Chapter II: Part 2

Among the chronical Distempers, which owe their Origine to irregularities in Diet, the Gout is neither the least considerable nor frequent; though perhaps the best and least dangerous Way of clearing the Blood of the morbid Matter; for it naturally tends to the Extreams, and is generally so great a Tyrant, that it will suffer no other Distemper to rage but itself; upon this Account it is that People wish for, and are complimented upon the Gout, as an Indication of the vital Powers being in such Strength and Vigour, as to drive forth the gouty Matter; and it is no wonder that Persons should wish such active, fiery Particles, as the gouty Matter seems to consist of, fixed to a certain Joint, and expelled the Body, when they are floating through the Mass of Juices, and disorder the whole Machine, which is often the Case of gouty Persons before it fixes: The gouty Salts (if they be Salts, as most probably they are) appear to be active, sharp, pungent, fiery Principles, and when, by the Force and Heat of the Body, they are brought into Action, are not improperly termed concentrated Fire it self; and indeed the Effects of their Action manifest something not very different therefrom, by calcining the animal Substance into Chalk or Lime, or somewhat approaching thereto, in the Knots of gouty Joints: Their Volatility may Occasion their being more easily brought into a State of Action, but at the same Time makes their Expulsion out of the Body quicker and easier. A fit of the Gout is no other than an attempt of Nature to collect and expell these Salts out of the Body, which, if successfully performed, leaves the Person free from the Gout, till such Time as from the natural Course of the Food, or other Causes, the Blood and Juices become again overcharged with gouty Matter, to such Degree, that Nature attempts the same Way of Relief it before experienced, and occasions another Fit.

From this Account it appears, that if any thing be to be done during the Time of a Fit, which is the Season many Persons very preposterously attend a Cure, it can only be by supporting the Powers of the Body, to enable Nature, to go on with its Work: (For it must be considered, that the Symptoms of Pain arise from the Action of the Body in that Work, as well as from the Action of the gouty Salts;) and by promoting the natural Discharges from the Part affected, by gentle heat and Warmth; all external Applications, foreign to these Ends, are useless, and generally speaking dangerous. Indeed if any thing may safely be applied in this Case, for these Ends, some Preparation of the Poppy seems to me to be the most promising, and least hazardous. This Plant is endowed with Powers that soften and attenuate in a great Degree, gently promote and encrease the Motion of the Juices, and occasion in Bodies properly disposed, as great, if not greater Discharges by the Skin, than any other Medicine yet discovered. If we add to this its particular Property of easing Pain, may we not justly form great Expectations from it? Its Virtues given inwardly, in the Case we are speaking of, have been long known and experienced; its outward Application hath not, that I know of, been mentioned before; and I would be understood now rather to mention it, than recommend it. I have tried it in about half a Dozen Persons, the better half of which found immediate and wonderful Relief from it, and those who did not, found no inconvenience, to my thinking, chargeable upon the Medicine; though perhaps I am fond enough, like other Patrons of new Tryals, to impute the want of Success to other Causes, than to a Deficiency in the Medicine; I only mention the thing, not being thoroughly satisfied about it, for want of sufficient Tryal. But thus far I may venture to assert, that this, or any other external Applications, are neither to be unwarily or unskilfully ventured upon.

Some Authors of good Note have recommended purging the Bowels upon the Recess of the Gout, and during the Intervals of the Fit, as a proper preventive Cure in the Gout. That keeping the alimentary Passages clean, and in good Order, is of Use not only in the Gout, but in several other Distempers, is undoubtedly true; but how far this may be attended with a weakening of the Fibres of the Stomach, and how far the gouty Salts, already lodged in the Blood and Juices, may be drawn into these Parts, so as to act thereon, deserves very well to be considered. The Tendency of Nature is to drive the gouty Humour to the Extreams, and expell it forth of the Body; the Tendency of purging by the Bowels, further than cleansing the first Passages, is to draw the gouty Humour thither, and expell it by Siege. The Consonancy of these Tendencies may be seen without any Witchcraft; but a very accurate Judgment is necessary to distinguish at what Time, or in what Degree, the Juices of the Body are impregnated with the gouty Matter, so as to determine upon purging with Safety, or what Progress they have made in their Collection, and Tendency to the Joints, to venture to disturb Nature, in her own way of discharging them. Purging during the Time of a Fit is always avoided even by the Patrons of habitual gentle Purging out of it, and a Looseness is esteemed a very dangerous Symptom at that Time; sure I am from Experience, that many gouty Persons, who have run into the Practice of habitual Purging, even with those Medicines that are most strengthning, have found very bad Effects from that Custom, have been afterwards less able to withstand the Attacks of the Gout, have had more frequent and longer Returns, have at length sooner sunk under it, and fallen into worse Habits of Body, than others who have avoided that Practice: There may no doubt be a Necessity for the Use of evacuating Medicines, but they are always to be exhibited upon the maturest Consideration, and the best Advice. People that take up such Practices upon their own Opinions, will in the End find cause to repent it.

