water running from it shall be of the same Heat and Virtue with the Bath Waters; tho' not so pleasant, nor so well fitted to human Bodies. This is a common Experiment, and these are the only natural Bodies known, which meeting together will pro­duce Heat in Water, without artificial Fires. Tournefort, in the Place before men­tion'd, says, ‘Its certain that Filings of Iron steep'd in common Water will grow considerably warm, and much more so in Sea Water: And if you mingle therewith some Sulphur pow­der'd, you'll see this Mixture really burn.’ Sir Isaac Newton, in his last Edition of his Opticks, pag. 354, says, ‘That even the gross Body of Sulphur powder'd, and with an equal Weight of Iron filings, and a little Water made into a Paste, acts upon the Iron; and in five or six Hours grows too hot to be touch'd, and emits a Flame.’ That the Heat of the Bath Waters is owing to a Principle within themselves, is evident, from their retaining it longer than any o­ther Water, heated to the same Degree, will. Wherefore there can be no Necessity [Page 37]of having Recourse to Vulcano's or subter­raneous Fires, to account for this Appear­ance. There are no burning Mountains known in this our Northern Climate; and 'tis pretty hard to conceive, how Fires shou'd have burn'd so long under Ground without a Vent, or any other remarkable Sign. The Sulphur in the Bath Waters is evident to the Senses, swimming in large Clusters on the Tops of the Baths mix'd with Earth, and some vegetable Sub­stances, wherewith the Guides commonly gild Silver; and is found an excellent Re­medy in Scurvies, Leprosies, Ring-worms, and other Foulnesses of the Skin. The Steel is manifested by the blewish Tincture given to the Water from the Pump, by an Infusion of Nut-gall. It is true, this Tinct­ure is neither so deep, nor is it to be had from the Water, in any short Time after it comes hot from the Pump, thereby to manifest any great Quantity of Steel in the Composition, such as can have the full Proportion to the Experiment now men­tioned. But, to set this in a clearer Light, let us put together these Considerations. First, That upon Distillation of Bath Wa­ter, there remains little in the Bottom of [Page 38]the Glass, but the common Calx or Sea Salt, that is found in the Distillation of Spring Water, if we except some Sand or Earth, that is forc'd up by the Violence of the Pump; wherefore the Bath Waters not being impregnated with any Quantity of a saline Mixture, can retain nothing in their own proper Substance but the lightest Parts of the Steel and Sulphur. Secondly, That this Water is as fully impregnated with Sulphur, as it can bear, has been al­ready shewn: And that there must be a greater Proportion of Steel in Bath Water than is manifested to the Senses, or dis­cover'd by any Experiment hitherto made, is evident from its healing Effects, which no known Medicine but Steel can bring a­bout, or account for: None but those who have seen it, can believe the wonder­ful Efficacy it has, in most Chronical Ca­ses. What, but Steel, in a few Weeks, can make the Blood, from a white blewish or Tallow Hue, resisting the Knife, like Glew, swimming in its Serum, like an Island amidst the Ocean, look all of a Piece, of a Scarlet Colour, and a due Proportion be­tween its nourishing and its watery Parts? Nothing but Steel can make a pale ash-colour'd [Page 39]Countenance, hollow and deep Eyes, no Appetite, little Strength, and less Sleep; eat, and drink, and sleep, look gay and sleek, like the best Health. Thousands of such Instances may be seen every Season at these healthful Springs. Thirdly, The Effects of Sulphur in brid­ling the sensible Appearances and Opera­tions of most active Medicines, is very well known. Instances of which, in na­tural Bodies, are, Antimony and native Cin­nabar; in artificial ones, Aethiops Mineral, and Cinnabar of Antimony: In all which the Mercury is so bridled up by the Sul­phur, that none of their sensible Opera­tions and Appearances are felt, while they produce the most wonderful Changes on animal Bodies. I cannot pass over Aethiops Mineral without pressing its more univer­sal Use than, for ought I know, it has yet had in common Practice. It is one of the most certain and universal Alteratives, if dos'd sufficiently and long enough persisted in, of all the Dispensatory. It radically extirpates the Itch, the Piles, scorbutick and scrophulous Ulcers; all cutaneous Foulnesses; all Inflammations and Fluxions of the Eyes; all internal Ulcers, Rheuma­tisms, [Page 40]white Swellings; sharp Humours in the Stomach and Guts, and almost all Distempers arising from sizy Juices. I say, it cures these, if Art can do it; for some of these (like hereditary Gouts) are so transubstantiated into the Solids, that no­thing but a new Conformation of Parts can cure them. It may be given almost to half an Ounce a Day, especially with interspers'd Mercurial Purges, without Trouble, or any sensible Operation, and continu'd for a Twelve-Month, if one plea­ses. The finest Sulphur, and fittest to make Aethiops of, is common Sulphur pou­der'd, and boiled seven or eight Times in Spring Water, whereby it becomes as light on the Stomach as prepared Pearl, and as effectual in the Cases mentioned, as the celebrated Sulphur of Aix la Chappelle Waters. But to return to the Business.

