By the first sort of humors the first kinde of bodies is maintained and by the second the second kinde of bodies is corrupted and by the third kinde the third sort of bodies are molested Now for the Gout it cannot come of good humors for that they bring no paine to the body but comfort And of the second sort it cannot proceed for then there should alwayes a bad fever go with the Gout for that such humors have alwaies in them a putrifaction Wherefore it remaineth it come of the third sort either through their overgreaâ— quantity or ill disposed quality or some depravation of substance and these are the humors which I call irregular for that they are not obedient to nature and yet not altogether repugnant to nature but by some slender meanes may bee corrected and reclaimed unto a good and naturall state It followeth that these humors are either bred in the feet or by a deflux descend thereinto from some upper part When ill humors breed in a part it is through an imbecility and weaknesse of that part The strength of all parts consisteth in a naturall heat grounded and setled naturally in that part by vertue whereof there is drawn to the part a competent food to maintaine it and by it that food is concocted and converted into a profitable nutriture for the same part retaining that which is good and expelling that which is excrementitious and nought Now when this naturall heat by any sinister meanes is infirmed and weakned then do the functions of that part faile in their duty for neither can there bee good concoction in the part as should be neither sufficient expulsion of the superfluities left of that concoction in the part as should bee Wherefore three inconveniences follow through this infirmity of naturall heat First good and profitable matter is not bred in the part so affected And the bad is not expulsed And thirdly the part is made a sinke to receive the drosse of other parts Now if by some meanes an imbecillity happen to the feet that neither they breed for themselves a profitable nutriture and yet cannot expell that which is unprofitable it must needs follow that in keeping thereof they cannot bee well but ill affected This is to shew that the matter of the Gout may be bred in the feet through the weake state and condition of naturall heat appertaining unto them whereupon doth grow humorum decubitus as we terme it that is when for lack of good concoction in any part ill humors by little and little are laid up in that part which after some season either by their overgreat quantity or ill affected quality and by some depravation of their substance prove offensive and hurtfull unto that part It followeth now how the Gout may come by a deflux of some humor descending from some upper part into the feet which is in two respects For either it may proceed from the braine or from other parts in the podagricall body The deflux of an humor from the braine is called a rheume which is the mother of many diseases For somtimes it taketh course to the eyes and thereof commeth a dropping and inflammation of the eyes and a dimnesse and losse of sight somtimes it taketh course by the nose and is called the pose sometimes to the mouth and causeth great expuition and spitting and the falling of the uvula and toothach somtimes to the windpipe and therof commeth raucedo the hoarsnes somtimes to the lungs and causeth exulceration or putrifaction thereof or some great obstruction which bringeth a difficulty of breathing and strangulation sometimes it taketh course to the stomach and causeth lack of appetite and ill digestion and if to the guts then falleth out the flux of the belly called a lask somtime it setleth in the braine and groweth into a grosse and thick substance either in the fore part as in the nerves optick which are the conducts whereby the power of seeing doth come unto the eyes and causeth either dimnesse or losse of sight or in the conducts that convey the power of hearing unto the eares and there causeth a dulnesse of hearing or deafnesse or in the conducts that convey the power of smelling to the nose and cause either a lack or losse of swelling or in the conducts that come to the tongue and there doth occasion the like imperfection in tasting Also if it settle in the fore part obstructing the cels or ventricles of the braines three ill diseases do grow thereupon called three of the dead sleepes carâ—s coma apoplexia Also in the fore part it causeth a hurt to imagination The middle part of the head is the seat of understanding and reason where if this grossâ— rheumatick matter do settle it causeth stultitia foolishnesse In the hinder part it causeth the lethargy another of the dead sleepes and the palsey and the falling sicknesse and the convulsion and oblivion or losse of memory And if it come down backward into the neck it causeth a kinde of convulsion called tetanos when as the neck cannot turne to nor fro but it standeth stiffe and stark without motion If it flow downe to the back it causeth another kinde of convulsion called â—pisthotonos wherein the head and the heeles are made to meet backward If it flow forward into the muscles of the breast another convulsion is caused called emprosthotonos wherein the head and the feet are drawn together forward Now if it go to the joynts it is morbus articularis if to the hands and fingers it is chiragra if to the knees it is gonagra if to the feet and toes it is podagra the Gout And the reason why