The best Way of curing the Gout, (if it may be allowed that Name) is to prevent it, that is, to hinder the Generation of this gouty Humour in the Body; this is to be effected no other way, that I know of, but by Diet: While the digestive Powers of the Body are in such full Strength and Vigour, as perfectly to assimilate the Food into its own Substance, and they be not oppressed with greater Loads than they are able to manage, the Choice of particular kinds of Diet will be of little Consequence; but these are always defective in gouty Persons, and these Defects are productive of different Habits in different Constitutions, which must be attended to in Rules for Diet in general, as well as in the Gout. Long Habits are not suddenly changeable with Safety; and after the _Ætas vergens_, the human Body doth not freely admit of Changes. A Body always supported in an high Manner, with Flesh Meats, and Wine, will not well bear a sudden Change to a low Diet; and on the contrary, a Body fed upon Water and Vegetables, will not well bear a sudden Change to an high Diet; sudden Repletions or Evacuation is dangerous, and therefore _Celsus_ well advises, _Nullum cibi genus fugere, quo populus utatur, interdum in convictu esse, interdum ab eo se retrahere; modo plus justo, modo non amplius assumere_, but this is to be understood of People in Health.

Milk seems to be the best Medium of Diet, and yet from what was before said of it, there must be many gouty Constitutions it will not agree with; the same may be said of Turneps, which have been in their Day reckoned Specifick to the Gout as well as Milk; and the Truth is, that many Persons have suffered irreparable Damage, and some lost their Lives, by attempting particular Diets in improper Habits of Body. It is utterly disagreeable either to Reason or Experience, to fix any one general Rule of Diet that shall agree with all Constitutions, or even all gouty Constitutions. The particular Constitutions of gouty Persons are hardly reducible to general Rules, and nothing but Observations, and accurate Judgment, can determine upon them so as to direct a proper Diet. _Lewis Cornaro_, who is one of the strongest Instances of the force of Diet, in the little Account he hath published, tells us that he found several Particularities in his own Constitution, which his Physicians could no way satisfy him in. One Instance is much to our purpose, old Wine disagreed so much with him, that in the Months of _July_ and _August_, in his later Years, he was forced to abstain altogether from Wine, this generally brought him to Death’s Door every Year with perfect Weakness; for though he had been gouty, and cured of it by Diet, he never refrained from Flesh Meat or Wine in some small Quantities, nor could he relish or digest his Food without Wine: So soon as the Grapes began to turn, even before they were full Ripe, he had Wine pressed out for himself, whence he was wonderfully restored, in two or three Days, to the Admiration of his Physicians, who could not conceive, that new Wine, before thorough Defæcation, should have so good an Effect. _Cornaro_ describes himself, and his own Diet very honestly; but when he comes to give Rules for others, leaves the Kinds of Food to its Agreement or Disagreement to every particular Constitution; and concludes with this Maxim, which is undoubtedly true with Regard to Diet in general, That for such Persons, to whom no kind of Food is offensive, the Regulation of the Quantity, and not the Quality of the Food is principally to be attended to; in which this Rule is always to be strictly observed, that no greater Quantity even of the most proper Food, be taken at a Time, than the Stomach is very well able to digest.

Having premised thus much about the Regard to be had to particular Constitutions, in ascertaining a Diet in the Gout, we may very well enquire, what Diet is most proper to prevent the Collection of gouty Salts in the Juices of the Body? From what hath been already said, and from pretty certain Experience, we may conclude this to be the Milk of an healthy young Animal, fed upon Vegetables; the next eligible is a vegetable Diet; and if animal Diet be absolutely Necessary, (as no doubt, some Part of it may be to many Constitutions) the Flesh of such Animals, as feed upon Vegetables, is preferable to such as feed upon other Animals. I prefer Wines to vegetable Diet, because all fermented Liquors are produced from Vegetables; of these the softest and smoothest are always to be preferred to the harder and rougher, though none should be used farther than as an help to Digestion; for Water is the Drink proper to all Animals. To assign Reasons for these Assertions would be only to repeat what I have said before; for if that be true, these evidently follow from it.

But so it is, that through the Difference of Constitutions, or different Habits superinduced, many cannot bear a strict Attendance upon one kind of Food; it shall disagree with the Body, be nauseous to the Stomach, fail in giving proper Nourishment, or if too strictly persisted in, may Cure the Gout, and bring on some other more fatal Distemper, or bad Habit, and even this hath been the Case of Milk it self. It is not within the Compass of my present Design, nor indeed, I am afraid, within my Power to enumerate all the several different Constitutions of gouty Persons, and the different Modifications of Diet necessary for them: A Constitution that will bear living upon Bread and Milk, will no doubt be in an happier Way of being cured of the Gout, than one that cannot. But what will not bend, must not be broke; vegetable Food is too flatulent, and gives too little Nourishment to many Constitutions, who require Food already assimilated into animal Substance. Stomachs long used to Wine, require it in Digestion, and in many Cases and gouty Constitutions, even while a Cure is attempting by Diet, a little Flesh Meat must be allowed at certain Times, and the Powers of the Body kept up, by the Moderate use of Wine, chusing the easiest of Digestion, and the softest of each Kind; taking especial Care never to overload the digestive Powers, by too great Quantities; which is a Rule that will hold at all Times, and in all Constitutions; and is of so great Consequence, that if not attended to, it will invalidate the Force of any other Rules that can be given for Diet in the Gout, or any other Distemper.