§. XXVII The sum of all then is, since the Bath Waters derive their Heat from a Principle within themselves; since no natural Body, but Sulphur and Iron can pro­duce such a Degree of Heat, as is in them; since nothing but Steel can produce those wonderful Cures on human Bodies, which Bath Waters do; since Sulphur will lock up [Page 41]and bridle the sensible Appearances and Ef­fects of the most active Bodies, and yet not destroy their healthful and medical virtues; it is plain, that Bath Waters must owe their Heat to a Mixture of steely and sulphurous Particles; and their healthful Effects to a greater Proportion of Steel, than is sensible, or easily discoverable by any Experiment hitherto made, join'd to a light Sulphur, whose Virtues and Efficacy in all Chronical Cases, we have already shewn. The Moun­tains which surround the Place, which eve­ry Body now knows, to be but the Nests of Minerals, and the Receptacles of the Wa­ters, which feed the Springs, (which Moun­tains are continued even to the Sea) confirm this Opinion. The manner I conceive thus: The Dews drilling and dropping through the Cranies of the Mountains, fall upon a Bed of Iron Oar, and are there as fully im­pregnated with Chalybeat Particles as such Water can bear; and gently owzing down upon a Nest of Sulphur, and there ferment­ing to such a degree, that requiring more room, they bubble up at the Foot of the Mountains, with their sulphurous Spoils, and furnish out this healing and balsamick Fluid. All hot Waters seem chiefly to con­sist [Page 42]of these two Principles; and to differ on­ly as the Sulphur or Steel predominates in them. Where the Sulphur predominates, they are hotter, more nauseous, and more purgative. Of the three hot European Wa­ters of Note, the Aix la Chapelle, Bourbon, and Bath; the first abounds more eminently in Sulphur, which makes its Heat, Nause­ousness and Purgative Faculty so great, that few weak Stomachs can bear its Heat and Nauseousness; and fewer weak Constituti­ons, the Violence of its purging. The Bourbon are of a middle Nature, between the Aix la Chapelle and the Bath Waters, and are less hot, nauseous and purgative than the Aix la Chapelle, but more than the Bath Waters. The Bath partake less of the Sul­phur and more of the Steel than either of these two; and are by far the most pleasant; of a milky Taste, never purge, except they be drunk either too fast, or in too great Quantities, and always mend the Appetite, and raise the Spirits. The weakest hot Wa­ters are but of little Use, except in the low­est Cases, and in hectick or consumptive Constitutions; but for medical Uses, the weaker hot Waters may be made pretty near equal to the stronger by Evaporation, as to [Page 43]the sulphurous Principle; as the stronger may be brought down to the weaker by Di­lution, as I have experienc'd; tho' Nature be always the wisest and most perfect Ope­rator. But neither the same Proportion of Steel, nor Sulphur, nor Heat, indifferently fit all Constitutions. Generally the Strength ( i. e. the Quantity of Steel and Sulphur) of the same hot Waters is in proportion to their Heat; and therefore to fit the same Waters to weaker Constitutions, they need only be drunk proportionably cooler.

§. XXVIII The Bath Waters having such an Origin, and such Qualities, must needs be an excellent Remedy in the Gout, and o­ther Chronical Cases, for these Reasons; 1. Because of their Warmth, just suited to the Wants of Nature, and a little above the Heat of human Bodies, sufficient to intro­duce a foreign Warmth and Motion to cold and decay'd Bowels and Fluids; whereby the natural Warmth and slow Circulation is encreas'd and enliven'd. 2. This, with its a­greeable Taste and milky Softness, makes it sit so easily on the Stomach, and become so excellent a Vehicle, to wash into the Blood other proper and specifick Medi­cines, without that Nauseousness and Fret [Page 44]on the Spirits, which all other hot Waters, hitherto known; or that Chillyness and Damp, which all cold Mineral Waters, give: whereby they are render'd useless or hurtful in some low and nervous Cases. To these add, 3. Their Chalybeat Principle, so pecu­liarly lock'd up in Sulphur, that the Patient reaps all the Benefit and healthful Effects of the best Preparations of this Medicine (and what are not two such powerful Medicines combin'd able to effect? (without the nau­seous Taste, and frequent Disorders upon the Stomach, that every other way of giving Steel produces. 4. The Sulphur united with the Steel, makes it a natural kind of Soap, for cleansing the insides of the Vessels from the Foulness that cleaves to them; and for opening the Obstructions of the small Ves­sels. But 5. That which, together with the others, makes it specifick in the Gout, is, its relaxing Quality, whereby it softens and supples the rigid and stiff Fibres, so as the Gouty Humours may pass freely by Perspira­tion. Much more might be said of this won­derful Remedy provided by the Hand of Nature, to relieve the Miseries of human Life; but this the innumerable Crowds of Cripples of all sorts, and those other Per­sons [Page 45]made miserable by Chronical Distem­pers, sent thence, every Year, cur'd, or re­liev'd, do witness, more convincingly than either Philosophy or Rhetorick can.

§. XXIX I will here remove two Difficul­ties: The First is, concerning Bathing in the Intervals of the Gout. The only Reason given for this Difficulty is, lest the Gouty Humour should be driven inwards upon the Bowels. But this seems to me a mere groundless Jealousy: For in regular Gouts, when the Fit is over, it is to be suppos'd, that the Gouty Fluid or Matter is mostly or altogether spent, and the Fluids in a healthy sound Condition. And therefore it might be as reasonably doubted, if in the Intervals of two putrid Fevers (of which many have had more than two in their Life-time) a Person might safely bath. There is no Question, but that a Gouty Person may both as safely bath, and take any Medicine, for any incident Disease, as any other Person; regard being had to his particular Consti­tution. And 'tis Matter of Fact, that those who have been crippl'd by the fixing of the Gouty Salts upon the Joints, or disabl'd by the Tenderness of the Parts, have been ex­tremely reliev'd by a long Course of drinking [Page 46]and bathing in these hot Waters, which by relaxing the Fibres, dissolving the sizy Hu­mours, diluting the Gouty Salts, and ma­king them pass by Perspiration, have re­stor'd them to the Use of their Limbs.

§. XXX The other Difficulty is, how the same hot Water shou'd relax contracted Fibres, as in the Gout and Rheumatism; and yet contract and brace relax'd Fibres, as in the Palsie and wasted Limbs. That the Matter of Fact is so, is past all Doubt in these and many other Cases of Contrac­tion and Relaxation. But to clear up this, we need only to consider what Contraction and Relaxation are. Since all the Fluids of the Body are contain'd in Vessels, Con­traction can arise from nothing but from the Blood and other Fluids (or whatever is the Cause of Muscular Motion) Their being retain'd and obstructed by their Si­ziness; or from some external Injury, in the Substance of the Muscle it self; where­by it becomes fuller and firmer, and so acts as upon its Office of Contraction. Relaxation, upon the other hand, is an Obstruction of the Nerves or Vessels of the Fluids, before they arrive at the Muscles; as is seen in Palsies and the Nervous A­trophy [Page 47]of the Limbs; so that in both Ca­ses, Obstructions are the Cause both of Contraction and Relaxation. Wherefore, whatever Medicine can dissolve the Sizi­ness of the Fluids; open the Obstructions of the small Vessels; make the Perspira­tion full and free, and brace the Fibres; will both contract Relaxations, and relax Contractions: And that these are some of the Effects of Bath Waters, has, I think, been made sufficiently appear.