the rheume should occasion all these diseases is this The braine is the fountaine of nerves principium nervorum and in the braine are made animall spirits which do give the power of moving and feeling and are conveyed by those nerves into every part of the body so that when the braine is affected in rheumatick sort partly by them and partly by other meatus as it were passages the inferiour parts shall feele the effects of this ill disposition of the braine And between the head and the feet there is a great consent by reason of many and great nerves and veines extended directly from the one to the other so that many shall bee ill affected in their head by taking cold in their feet This deflux also which is in cause of the Gout may proceed from other places as the liver and therefore in every deflux there are foure points to bee considered The first is the mandant from whence it proceedeth The second the matter that floweth The third the passages whereby the matter descendeth The fourth is the part recipient wherein this matter setleth it selfe Now when we are to deale with a disease that dependeth upon a deflux wee must find out from whence it proceedeth what it
is and by what wayes it descendeth so wee shall the better finde a releefe to the part whereunto it descendeth And so to conclude this point the Gout is a paine of the feet depending upon some distemperature of the part or of some irregular humor either bred in the part by imbecility thereof or derived from some other part and that principally the braine which definition how it is to bee understood I have for better declaration sake verbatim expounded so that this may suffice for the first point to wit what the Gout is The second point conteineth the causes The causes of the Gout are partly externall and partly internall The externall are first too moist a state of the aire for that doth engender great store of rheum Also the use of many sorts of meats and too great ingurgitation thereof for that doth heape up great store of humors which one way or other must have a vent Also ill digestion for that doth engender ill humors Also the often use of strong wines especially fasting because they do send up many vapors unto the braine and fill it full of rheumatick matter and do withall procure a weaknesse to the nerves and sinewes whereupon must needs follow that nothing can bee worse for the Gout than to be often drunken The immoderate use of Venery is wonderfull ill for that it spendeth the spirits and decayeth naturall heat and so procureth a weaknesse to all parts of the body Also the Gout may come of overmuch sleepe especially in the afternoone and that immediatly after meat for that doth fill the brain full of rheumatick matter Also overmuch watching and fasting and study and labour and sorrow and care because they spend the body and cause a weaknesse in the parts thereof may occasion the Gout It may come also of too much rest and ease for that such superfluities are retained in the body as should bee discussed by exercise Also much walking and travell on foot because it draweth a deflux to the feet may procure the Gout Also the use of cold and moist meats as Cucumbers Gourds Lettuce Endive and such like Also it may come when any usuall evacuation is stopped for then the matter wanting an usuall vent will flow into other parts of the body And because exercise doth evacuate by sweat much superfluous and excrementitious matter the omission or long intermission of any accustomed exercise may be an occasion of the Gout Also too much cold in the feet because it dulleth the naturall heat of the part And too hot keeping of the feet because it resolveth forth the naturall heat of the part and so weakneth the feet may procure the Gout Sometimes the Gout commeth by inheritance The reason whereof is this The seed wherof conception is made is taken principally from the principall parts For the liver giveth the blood whereof it is made the heart giveth the vitall spirit whereby it receiveth life the braine giveth the animall spirit whereby it receiveth motion and sense and secondarily it is taken from all parts of the body so that if any imperfection be in any one part of the parents the inconvenience thereof often befalleth the child These and such like may bee the causes of the Gout externall and they are to be found out by the inquisition of the Physitian and relation of the patient All which do not one way procure the Gout but some by breeding the matter thereof some by procuring the deflux of the matter some by weakning the joynts making them subject to the deflux Now to come to the internall causes they are either blood or choler or phlegme or melancholy and that simply some one or moe mixed together Blood is of all humors the best First for that it is the matter or substance whereof the spirits are made wherein doe consist all actions and functions either vitall or animall or naturall Next for that it is that that doth nourish the body for it is the treasure of nature and the upholder and maintainer of life and therefore Moses said that anima omnis carnis est in sanguine the life of all flesh is in the blood This blood is made after this sort The food which we receive into our stomach is there converted into a white substance called chylus which being put over into the guts is from thence sucked out by certaine veines called venae mesaraicae which are dispersed all over the upper guts and bottome