The Necessity of varying from the strict Milk-Diet, in which the Cure of the Gout absolutely consists, according to the Unhappiness of particular gouty Constitutions; must be left to the Observations of the Patient, of the Agreement or Disagreement he shall have experienced of particular Kinds of Food, to his own Body; and to the Judgment and Advice of a skilful and diligent Physician.

_DOLÆUS_

Upon the CURE of the

GOUT

BY

MILK-DIET.

_DOLÆUS_ Upon the CURE of the GOUT, _&c._

CHAP. I.

Before I explain this Method of Cure, I would have my Reader take Notice, that he is not to expect any thing perfectly new: I only propose to confirm, by fresh Experience, what hath been long enough known. The Method of Cure here advanced consists in the proper Use of Milk for a Year and upwards. Many will perhaps wonder at my Endeavours to revive a Method so long known and exploded by Physicians, as hurtful to gouty Constitutions, and shortening the Period of Life itself: But being fully satisfied from Reason, and certain Experience, that this most excellent Remedy is the Gift of Providence, for the Relief of Persons afflicted with this cruel Distemper, I could not help drawing up and communicating my Experience and Observations for the Relief of others.

_Cornelius Celsus_, the celebrated _Roman_ Physician, speaking of the Pains and Evil that gouty People suffer, tells us of some Persons who entirely avoided this Distemper by a strict Adherence to the Use of Asses Milk, and of others that by abstaining a whole Year from the Use of Wine and Women, were never afterwards troubled with it.

Among the Moderns, _John George Grezzell_ hath wrote a very learned Treatise upon the Cure of the Gout by Milk, wherein many curious and useful Observations are delivered; that excellent Physician Dr. _James Sacks_ hath inserted, in the _German_ Ephemeris, a Method for the Use of Milk, communicated to him by a noble Baron, wherein many useful and elegant Observations, founded upon Experiment, are contained. The late learned _Waldsmid_ hath published a learned Dissertation upon the Relief of gouty Persons by Milk, wherein he agrees with the Authors now mentioned as to the Cure. I have lately received a Letter from a _French_ Gentleman my Friend, who having been for many Years afflicted in a most terrible Manner with the Gout, hath been now by the Use of Milk, free for some Years. From these Examples I had Occasion to admire the wonderful Effects of this Diet, and therefore advised it to many gouty Persons here at _Cassell_, who have all recovered a perfect State of Health, by a strict Adherence to the Regimen Necessary in the Use of this Remedy: Even some whose Limbs were before perfectly crippled, are now able to walk and exercise. Colonel _Nicholas Dumont_ hath experienced the Efficacy of this Method here at _Cassell_, for his Limbs were so entirely contracted that he was forced to use Crutches, but having confined himself strictly to the Use of this Diet for an Year and an half, he walks very well without a Cane, and hath performed several Journies. I have been free from the Gout my self upwards of an Year, notwithstanding I had three or four Fits every Year for Sixteen foregoing. Colonel _Haste_ hath been restored by the same Means, though he hath had some mild Returns at several Times.

I shall in the first Place communicate the Letter I just now mentioned; next I shall lay down the Rules Necessary to be observed in the Use of this Milk-Diet; I shall then demonstrate from undeniable Principles, that this Method is the most convenient to asswage and cure the Gout, and that no bad Consequences can attend the Constitution, if it be taken with the proper Regulations. The Letter is as Follows.

To Monsieur _de Collet_.