§. XXXI If it be enquir'd into, what o­ther Cases, besides the Gout, Bath Waters may be useful in; the Answer will be ob­vious from the Account now laid down; to wit, That they must be beneficial in all Cases, where Steel or Sulphur is; that is, in almost all Chronical Cases whatsoever. In Acute and Inflammatory Cases, in all Ca­ses attended with a strong, quick Pulse, no Mineral Water, nor Chalybeat Medi­cine can be proper. But in all other Ca­ses (excepting those only attended with a Bleeding or Haemorrhage) they are not on­ly safe, but exceedingly beneficial. More particularly, their wonderful Efficacy has been often experienc'd in Cachexies, Scur­vies; in the Stone, Rheumatism and Jaun­dice; [Page 48]in Hypocondriacal and Hysterical Af­fections; in Vapours and Melancholy; in Palsies, Epilepsies, and other Cephalick and Nervous Distempers; in Disorders of the Stomach and Bowels; Obstructions of the Liver and Gall-bladder; in green and bree­ding Sicknesses; in Barrenness and Weakness after Child-birth; in Obstructions of the Monthly Purgations; and all other pecu­liar Diseases of the Sex. And truly, if a Person afflicted with a low, broken or ten­der Constitution, suffering under the te­dious Pains and Inquietudes of any of the lingering Distempers now mention'd, where the Viscera or Bowels are yet sound, wou'd know the fittest Place in Britain to spend their Life-time with the greatest Ease and Pleasure; take all the Advanta­ges of the Place together, the Agreeable­ness of the Waters to the Stomach; the Certainty of their procuring a good Appe­tite, when it fails, and the no less certain Consequence thereupon, Freedom and Chearfulness of Spirits; the regular way of living; the Excellency of the Provisions; the Warmness, Cleanness and Neatness of the Housing; the Conveniency of the free, fresh and open Air of the neighbouring [Page 49]Downs for Exercise; the Easiness of the Amusements; and the Advantage of what Conversation one desires; I say, taking all these Advantages together, I can affirm, from near twenty Years Experience, with­out Suspicion of Flattery, or Fear of Con­tradiction, that Bath is the Place.

§. XXXII Some wise and frugal People think the mere drinking of these Waters, for some Time, without taking any Medi­cine, either before or with them, may be sufficient to remove any of the Chronical Ails they are good for; but those, if they are really ill, in any other Manner, except mere loss of Appetite, are generally con­vinc'd, upon Trial, at their own Expence, that they neither ought to begin a Course of the Bath Waters, without a previous clean­sing of the Stomach and Bowels, lest they wash into the Blood through the Lacteals, by the perpetual Dilution of the Bath Wa­ters, those Impurities, which constantly cleave to them; nor that they ought to ex­pect a perfect Cure of a long breeding and lingering Distemper, without the Assistance of those other Medicines which are reckon'd Specifick in the Case; and to which the Bath Waters are so pleasant and so assistant a [Page 50]Vehicle. For it is but Prudence to bring all the Forces one can raise, against so po­tent and so formidable an Enemy as a Chro­nical Distemper.

§. XXXIII It is not possible to lay down a general Rule, about the Quantity of Bath Waters, which it is convenient to drink daily; that being to be varied according to some Circumstances of the Patient, and the Nature of the Distemper: Strong, full and large Bodies bear more Waters than tender, thin and lesser ones, the younger more than the elder; those of strong and firm, than those of weak and relax'd Nerves; those who labour under the Gravel and Rheumatism, than those who are disorder'd in the Alimen­tary Passages, or are subject to Scorbutick or Nerv [...]us Weaknesses, and the like. But in general, it were to be wish'd, that People who come to Bath for their Healths, drunk less daily than they commonly do; and al­low'd more Time for a Chronical Distem­per. I think it may be safely advanc'd, That any Quantity greater than an English Quart, in a Morning, drunk in two Hours Time, half a Pint every half Hour, is more than what is reasonable. For, drinking in this Proportion, all the rest of the Day; at [Page 51]Meals, to wit, in the Afternoon, and going to Bed, they must take down no less than five Pounds in about sixteen Hours; viz. two Pounds in the Morning, a Pint and an half with Wine at Dinner, half a Pound in the Afternoon, and as much at Supper and at going to Bed. This every Body must see is fully sufficient to answer all the Inten­tions of drinking Mineral Waters. A grea­ter Quantity than this will serve only to di­stend and relax the Alimentary Passages; to force its way through the largest, and most patent Tubes; and to propagate the Circu­lation through the Branches and Inoscula­tions of the larger Arteries and Veins, where the least Foulness and fewest Obstruc­tions can happen: So that it will scarce ever reach the finest Capillary Vessels, in which alone the Danger lies. And the late Inge­nious and Learned Doctor James Keill ^* has made it evident, that the most expeditious way of altering the whole Mass of the Blood, by Mineral Waters, is, by small and frequent Draughts. In most Cases a Pint in a Morning is sufficient, and in low Constitutions and Disorders in the Alimen­tary Passages, tending to Vomiting and [Page 52]Purging, half a Pint is enough; and what­ever Quantity is to be drunk, 'tis always best to take it in small Quantities, and at good Distances, provided it come within the Compass of the Morning. What is drunk at Meals, tho' cold, yet being fresh, and not altogether drain'd of its Principles and Virtues, contributes near as much to the Cure, as that which is taken in the Mor­ning. The Afternoon and Evening's Draughts are more Arbitrary, and must de­pend upon the Observation of the Patient, as he finds them agreeable to his Stomach, and sit easily or not: Where too great Quantities have not been swallow'd down in a Morning, they are very proper, pro­vided they be in Proportion to the Mor­ning's Quantity, and never taken under four or five Hours after Dinner; and that at Night, not under two or three Hours af­ter Supper; these Times being the most proper to assist the Digestion, and carry off the Remains of the Food. But the Truth is, as nothing is more necessary, in a Course of these Waters, than setting out right at first; so nothing requires more the Experience and Judgment of a Physician, than the accommodating the previous Pre­parations, [Page 53]the Quantities to be drunk, and the Medicines to be taken with them, to the Distemper and the Constitution of the Pati­ent. For these once settl'd, the rest gene­rally goes on successfully.

§. XXXIV I come now, in the last place, to make a few Observations upon irregular Gouts. When the original Constitution is broken and impair'd; the Parts subdu'd and full of Gouty Salts; the Force of the Circu­lation, by Age and frequent Fits, weaken'd, and continu'd only through the Inosculati­ons of the great Vessels; the Humour re­coils inwardly upon the Bowels. And this is call'd an irregular Gout. While it is in any Joynt, or any Muscular Part, it is still e­steem'd regular, tho' the nearer it comes to those outward Parts, the least remote from the Heart and Bowels, the nearer it comes to an irregular one, and so consequently to its last and fatal Stages. To which it seldom comes unattended; for it generally brings the Stone along with it: Of which it mayn't be amiss to make this one Observation, to wit,

§. XXXV That the Chalk-stones voided from the Joynts of Gouty Persons, and the Gravel Stones found in the Bladders of such [Page 54]as were afflicted with this Distemper (per­haps the Stones found sometimes in the Gall-bladder, but of this I can affirm no­thing) are, to all their essential Qualities, the same. They have both the same Co­lour, Taste and Smell; they yield both the same Principles, and produce the same Ap­pearances, when treated chymically. They have both the same internal Texture of Parts, as far as can be known, and even the same outward Shape, when unbroken and unconfin'd by hard Substances; and they generally happen to one and the same Per­son: At least it seldom comes to pass, that any one is much troubl'd with the Gout, but he has the Stone at last. And this shews that they are both owing to the same Conforma­tion of Parts, and other general Causes. It is true, some have suffer'd violently by the Stone, who never had the Gout; but this may be owing to a special, hereditary Nar­rowness and Stiffness of the Urinary Passa­ges, in respect of the other Vessels; and a particular unhappy Texture of Parts, as it happens to some other Organs in other Per­sons: For fat People have smaller Vessels in proportion to their Stature than lean. But in the general, it is pretty constant, [Page 55]that those who suffer long under severe Fits of the Gout, seldom escape the Stone. Dr. Cyprianus, the late ingenious Cutter for the Stone, had observ'd, that those who on­ly drunk Malt Liquor were seldom ever vio­lently afflicted with that Distemper: And among many hundreds he had cut, he had never found one, who had only drunk Ale or Beer. Whether this was owing to the lesser Quantity of Salts in those Liquors than in Wine, or to the Slipperiness they induce upon the Bowels and other Vessels, or to both, I will not here take upon me to determine. But I believe the Fact is, both in the Stone and acquired Gouts, that those who only drink Malt Liquors, without Wine or Spirits, are seldom violently afflic­ted with either. And for the same Reasons it comes to pass, that the Gouts and Gravels of the Sex, are seldom so severe as in Men; they generally drinking less Wine, and feeding less of Fish and Flesh Meats. And that in the Gouts, both of Men and Wo­men, who drink no Wine nor Spirits, any little proper Medicine has entirely kept off the Pain, and prevented the Fits. I know an antient Gentleman, formerly treated pretty roughly by the Gout, who drinking [Page 56]only Malt Liquors, has, for several Years, with certain Success, entirely kept off the Pains and Fits of the Gout, by taking only every Morning, regularly, a Pint of warm White-wine Whey, to encourage Perspira­tion: Which when he neglects to do, they as certainly return. We may therefore con­clude, 1. That since the Gout and Gravel Stones are, as to their essential Qualities, much the same; and since 'tis hardly possi­ble to account for the breeding of the Stone, but from a particular Narrowness and Stiff­ness of the Urinary Vessels, and an Abun­dance of such Salts in the Fluids; it is high­ly probable, that the Gout must proceed from the same general Causes: And this is some kind of Confirmation of the two first Propositions laid down in the beginning of this Discourse. 2. The same Method and Medicines that have been deduc'd from the first two Propositions, for relieving Gouty Persons, in the Intervals of the Fits, will likewise serve for preventing the Encrease of the Stone and Gravel; as we are certain they do from the best Experience and Prac­tice in this Case. I will now go on with my purpose, and consider an irregular Gout, fix'd on these three great Instruments of hu­man [Page 57]Life, the Head the Stomach, and Guts.

§. XXXV When the Gout has seiz'd on the Head, it is to be treated as any other vi­olent Head-ach, or as an Inflammation on the Brain, or its Membranes; by Bleeding at the Arm or Jugular; Cupping on the Back; Blistering between the Shoul­ders, but especially on the Ancles, to give the Gouty Humour a Vent downwards. In young and strong Constitutions, Mercurial and Antimonial Vomits will do Wonders, tho' they are seldom to be ventur'd upon in any Constitution above Forty. The Inten­tion here to be had in View (as in all other irregular Gouts) is to expel the Gouty Hu­mour outwardly upon the Muscles or Joynts, and to fix it there. Wherefore in order to carry it to as great a Distance from the no­ble Organs as may be, a free Passage is to be open'd to it on the Limbs, by blistering the Ancles and Wrists; and to promote its Con­veyance thither, gentle Stomach Purgers are to be pour'd down continually, two or three Spoonfuls every third Hour, 'till the Effect is obtain'd. And for this end, I re­commend principally Tincture of Hiera Picra with, compound Spirit of Lavender, [Page 58]and a few Drops of Tincture of Snake-weed, and Tincture of Diambra, as being one of the most powerful Expellents, and an excel­lent Strengthner of the Stomach and Bow­els. Its common Mischief is little to be minded here, for the forcing Blood or the Piles will carry the Gouty Humour along with it; and these Disorders are but Trifles in respect of an irregular Gout. This Me­thod will either spend the Gouty Humour, or turn it to a regular Fit. But here Care is to be taken that the Medicines be not too hot, especially in young sanguine Complexi­ons, lest an Inflammation on the Brain, or its Membranes shou'd turn to a Phrenzy or Fever: but there is less Danger of this, because the Gout in the Head seldom hap­pens to the younger, except through much and long Intemperance.