_SIR_,

Nothing can be more agreeable to me, than to satisfy the
Desire of my Friends afflicted with the Gout, in communicating
the Method of Diet, by which the Marquis _de Bongi_, _Mons.
Chamar_, and my self were relieved from the Gout; you will
please to take Notice, that the Milk we used was fresh drawn
from the Cow, Morning and Evening, without other Art than that
we both eat and supped it, as warm as we could well bear it; my
Reason for mentioning eating and supping the Milk, is, because
as soon as we arose in the Morning we supped a large Bowl of
warm Milk; but the Milk which was brought us at Dinner and
Supper, we eat with fine light Bread, cut thin and put therein;
this is all our Secret in this Matter. Persons afflicted with
the Gout may promise themselves Relief, provided that once a
Month, during the Course of this Diet, or at least once in two
Months, they take a gentle Purge, which we made Use of, and
were so strict in our Regimen, that we neither drank Wine nor,
eat other Food, than Biscuits made of very fine Flower, Eggs,
and Sugar, and some sweet Fruits, as Strawberries in Summer,
but we chiefly avoided Raspberries. For my own Part, I never
sweetned my Milk with Sugar, though some Friends who were in
the same Course did, yet without any bad Effect. The Marquis
_de Bongi_ used to mix Crabs Eyes with his Milk before Dinner,
upon a Presumption, that it would prevent any Sourness in his
Stomach, but neither Monsieur _Chamar_ or I ever used that
Remedy. When we had strictly adhered to this Diet for a Year,
we began to hope we might eat Fish, or indulge our Appetites
in some varieties of Food, which one or other of us did, more
or less, occasionally, and without any bad Effects. At the
End of Nine Months I apprehended my Stomach to be somewhat
weakened, which made me resolve to use a Glass of Wine after
my Milk, and accordingly after Dinner and Supper every Day,
I drank one Glass of Wine, in which I sopped a bit of Bread;
this was very delicious to me while I used it. At length as we
found the State of our Healths to mend, we began to eat and
drink with our Friends. This Method hath succeeded so well,
that we live hitherto in our common Way upon Milk, yet not so
strictly, but that we dine or sup, once, twice or thrice a Week
with our Friends in their Manner, and return afterwards to
our Milk without Ceremony; and by the Blessing of God we are
wonderfully well. We dont here pretend to say, that none of
us have been since afflicted with the Gout, for the Marquiss
_de Bongi_ hath had two or three pretty sharp Fits; but both
he and I know the Difference between having two or three Fits
in nine or ten Years, and of being perpetually oppressed, and
confined to Bed with this cruel Distemper, which was our Case
before; especially the Marquiss _de Bongi_, who at Six and
Thirty was almost continually confined to his Bed, deprived
of the Use of his Limbs, and the Joints of his Hands and Feet
knotted and chalky; instead of which, he now uses his Limbs
without any Marks of Infirmity, insomuch that any one who had
seen him in his former bad State, and compares it with his
present, would look on him as one raised from Death to Life.
As for Monsieur _Chamar_, and my self, who are more advanced
in Years, considering our Age, we are mighty well; ’tis true
indeed that sometimes, as upon Changes of Weather, or of the
Moon, we find (or at least we fancy so) that we have some
Threatnings of Pain, especially about those Joints where the
Gout used to ravage, but a little Exercise soon dissipates
those Apprehensions.

It is now Seven Years, that Monsieur _Chamar_ and I have
adhered to this Diet, in all which Time we have neither of
us been so far oppressed by the Gout, as to be confined to
our Beds, or even to our Chambers, so much as one whole Day;
notwithstanding before we fell into this Method (though we
were not perpetually under actual Fits of the Gout) we had a
continued Weakness in our Limbs, we walked very infirmly and
with difficulty, and if we chanced to make a wrong Step, or to
slip in walking, we suffered Extremity of Pain; our Case is
now so far altered, that we walk as firm, as if we had never
had the Gout. I must confess indeed that both the Marquiss
and I used the Diet for a good while, before we perceived any
manifest Change, but afterwards our Pain diminished by Degrees,
and the Strength of our Limbs returned. The Milk must be
used a good while, that the natural Temper and Vigour of the
Constitution may have Time and Leisure to come to itself; for
though this Diet may be often used Six Months or even Twelve
before the Patient can use his Limbs free from Pain, yet let
him not despair, for if once he begins to gather Strength,
it will daily increase. As to Purging, and Evacuation of the
Humours, if possible it should be done once a Month, in the
Decrease of the Moon: I hold purging extremely Necessary; for
my own Part, it was what I did for the first Seven or Eight
Months of this Diet constantly, till I grew tired of it. This
is truly the Method I used, and though I afterwards remitted, I
found no bad Consequence. The Marquiss and I, at present, take
a Bowl of Warm Milk every Morning, but for the Rest of the Day
drink and eat as usual. The Marquiss indeed, for the Space of
Eight Years, hath had at Times several small Fits of the Gout,
but for my self I have hardly had any, except sometimes upon
Changes of the Weather, or of the Moon, I have perceived a
Numbness and Weakness in my Knees and Joints, like Threatenings
of the Gout; but I thank God, it never confined me, and as
it came on easily, it as easily went off. The following is
the Method of purging: _Take of Scammony, white Turbith,
Hermodactyls, Leaves of Sena, Sarsaparilla, Cinamon, and
Sugar, of each one Drachm, powder them very fine, and divide
the whole into Seven equal Parts, one of which is a Dose, and
may be taken in white wine or a little Broth_. It is necessary
to purge once a Month, especially in the Decline of the Moon.
If it be thought necessary to purge twice in the Month, let
the first Dose be taken in the last Quarter, the second the
last Day of the Quarter. The Day I took Physick, I used Milk
after it as usual. When I had pursued this Course about Seven
or Eight Months, I found my Stomach so much weakened from the
Milk, that I was forced to take a Glass of Red Wine every Day
after Dinner, which agreed mighty well with me, and I have
continued it ever since; so that I am often impatient to finish
my Milk, that I may have the Pleasure of regaling my self with
a Glass of Wine, and a bit of Bread.

CHAP. II.

In the foregoing Letter are contained many useful Observations about the Use of Milk, and its wonderful Efficacy in the Cure of the Gout, from uncontestable Facts, in the Account of the Persons there named. I shall next lay down the Method of this Diet, by which many Persons here at _Cassell_ were relieved. Whoever expects Benefit by this Method, must observe the following Rules. No one ought to go into this Diet without having his Body duly prepared; he must take Care by Degrees to change his Habit, and for the first Month to regulate his Diet, by strictly avoiding all Salt or smoaked Meats; Legumes, and stale, acid or feculent Liquors, and to eat white Meats sparingly, with clear small Drink, as small Beer or Barley Water, or Decoctions of the Woods: A Glass of _Moselle_ or _French_ Wine free from Acidity, may be allowed at Dinner, and Gruels and Broths made of white Meats. There is a necessary Caution to be used, that both in Meat and Drink, the Quantity taken be rather within the Appetite than beyond it; for from overloading the digestive Powers, arise Crudities, Flatulencies, and acid Humours, which are the Origine of many Disorders. Upon this Account it is necessary to purge the Bowels, two or three Times a Month, with Tincture of Jalap, Elixir _Proprietatis_, Rhubarb, some of the purging Pills, as the Arthritick or Mastich Pills; that the Viscidity arising from indigestions may be carried forth of the Bowels, and the Stomach be better disposed to receive and digest the Milk. I am of Opinion, the first Dose should be taken the first Day of the Month, preparatory to this Diet, the second after some few Weeks of this first Regimen, and the third the last Day of the Month; after this I advice the taking an Ounce of Crabs-Eyes, or prepared calcined Hartshorn, especially if there yet remains any Marks of Acidity in the first Passages. This further Caution is very absolutely Necessary, that not only in the first Month, but in all subsequent, all Passion, chiefly Anger and Grief be avoided, because of their pernicious Consequences; more especially the Use of Women during the whole Year.

SECT. 2.

All those who have other Distempers complicated with the Gout, as the Scurvy, Leprosy, bad Habit of Body, Stone or Gravel, Hystericks, the Pox, or other Distemper arising from the Impurity of the Blood, too great a viscidity or acrimony of the Juices, or a known or latent Acid in the Blood, are first to use Absorbent, Diuretick, Sweetening or other Medicines, proper to their particular Distempers, till the Acrimony or Tenacity of the Blood and Humours be corrected, the Acid expelled, and such complicated Disorders overcome, and then apply this noble Remedy of a Milk-Diet to the Cure of the Gout alone, from which they may certainly promise themselves Success: But if while the Body is ill prepared, or full of vitiated Juices, the Milk-Diet should be preposterously brought into Use, they will not only be disappointed in their hopes of Relief, but bring certain Destruction, and Increase of their Disorders; as actually happened to the Count _de Perlebourgh_, and _a Lubech_ Consul in this Neighbourhood, who having a Complication of Distempers, made an improper Trial of a Milk-Diet.

SECT. 3.

The Milk in which the Cure of the Gout consists, ought to be excellent in its Kind; the Animal from whence it is taken, as described by _Waldsmid_, should be an Heifer, or Cow of a middle Age, of a good Habit, either of Red or a Black Colour, (though this need not so strictly be minded) neither fat nor lean, nor pregnant, and kept separate from the Bull: In Winter fed upon good Hay, Barley, Bran or Straw; in Summer at good Grass, and led in a Collar like an Horse. If any one can keep a Cow for their own Use, it is best, and they may more safely rely upon help from it; but if not, the Milk as the Milkmen sell it will do; taking Care however that the Cow be of a good Habit, well fed, and not too old.

SECT. 4.

As to the Quality and Quantity of the Milk, it is to be observed, that as soon as it is milked it should be warmed, but not so as to boil it. Let the Vessel full of Milk be put into boiling Water, and when it is so hot as to be conveniently supped, or at least so warm as when it came from the Cow, let it be taken after the Manner of Tea or Coffee. The Times of taking ought to be, two Pints in the Morning, some four or Five Hours before Dinner, as much about Noon, and as much about Seven in the Evening; but the Quantity cannot be exactly determined, because the Weakness or Strength of the Stomach must give a Rule in this Case; or let so much be taken as the Stomach can bear without Inconvenience, and the Patient may increase the Quantity daily till he comes to about forty Ounces. If the Stomach be weak, he may take it in a smaller Quantity, four or five Times a Day; if four Times, let two of them serve for Dinner and Supper, with some of the finest wheaten Bread; and a Draught of Milk may be repeated every four Hours; if the Milk be taken at five Times, it may be so ordered as to let three Hours intervene; those who are of more robust Constitutions, may be content with three Meals of Milk a Day; and it will not be amiss to take every Morning a Dose of Crabs-Eyes, or some other absorbent Powder: I usually take about twelve or fourteen Ounces of Milk in the Morning, Twenty four Ounces with Wheat Bread at Noon, and about Twenty Ounces at Night, half with Bread, and the other half drank as common Drink. Some allow the Use of white Meats at Dinner, lessening the Quantities by Degrees, and making up the Deficiencies by Food of Milk and Eggs, so that by Degrees the Milk and Eggs are entirely substituted in the Place of the Flesh Meat, and then by diminishing the Eggs daily, Milk becomes entirely substituted for other Food: This Method seems to me, entirely agreeable to tender Constitutions, and such as dont well bear sudden Changes. Some who have strictly adhered to Milk for fourteen Weeks, have indulged in the Use of poached Eggs without Salt, Barley boiled in Milk, fresh Butter without Salt, Custard and other Milk Foods; and in Summer, some Kinds of Fruits, as Strawberries, Peaches, _&c._ tho’ in my Judgment improperly, especially such Fruits as are cold, or seem to have a latent Acid, or such as weaken the Bowels. On this Head it may be observed in general, that the less whatever be used for Food differs in its Nature from Milk, it may be more freely ventured upon in the Milk-Diet; but the Prudence and Care of the Physician is to be relied on, according to the Diversity of Circumstances that may happen in different Constitutions.