§. XXXVI The Gout in the Stomach is a common and less dangerous Case; for the Gout seldom comes on and goes off without touching there by the way. In the slight Touches of it, any little Stomach Purge will set it a packing. But it is more obstinate towards the Decline of Life; when it settles in a constant Pain, nauseating and kecking in the Stomach. Vomits are reckon'd dan­gerous [Page 59]in the Gout, lest they shou'd de­rive the Humour on the Stomach: But there can be room for no such a Suspicion here. Wherefore upon the first Seizure of the Sto­mach, a Vomit is instantly to be admini­stred, and repeated according to the occasi­on of the Case: After that Hiera Picra as is before caution'd and qualify'd, with a hot Sinapism, or Blister oh the Ancles: And last of all, the highest Cordials, and most generous Wines, may be freely indulg'd, without fear of Inflammation. Among the Cordials, I would recommend the Electua­rium de Ovo, as containing Camphir (the most constant and active Diaphoretic, and the most useful one for that purpose) and some other of the richest Cordials. After all this Management, should the Gout still continue in the Stomach and become habi­tual (which it seldom does after such a Me­thod taken in time) nothing but a long Course of the Bath Waters with Steel, Bit­ters, and gentle Stomach Purgers, a regu­lar Diet, and proper Exercise, can effectu­ally cure it.

§. XXXVII The Gout in the Guts, on its first Seizure, may be easily treated, as a bi­lious Cholic; only the Opiats, commonly [Page 60]and justly given in the Cholic, are not here to be us'd, but in the last Extremity. But this Distemper ought to be treated altoge­ther in the manner prescrib'd in the former Section, about the Gout in the Stomach.

§. XXXVIII There remains but one Dist­inction more of the Gout, and one which has not hitherto been much consider'd: For as the Cholic or Asthma is, so the Gout may be, divided into the Humorous and Nervous; tho' this Distinction depends more upon the Complexion of the Patient, than the abstracted Nature of the Distem­per. The Humorous Gout happens only to people of grosser Habits, more robust Constitutions, and more stiff and springy Fibres, and is the Gout which I have been hitherto treating. All I can further add to what has been said, is, that under the Fit, White Wines are more eligible than Red; because those part more readily with their Spirits, and are less astringent than these. And for the same Reason in the Intervals, the Red is preferable to the White: Tho' neither of them, in either Case, be useful or necessary, but because Custom or Habit, which it is not safe to alter suddenly, has made them so. For in all the Ottoman Em­pire, [Page 61]where little Flesh Meat, and no Wine is us'd; and in Spain, where they use them very moderately; and among the wild Mountaineers in the Northern Countries; and the lower Rank of the People in every Country, where they can procure neither, there is little or no Gout. Rubbing the Part affected with a soft Hand, or warm Napkin, as strongly as the Patient can bear it, is the ready way to make the Humour perspire in the Fit. And Cold Bathing, and rubbing with a Flesh Brush, Morning and Night, are some of the most certain outward Means, to bring Strength and Nourishment into it, in the Intervals.

§. XXXIX Having mention'd Cold Ba­thing, I am the more willing to set this so safe and universal a Mean, for the Recovery of the weaken'd Parts, after a Fit of the Gout, in a clearer Light; because a ground­less Jealousy of the Danger of its throwing the Gout inwardly, has made it universally disus'd. Nothing made a greater Noise upon its first Restoration, and nothing cou'd have sunk lower in its Reputation since, than Cold Bathing: And it will al­ways happen so in Things fitted to the vul­gar Capacity, when they are universally [Page 62]prescrib'd, without Distinction and without Choice. Those who know how greatly Foulness and Uncleanliness promote Epide­mical, Pestilential and Infectious Distem­pers, can only tell what Cleanness contri­butes to Health. The Eastern People (whose Laziness, in other Things, is ow­ing to their Climate) have found Cold Ba­thing and Ablution so necessary to their Health, that they have made it a part of their Religion, as it is a Precept of a Reli­gion of a nobler Extract, from whence they borrow'd it. If the modern Doctrine be true, as I really think it is, that the smallest Fibres, or those of the last Division, in ani­mal Bodies, be not open and pervious, but solid; then it may be affirm'd, that warm Water (I mean pure Element, endu'd with no Medical Principle) by the active Power of its Heat, must necessarily relax such Fi­bres. And that cold Water from the Nitre, which produces its Coldness, must necessa­rily contract them. The Tumour of the Gout, like other inflammatory Swellings, is owing to an Obstruction, or to the Gouty Humours flowing faster by the Arteries, than it can be receiv'd by the Veins; the Smallest or Capillary Vessels are thereby [Page 63]extended and stretch'd, beyond their natu­ral Power of Restitution; so that when the Gouty Humour is spent by Perspiration, or driven into the Veins by the successive Stroaks of the Circulation; the Obstruction remov'd; and the Pain entirely gone off; the Vessels continue thus widen'd and stretch'd, beyond their Power of Restitu­tion, for a long Time after. And this is the sole Cause of the long and tedious Weakness on the Part after the Fit is over; which wou'd yet continue longer, did not the Coolness and Pressure of the Ambient Air, and the now sufferable Weight of the Cloathing, give the first Impulses to the Fibres towards their contracting themselves again: Now nothing in Nature can so rea­dily or so certainly bring this about, as Ba­thing in cold Water: For the Nitre in the Water, which is the Cause of its Coolness; and also the uniform equal Pressure upon the Part, which arises from its Gravity and Flui­dity, concur to communicate to the Fibres a strong and lasting Impulse towards restor­ing themselves to their natural State of Con­traction. And the Gouty Humour now be­ing spent, and the Obstruction entirely re­mov'd, as is suppos'd, how can any such [Page 64]Humour be translated upon another part, by cold Bathing, more than if the Person had never had the Gout? Now to make this Remedy still more effectual, after a pre­vious Course of cold Bathing, cold Pump­ing on the part, by the Force of a Pump, or the Fall of Water from a Height, may be conveniently us'd: The wonderful Efficacy of which is no less certain here, than it is in White Swellings on the Joints, where, I think, it is a never failing Remedy. I am very well inform'd of the Case of a very con­siderable Person, who, for many Years be­fore, being tormented with constant and uninterrupted Pains of the Gout, Summer and Winter, by daily bathing in a Tub of cold Water, has, for these several Years by-past, brought them to regular and peri­odical Fits, at the Cardinal and Critical Sea­sons only; and of no longer Duration than usual. I know also an ingenious Physician, who, after a Fit of the Gout, goes daily into the cold Bath, till the part has recover'd its natural Strength, which constantly hap­pens in much less Time than it wou'd do o­therwise. And many others, who are con­siderably strengthen'd, and preserv'd from catching Cold, by cold Bathing in the In­tervals [Page 65]of the Gout; tho' this Practice is ve­ry cautiously to be gone about by the old and weak.