SECT. 5.

This Diet ought to be so long continued, until the whole gouty Matter be discharged forth of the Body, which is to be computed by the Degree and Length of the Distemper, and Observations upon the Cure in others. The longer it is continued, the more perfect Cure is to be expected; those that are over-run with the Distemper, are always to use it, others for an Year, and others for an Year and an half; some Persons who have, upon continuing it only for half an Year, thought themselves perfectly cured, and have returned too soon to their former Method of living, have so far exceeded, as to be seized again with the Gout, but returning to the Diet, have been cured; some more prudent, have continued the Diet for an Year, and then returned to their ordinary Manner of living by Degrees, always taking about sixteen Ounces or a Pint of Milk every Morning, and have thus for many Years been free. The best Time of Beginning the Diet is in the Spring, and that from the Beginning of _May_, to the End of _April_ in the succeeding Year.

SECT. 6.

Some have in the Continuance of this Diet been seized with Oppressions and Difficulty of Breathing, Weakness in their Limbs, Coughs and Phlegm; but these Symptoms either vanish of themselves, or quickly give way to Elixir _Proprietatis_ without an Acid, Spirit of Hartshorn succinated, _Sal volatile oleosum_, or any of the more fixed absorbent alkaline Medicines.

SECT. 7.

For those who are oppressed with an abundance of Humours, whose Bowels are full of Flatulencies, or are constipated, let them once in every Month or Six Weeks take a gentle Purge of Rhubarb, or of the Arthritick Pills, or half a Scruple of _Pill Ruffi_, or of _Sylvius_ his Gum Pills: But if the Body be open, and the Milk passes too quickly through, it may suffice to take twenty Grains of Rhubarb; or if the Body be bound, take twenty Grains of Rhubarb in the first Draught of Milk, drinking the rest of the Quantity after it, or else in the Evening take twenty Drops of the Essence of Rhubarb with the Milk, and repeat it as often as there may be Occasion; but for the general, if it can be conveniently done, the purging Medicines should be used in the Decrease of the Moon.

SECT. 8.

If the Milk should occasion a Looseness, let it boil before it is used, adding a Grain of Salt and so supping it hot; if it do not succeed the first Time, try it a second Time, and a third; but if it doth not do then, take a Dose of Crabs-Eyes, _Unicornu fossile_, or _Terra sigillata_.

SECT. 9.

If the Milk should heat the Body, let a third Part of Barley Water, made with Raisins, be added to it; or if it occasion Thirst at any Time, Barley Water with Raisins; or in case of a Cough, the pectoral Decoction may be used between the Intervals of using the Milk.

SECT. 10.

If the Stomach be weakened by the Use of the Milk, the Patient may be allowed Sugar Biscuits, sopped in _Spanish_, _Italian_ or _Burgundy_ Wine, or any other that is neither Acid nor Foul; and if necessary, even a Glass of those Wines: Thus the Stomach will be fortified, and more easily perform its Office; if there should be a Necessity for it, some of the warm aromatic Powders may be brought into Use.

SECT. 11.

After this Diet hath been used twelve or fourteen Months, the Patient may begin to use Flesh Meats of easy Digestion, avoiding sharp, acid or salt Meats, but using such as we mentioned before, drinking Milk still, or small Beer well wrought, neither stale nor turbid.

SECT. 12.

The Cure being thus absolutely finished, it will be still necessary to take every Morning a Pint of warm Milk, and to be constantly cautious about your Diet, avoiding every thing acid or sharp.

SECT. 13.

To prevent the Milk from cruddling, some Sugar may be mixed with it, or even a little Salt, thus the Acid is prevented from gathering; but this should be done but seldom, and upon the most urgent Necessity.

SECT. 14.

Though there should not follow an immediate or sensible Change upon the Use of the Milk for some Time, yet the Patient ought not to be disheartned; for if these Rules be strictly observed, and the Patient be otherwise in a good Habit, the Pains will vanish by Degrees, and a due Strength and Tone return to the Limbs.

CHAP. III.

I Have now delivered the Directions I proposed, partly from the Authors before-mentioned, and partly from my own Experience; by a due Observation of which many Persons have been perfectly relieved from this grievous Distemper; of which I shall give some Examples. _D. Sorbait_, p. 741, tells us, that he knew several Persons, by the Use of the Milk-Diet, either perfectly cured, or their Gout so much overcome, that their Pains were dwindled to nothing. _John Pilus_, the Emperour’s Surgeon told me, that tho’ he frequently had Fits of the Gout, and almost lost the Use of his Limbs, so that he was in a very miserable Condition, yet for these three Years past, by the Help of this Diet, he hath been perfectly free from Pain, his Countenance is now become fresh and healthy, he hath had several Children, and appears as if he were born a-new. Count _Coningseck_, his Imperial Majesty’s Counsellour, found the same Benefit by this Diet; and Count _S. Hillario_ of the Emperour’s Bed-Chamber; several others, who were almost worn out with the Gout, grown pale and wan, have in a manner become young and florid again by this Diet. The Bishop of _Wallendorf_, tho’ quite impotent by the Gout, was cured by Milk. Three noble _French_ Refugees, the Marquess _de Bongi_, Monsieur _de Chamar_, and the Counsellour _de Talo_, have been now many Years free from the Gout, as appears by the Letter before inserted. I am told that a Consul, and several others at _Hambourgh_, are now using this Diet with Success. A Counsellour of _Oldenbourgh_, the Sieur _Van Velden_, hath used this Diet this last Winter with very wonderful Success; for tho’ he could neither use his Hands nor Feet, he uses both now readily and perfectly well. A Miner here in the Neighbourhood hath used Milk for these six Months past with great Benefit; he was almost a cripple, but now walks very well to the Mines. All the World knows that the famous Prince of _Conde_ was cured of the Gout in _France_ by Milk-Diet. There are two Citizens of _Hambourgh_, one of which, tho’ he hath had the Gout fifteen Years, is well recovered by the Use of Milk, and the Knots in his Joints are quite wore away. Colonel _Haste_ hath used Milk for six Months, and been free from the Gout; and tho’ he hath left off the Use of it, the Fits are much easier than before. There is no Occasion to multiply Examples; many more may be found in _Sorbait_, _Sacks_, _Greizel_, _Waldsmid_, Authors already named. I have experienced the great Benefit of this Diet in myself; I was so cruelly handled by this Distemper, that I almost lost the Use of my Limbs, and at last had a Fit every Month or Six Weeks; I was at the same Time violently afflicted with the Stone, and difficulty of Urine; but now that I have confined myself to this Diet for an Year and upwards, I have not only been free from any Fit in that Time, but the Strength of my Limbs is returned, the Dysury is abated; and what is wonderful, the Stone in my Bladder is lessened and dissolving, so that I now hope I shall get the better of the Gout, having been in a manner free from it an Year and an half; I have had some Fits indeed, but very mild ones. I take Milk to be a Medicine beyond any yet discovered for the Stone, since within the Space of one Year, the Stone in my Bladder diminished an Ounce, as I judge from the Bits I have voided and collected in that Time; and since I have left off the Cure, I have not voided one Bit. I am of Opinion, contrary to most Physicians, that Milk doth not breed the Stone in the Bladder, but only a viscid kind of Phlegm in that or any other Part.

SECT. 2.

These Things premised, I shall next examine how it comes to pass that Milk is endued with this mighty Power; but it is necessary first to enquire concerning the genuine Cause of the Gout. All the Symptoms testify the first and nearest Cause to be some viscid, sharp Liquor, endued with some acid or lixivial corrosive Salt, more or less fixed; this Salt indeed occasions such a singular smart Pain, that it seems to be specifick. I think it not only acid, but also somewhat austere, from the different earthy, cheesy Particles it contains. Hence it fixes its sharp stiff Points in the Membranes, Tendons and Nerves, and more readily thickens and coagulates the lymphatick Juices. Where and how this Liquor that causes the Gout is generated, I shall explain in a few Words. First then the Stomach and Bowels, whether from too great an use of Wine or Women, or from too sedentary a Life, and want of due Exercise, or from the particular Disposition of the stomachick Juices, or from bad Diet, become so affected, that by Degrees the Digestion or Dissolution of the Food is lessened; the Chyle thence produced, becomes more thick and viscid than formerly; so that this Chyle, thus delivered into the Blood, renders its Mass thicker, and of Consequence the several Secretions of the Humours, as the Lymph, animal Spirits, the mucilaginous Juices about the Joints are more slowly performed; thus the Stomach and Bowels become more tainted, the stomachick Juices and those separated by the Glands of the Intestines become more viscid, and the Difficulty of Digestion is increased; Part of the Food turns to Flatulency, and viscid sharp Slime in the Bowels; Part of the Chyle becomes infected with a corrosive acid Salt thence produced, and being again thrown into the Blood, the Lymph and other Juices become infected with the same acid Salt, which gives Birth to many Distempers. It is observable these viscid Juices, thus stopped in their Progress, and infected with this noxious Salt, so as to be more liable to an intestine than a progressive Motion, are the most subject to Corruption of any in the Body, and to contract a Thickness, and Inaptitude to Motion. Such an Humour is the Lymph, and more especially the mucilaginous Juice separated in the Glands of the Joints, in order to keep them moist and smooth for Motion. If therefore a sufficient Quantity of these acid Salts be brought into the Mass of the Blood, or the Humours impregnated with them, be lodged about the nervous or tendinous Membranes, and there acquire so extraordinary a Tenacity or Sharpness, as to be coagulated, the Gout thence arises, as is evident both from Reason and Experience. That this may more evidently appear, I shall next explain the Figure, Situation and Structure of these Glands.