§. XL The Nervous or Flying Gout (both which I take to be the same, and to differ from the Windy Gout, which is nothing but a Hypochondriacal or Hysterical Symptom) is owing to the Weakness, Softness, or Re­laxation of the Nerves of those Persons who labour under it. All the Solids of the Body are made up of small Threads or Filaments of different Natures and Textures. They are divided into the Fleshy, the Nervous, the Membranous, and the Bony; and make up the solid Substance of the whole Animal Body: But all of them agree in a greater or lesser Degree of Springiness or Elasticity. And it is observable, that some of the most perfect springy Bodies, are made of ani­mal and vegetable Substances; such as Ivo­ry, Ebony and Whalebone. Wherein the general Nature of Elasticity consists, or what is the particular Cause of the eminent Springiness of animal Fibres, is as hard to explain as conceive; which notwithstand­ing, is the noblest Instrument of all the Actions and Functions of an animated Bo­dy. All the Attempts hitherto made to [Page 66]discover the particular Nature of a Con­tractile and Distractile Animal Fibre, to me seem insufficient and conjectural. Lewenhoeck has discover'd, by his Glasses, that the smallest Fibre of an Elephant is not big­ger than that of the smallest Insect: And if the modern System of Generation be just, to wit, That an Animal or Plant comes from another lesser one; then Growth is nothing, but the unfolding the original Membranes and Fibres: And the length of every Fibre is the same in the youngest, as in the full grown Animal or Plant. So Growth and Motion both, that is, the whole Business of the Animal Life, is owing to the Springiness of these Fibres. The best Resemblance I can make of them, is that of a long Hair, or small twisted Gut, which, when stretch'd to any length beyond its na­tural State, will restore it self again to its former Dimensions. And in this Contrac­tion and Restitution of an Animal Fibre; the greatest Mysteries of the whole Struc­ture consist. As there are some People who have hard, gross, stiff Hair, with a strong Spring; so there are others, who have soft, fine, weak Hair, with a feeble Spring: And generally speaking, as the Hair is, so the [Page 67]Threads, Filaments and Fibres of the Body are. Those whose Fibres are soft, fine, weak and of a feeble Spring, are generally said to be of weak Nerves, and liable to Ner­vous Distempers. And here we may observe the Difference between more tense and stif­fer Fibres, and more springy and elastick ones. All the Fibres of the Body are in a State of Distension, as is evident from the gaping Lips of Wounds. Two Persons may have Fibres of the same Degree of Springiness and Elasticity; and yet in their natural State, and original Formation, the Fibres of the one may be more stretch'd, bent and distracted, and consequently more stiff and tense than those of the other; whereby the more stiff or tense Fibres mak­ing a greater Resistance, and being with more Difficulty stretch'd and widen'd, will give more Pain, when a gross Fluid passes thro' them, than less stiff or tense Fibres will. Which gives an Account why of two Per­sons, both of them of weak Nerves, the one shou'd have the Gout, the other be free from it. Persons of weak Nerves must necessa­rily have less Strength, a weaker Pulse and Digestion; a slower and more imperfect Circulation of the Fluids, and a less free [Page 68]and perfect Perspiration; and if they hap­pen to indulge in strong Meats and generous Wines, they must become subject to Hyste­rick, Hypochondriac and Cephalic Disorders. But if, together with weak Nerves, a grea­ter Degree of Tensity or Stiffness be join'd, under the same Circumstances, they will be liable to Gouty, together with the foremen­tion'd Disorders. But by reason of the Na­tural Weakness and less Original Springiness of their Nervous Fibres, the Fits of these Gouts will be less painful and more constant.

§. XLI Coroll. From this Account of the Nervous Gout and other Nervous Distem­pers, 'tis plain, all Evacuations (except the most gentle) must be prejudicial in them. Gentle Vomits, as they cleanse the Sto­mach and Bowels, and principally as they free the Nerves from all extraneous Bodies, and increase the Perspiration, by the vio­lent Convulsions and Contractions of the internal Muscles and Membranes; Blisters, as they open the Obstructions of the small Vessels, by their external, and thin the si­zy Juices by their internal Efficacy; I say, both these Evacuations, may not only safe­ly, but with great Advantage, be us'd in Nervous Cases. But all violent Purges and [Page 69]excessive Bleedings, are religiously to be ab­stain'd from, as encreasing the original Weakness. Purges in People of weak Nerves, in Chronical Cases, carry off a great part of the Nourishment of almost three Days. Vomits, on the contrary, carry off only those Crudities, that send up to the Head and Nervous System, the noxi­ous Fumes and Vapours that cause their Mi­sery. Purges relax and weaken the Fibres of a natural and necessary Function, to wit, those of Digestion: Whereas Vomits can but weaken the Action of Muscular Fibres, less us'd, strong in themselves, and not so necessary to Concoction; as is evi­dent from Monsieur Chirac's Experiment a­bout Vomiting. Purges carry off little, but what wou'd otherwise pass off, in Time, by the natural Course of the Peristaltic Mo­tion; and generally leave behind them what wants the inverted Motion, as they found it. Whereas Vomits pump up those Crudities, that Nature it self would (gladly, so to speak) throw up, by the same Organs, the same way Nature tends. Lastly, four and acid Humours, lodg'd in the Stomach and Guts, must necessarily weaken both, more than either gentle Vomits, or Purges [Page 70]possibly can; with this Difference, tho' that a very gentle, natural, or artificial Purging, continu'd for any long Time, in Persons of weak Nerves, shall both weaken the Person, and waste the Muscular Flesh. Whereas you shall find, after several Months daily Vomiting, in a Sea-Voyage, a Day or two's Refreshment ashoar, restores the Per­son to a greater Degree of Alacrity and Strength than before: Whence it comes to pass, that Persons of weak Nerves are so much reliev'd and rais'd by Vomits; and, on the contrary, so much sunk and depress'd by rough and strong Purges in Chronical Cases. What farther is to be expected in such Cases, is to be done by a regular and strict Diet, fitted to the mere Necessities of Nature. Strengthners of the Digestive Faculties, (and here the Bark and Steel claim the first place, as being the most certain Strengthners of weak Nerves) gentle and constant Exercise, as encouraging the Per­spiration: Aromatick and Spicy Bitters, Vo­latile and attenuating Medicines, and what­ever may be thought fit to nourish, com­fort and support the Animal Functions.