SECT. 3.

These Glands, as described by Dr. _Havers_ in his new Osteology, and as they discover themselves upon Dissection, are of two Kinds; some are small and thickly interspersed in the Membranes of the Joints, and with very few Exceptions of an equal Bigness, so as to render the Membrane perfectly Glandulous: In some Parts of the Membrane, in the Joints, and in the Furrows of the Bone, these Glands are so united as to form very remarkable and large conglomerate Glands. In some of the large Joints there is but one, as in the Hip Joint; in others, as in the Knee, four or five; they are of a red Colour, which is communicated from the blood Vessels; as to their Substance, soft and papillary, tho’ not tender and friable; they are in their Structure Conglomerate, consisting of divers Membranes, wove one within another, interspersed with small round Vesicles, which are not only contiguous, but adhere closely one to another, as the Membranes also do. By the Pores of these little Vesicles a mucilaginous Liquor is strained and secerned from the general Mass of the arterial Blood, and thence by the excretory Duct, with which all these Glands are furnished, is shed into the Interstices of all the Joints.

SECT. 4.

These Glands have a sufficient Number of blood Vessels, they dont come out of them in right Lines, but are observed to have many Convolutions, Windings, and Insertions; there seems to be a very particular Reason, from the Nature of the Liquor to be separated, for this Obliquity of the blood Vessels; for since that Liquor is to be viscid and mucilaginous, its Parts should proceed slowly, and not without Difficulty, through the glandulary Pores; and therefore the Vessels are contorted in the Manner we see, that the Motion of the Blood may be retarded, and more Time and Leizure given, both for the separating Particles of such a Nature, and for their Admission through the Pores of the Glands.

SECT. 5.

These Glands are of different Shapes, so as to fit the Furrows and Cavities where they are placed; some are long, others conical, broad at their Base and grow narrow towards the Top, so as to terminate in an Edge; some have a broad Base, and rise into a sort of Cone; some are like little Ridges; some like Fringe; some are broad and pretty flat.

SECT. 6.

As to their Situation, they are differently seated in the several Joints; in some they stand over-against the very Interstice of the Bones, and run in a little way between them, where the Ends of the Bones towards that Side are not contiguous, but so formed as in their Conjunction to make an Interstice, and these are commonly in the Manner of a Fringe; some are seated in some Sinus or Cavity, others planted upon the Membrane, which immediately covers the Articulation: In general they are so seated, that they cannot be injured by a Compression from the Bones; and yet there is this Contrivance, that the Bone does, either in the Inflexion or Extension of the Joint, lightly press upon them, so as to promote the Excretion of the Humour, which they separate into the Joints, when they are moved and stand most in need of it; and by this Means it seems to be most plentifully supplied, when there is occasion for the greatest Quantity of it, and to be proportioned to the present Exigence, according to the State of Rest, or the several Degrees of Motion in the Part when it is moved. And it is no small Security to these Glands, against the Obstructions which the mucilaginous Quality of the Liquor that they separate does naturally dispose them to, that they are solicited, and the Liquor expressed out of them by the Motion of the Parts where they are seated: The same sort of Glands are placed about the common Membrane of the Muscles, and about the Tendons.

SECT. 7.

The Liquor that is separated from these Glands is a Mucilage, not unlike the White of an Egg, tho’ not always so clear and pellucid; when pure it is very like it. In some Animals it is of a Colour inclining to Yellow, and is composed of watry, saline and slimy Particles; it is supposed that the earthy Particles may be about a two and thirtieth Part. The Nature of this Mucilage seems nearly to approach to that of the _Serum_ of the Blood, separated from the grumous Part upon being exposed to the Air, and exhibit much the same Appearances upon Trials by Mixture with other Bodies, only the _Serum_ is not so mucilaginous. The _Serum_ is coagulated upon being mixed with Spirit or Oyl of Vitriol, Spirit of Salt, Oyl of Sulphur, and other acid Spirits. The _Serum_, upon being held in a Spoon over the Fire, becomes a thick Jelly, and at length a sort of friable Glew; on the contrary, the Mucilage grows thinner, upon the same Application, throws up a slight thin Film at Top, and produces but a slight Coagulum. After the aqueous Parts are evaporated, there remains scarce a thirtieth Part of the whole Mass.

SECT. 8.

The principal Use of this Mucilage is to lubricate the Joints, and to render and preserve the Extremities of the Bones, at their Articulations, smooth and supple, for the easy Performance of animal Motion. Besides this mucilaginous Liquor from these Glands, there is an oily medullary kind of Substance transmitted through the very Bone into the Cavity of the Joints: These two Liquors are mixed by the Motion of the Joints, the Mucilage contributes to make the Oyl more slimy, and the Oyl preserves the Mucilage from stiffening into a Jelly. This Mucilage further serves to prevent the Extremities of the Joints from being burnt up in the Gout. In the same Manner the Muscles and Tendons are lubricated and kept in Vigour by the Liquor supplied from the same kind of Glands placed on their Membranes.

SECT. 9.