§. XLII Having had frequent occasion to mention the Bark, as being absolutely ne­cessary [Page 71]to the Subject I treat; it may not be amiss to remove one Objection against it; and the only one I have ever heard or read made with any Shew of Reason. I have ta­ken as much of it my self, and as often, and have prescrib'd it as freely as any of my Age; I believe; and never observ'd it, either in my self or others, do any Hurt, except when it has been injudiciously and improperly prescrib'd, and that in continu'd acute Cases only. The Objection is, that it often leaves behind it a bad Habit, a Scorbutic, Cachectic, or Hectic Constitution; bad Lungs, Liver, or Stomach; or some of the great Viscera spoil'd or corrupted. But the Mistake in this Objection lies here, to wit, that few Constitutions break, and seldom any of these great Organs become vitiated; but they begin with an intermittent or periodi­cal Fever. And these I have constantly ob­served to be of that kind, and approaching that Season, which Sydenham most judici­ously distinguishes from Vernal ones, and calls Autumnal Agues; and are indeed symp­tomatical only, arising from beginning Obstructions in the whole Habit, or in these greater Viscera: where all Nature is at work, and the whole Organs labour and [Page 72]struggle to thin the sizy Fluids, and to open the obstructed Bowels; but not being able to bring about this End, Nature succumbs after every Feverish Fit, thus excited, into a worse State. And even here too, the Bark does all its proper Office, in quench­ing, to wit, the violent Paroxysms of the Fever, which only can endanger the Life of the Patient: and allows time for other Me­dicines to act. But when the Habit is alrea­dy broken, and the great Viscera already unsound; it cannot be blamed that it do's not restore these; nothing like that being ex­pected from it, or ascribed to it. When the Bark has extinguished the Feverish Fits, which threaten Death to the Patient, a Re­prieve is obtain'd: in which, by deobstru­ent and attenuating Medicines, Health and Life may be secured. In relax'd Nerves of the Primaeviae; in almost all sorts of Ner­vous and Cephalic Diseases depending on these; in all Gouty Disorders in the Alimen­tary Passages; in all Nervous Gouts; in all Intermittent and Periodical Distempers, or Pains whatsoever: 'tis preferable to any thing hitherto us'd; only in very cold Sto­machs and Constitutions, I have found a Decoction of the Indian Bark, by some [Page 73]call'd Elatherium to be yet more effectual and strengthning; as it will also more readi­ly remove the periodical Disorders of such. But the Peruvian Bark I never found did any Hurt, but in acute continu'd Cases; where it runs into violent Purgings: And in the Monthly Purgations of the Sex, which sometimes it will obstruct; and therefore it ought not to be given without Steel; which ought also to be added, when it is given in Chronical Cases. It were to be wish'd only, in these Cases it gave the same Relief the se­cond and succeeding times it does the first.

§. XLIII I have formerly observ'd, that when, the Gout becomes dispers'd over the whole Habit, or fix'd and settl'd on a parti­cular Joynt, Mercurial Vomits and Purges were absolutely necessary to dislodge it. But there is one Species of the Gout which miserably torments its Subjects, and yet yields not to that, or very rarely to any of the Methods in use; I mean the Gout on the Hip-Joint, when fix'd and constant, com­monly call'd the Sciatica; and yet treated after the manner I'm to explain, never fails of a perfect Cure. The Foundation of the Method I had from the late most Learned and Eminent Physician Doctor Archibald Pitcairn; he having communicated it to [Page 74]me under no Restriction of Secrecy, I think my self oblig'd to publish it to the World, for the Benefit of the afflicted. I have us'd it with great Success these several Years, and I think have improv'd it in several Parti­culars of the Management; and so never fail of a perfect Cure, if the Distemper is a genuine Sciatica, tho' of many Years stand­ing; and after having baffl'd all other At­tempts. It consists in taking from one, two, three Drams, to half an Ounce (according to the Strength of the Patient's Stomach) of the Aetherial Oyl of Turpentine (that which comes off between the Spirit and Oyl, in drawing off the common Oyl of Turpen­tine) in triple the Quantity of Virgin Ho­ney in a Morning fasting, for four, five, six, or eight Days at farthest, intermitting a Day now and then, as the Patient's Occasi­ons require, or his Stomach suffers by it: In drinking, after it is down, large Draughts of Sack Whey, to settle it on the Stomach, and carry it into the Blood: And lastly, in taking a proper Dose of Matthew's Pills eve­ry Night, that Day the Medicine is swallow­ed. This Course never fails to remove the Violence of the Pain, and to leave only a Weakness en the Part. To remove the grosser Remains, and strengthen the weak­en'd [Page 75]Part, I order a Dram or two Drams of Flower of Brimstone, for some time, twice a Day, in a Tea cup full of Milk. If through great Intemperance, or a violent Cold, the Patient relapses, I or­der the Repetition of the former Medicines for a Day or two, which commonly sets it a packing. And lastly, to strengthen the Primaeviae, and enliven the Spirits, I advise Bath or Spaw Waters with Steel, and Bitters with Volatiles; and perhaps pumping on the Part affected, which never fails to per­fect the Cure in a genuine Sciatica. And I hope it may be of some use, to have a Me­thod of Cure for this Distemper, so plainly laid down, so effectual in it self, so easy to the Patient, and so restorative of his Con­stitution in general, in respect of those Tor­tures and the nauseous Load of Medicines the afflicted are forc'd to go through in common Practice. The great Efficacy of this Course consists in the Aetherial Oyl: It has been common to prescribe a few Drops of the Oyl of Turpentine in cold Rheu­matisms and fix'd Pains on the Joynts: But this seldom proves effectual in the Sciatica: Whereas this Aetherial Oyl, having all the Penetration of the Spirit, together with the Softness and Detergency of the finest Bal­sam, [Page 76]but chiefly being of such Lightness, that any Quantity of it may be given, that can stay on the Stomach, or be kept down by frequent Draughts of any soft Liquor, especially Sack-Whey: which by its Milki­ness uniting readily with the Aetherial Oyl; Penetrates into the least and finest Vessels, and the most secret Recesses of the Animal Oeconomy; opens their Obstructions; dis­solves the glutinous Gellies in the Joints; cleanses the insides of the Tubes, and makes all pass by Perspiration. The Rule where­by to accommodate the Dose to the Patient, is to order it so, that it mayn't be so much as to recoil upwards; to prevent which, a large Quantity of Sack-Whey is order'd: And it seldom moves above once downwards; but lest it shou'd go farther, in the subsequent Doses, the Pills take place.

§. XLIV As to Topicks or outward Appli­cations, to ease or relieve the Part affected in a Fit of the Gout, they are dangerous, un­less discreetly manag'd. In the frequently mention'd Cardinal Fits of Spring and Autumn, when, through Ignorance or Ne­glect of the Methods hitherto laid down, they shall happen Regular; I would by no Means encourage any such outward Appli­cation of what kind soever hitherto disco­ver'd, [Page 77]except in the very last Extremities [...] Pain. In the Regular Gouts at those Seasons, these Fits are not to be tamper'd with in any Manner, but in the way formerly directed. For the Habit being loaded with the Gouty Humour and Salts, must be allow'd a Time to discharge it self, and drive them out of the Body; otherwise Life must be endanger'd by a putrid or malignant Fever: And these being the Seasons when the Humours natu­rally undergo some Alterations; if the Gout be thrown upon the extreme Parts, Nature must not be disturb'd in her Operations: But whatever is to be done, is to be directed to encourage and fortify her in her own way; and to assist her to expel the last Breathings of this Humour upon the Parts most remote from the Head and Heart, the two Sources of the Motion of all the Fluids: (which has been the Intention of all the Methods and Medicines prescrib'd in this Treatise:) For thus the Blood will be purify'd; the Spirits reliev'd from their Oppression; the Joints render'd pliable, and all the natural Functi­ons set at liberty. When these Fits are over, any thing that is just and probable, and at­tended with no Danger, for lessening the future Fits, and lengthening their Intervals, may be try'd. But in the Fits falling out [...] [Page 78]these Seasons; in the tedious and lingering Fits of those broken with Age, and Habi­tual Gouts; a well chosen outward Applica­tion may be safely and successfully us'd; es­pecially, if at the same Time gentle Stoma­chic Purges be administred; or a Blister on the Ancles or Wrists be open'd, to let out what may be repell'd by the Topick; and thereby to secure the noble Organs. For let Pretenders brag what they will, I know of no outward Application, hitherto disco­ver'd, but what by its Sluggishness stops the natural Perspiration: Or by its Activity counter-acts the Direction of the Circula­tion; and consequently repels the Humour in some degree or other. But by thus open­ing a Way for the Humours to pass else­where, the Part affected may be much re­liev'd by proper Applications. Fuller and Bates give the Forms of some; and Doctor Pitcairn was exceeding fond of, and held as a great Secret, that which himself has pub­lish'd in the last Edition of his Treatises, which is made of two Ounces of white Arse­nick, and six Ounces of Live-Lime Stone, put into four Quarts of boiling Water, set in a warm place twenty four Hours: Stoups of this apply'd warm to the Part, he had found [...]ectual and safe. That which I wou'd ra­ther [Page 79]recommend is, Stoups of a Decoction [...] Butterbur, Ground-Pine or Camomel Flow­ers, or any Aromatic bitter Plant in Milk; or a Pultis of the Head of a Sack-Whey Pos­set, or any such soft and active Application, to moisten, soften, relax and open at first; and towards the Decline of the Fit a Mithri­date or Venice Treacle Plaister; the Empla­strum Stomachicum Magistrale, or the like, to strengthen, warm and comfort; espe­cially if with these last a stomachic warm Purge be join'd. As to Symptomatic Gouts, there can be no place for them, in the Doc­trine hitherto laid down. For on the Sup­position, that the Gout is owing to a particu­lar Texture and Conformation of Parts; where that Texture and Conformation of Parts is, and the Materials for forming the Gouty Humour is supply'd, there the Gout must necessarily be, without the Concur­rence of any other Distemper: And where these are not, there it cannot be, let the Person be subjected to what other Distemper soever. And if a Person be subjected to two Distempers, in the Cure of the one, due re­gard is to be had to the Cure of the other. What has been said is all I intend at present on this Subject.

§. XLV For a concluding Observation, we shall take notice, as it is only the Rich, the Lazy, the Voluptuous; who suffer most by the Gout: (I mean Acquir'd Gouts, and those he­reditary ones enrag'd by Luxury) so those only, who have spent their Life-time under its Tortures best can tell, what astonishing Miseries Wealth and Vice bring upon Hu­man Kind! When the Gouty Humour has seiz'd upon all the Noble Principles of Life, when it has broken, subdu'd and obstructed all the fine Pipes, and slender Passages, in whose Openness and Soundness all the Ex­quisite Sensations, all the Delicate Usages of the Animal Faculties consist. When nothing but Pain, and Melancholy, frightful Ideas, horrible Dreams and black Despair remain; who wou'd not have parted with the Richest Delicacies, the most Delicious Wines, and the most Enticing Vices, for a plain, simple Diet, an useful laborious Life, Freedom from Pain, and a good Conscience? TEMPERANCE only, Divine, Innocent, Indolent and Joy­ous Temperance can Cure or effectually Re­lieve the Gout. For let Us, or our Brethren the Quacks, brag what we will,