of the stomach and by them is conveyed into a veine entring into the liver called vena pâ—rta aâ—d by that it goeth to the liver wherein it is converted to blood by a peculiar property and faculty naturally given unto the liver Wherefore blòod is a humour hot and moist made ex chylo that is a substance of food concocted in the stomach being from thence and the guts by certaine veines conveyed into the liver It is after two sorts either good or bad The good is knowne first by his substance it is not too thick nor too thinne but of an indifferent substance Next by the colour it is very red Thirdly by the tast it is sweet Lastly by the smell for it is of no ill savour or sent The bad is when it declineth from these conditions and that either in respect of it selfe or of other humors mixed therewith In respect of it selfe it is sometimes not good either for that the substance therof is thicker or thinner than is convenient or because it is adust or burnt blood the thicker part wherof goeth into melancholy and thinner into choler By admistion with other humors it may bee made naught after sundry sorts in respect of great variety of many other humors as may be mixed therewith As being mixed with melancholy it is made thick and grosse and black being mixed with phlegm it is made cold and whitish with choler it is made thinne and pale or yellowish and hot and fretting and bitter And being mixed with putrified humors it is wholly corrupted in substance in colour in taste and is of an ill savour This blood amongst the rest is one internall cause of the Gout when as it is good but in too great quantity whereof I have given a reason before but most of all when it is bad either in it selfe or by admistion with other humors for being once made in the liver it is put over into a great master veine out of the which a great multitude of other veines some big some lesse do ramifie whereby this blood is conveyed into all parts of the body and such as it is good or bad so doth it affect the parts of the body either in good sort or in bad The second internall cause of the Gout is the humor phlegmatick which is next unto blood for that it is indeed a crude or inconcocted blood and
such as are subject to the Gout it shall bee best most to exercise with the upper parts to pluck back such humors as are ready to take their course downward As by listing of weights or by tossing a ball at a wall or by shooting or having a pully with a cord put into it and a little stick tied at each end and so holding each stick in each hand to reach up and down and to swing up and down In this case I take this to be a most excellent exercise But to exercise the feet overmuch or the legs will but draw humors unto them Now for rest and ease and too much sitting still it heapeth up great store of superfluous matter fit for the Gout and dulleth naturall heat and maketh the body heavy and unweildy wherefore it must not be used too much in this case Another point in this preservative diet concerneth all such things as should be retained in the body and such as should bee put forth For the first any great bleeding is hurtfull for that it decayeth naturall heat and weakneth the body too much And oft sweating is not good for sweat being but an excrement must bee avoyded in a competent quantity and time convenient for otherwise it spendeth the good humors of the body and drieth and weakneth the body too much Hereupon often and immoderate Venery is discōmended for being used as it should bee it lightneth the body and cheereth the senses and edgeth the stomack and gladdeth the minde and this is when it is used upon a fulnesse of seed then nature being disburdened thereof as of an unprofitable matter it is greatly releeved and lightned But to doe it more often it doth occasion a great decay unto the principall parts and to the rest for that from them that matter is taken whereof the seed is made as I have declared before To have a continuall lask is in this case hurtfull also and any such evacuation as wasteth the good humors and spendeth the spirits and enfeebleth naturall heat or weakneth the body or any part thereof As those things should bee kept in the body so some things there are which should be put forth as emission of urine and an orderly going to stoole and a competent sweating and such like which being under the name of excrements they are unprofitable to nature and therefore nature should use thereupon the power of expulsion which if of it selfe it do not then it must bee releeved by art And here it is very hurtfull to have the belly costive for it doth force up to the braine great store of vapors and fils the body otherwise full of bad humors wherefore such a one must now and then bee dealing with some gentle mollitive clyster or other medicine it must bee gentle and not too often lest wee make nature too slothfull and then it will looke for a stronger and that more often Now remaineth the last point of this preservative diet which conteineth the passions and the perturbations of the minde wherein wee shall do well enough if we give our selves to be merry avoyding pensivenesse sorrow and care not giving our mindes to great meditation and matters of study but using our time of recreation solace and pastime Which counsell Benedictus Victorius doth give to all sick men and whole men Laetetur saith he praesertim cum medico crebrò offerendo illi pecunias citius quoniam sanabitur Thus farre forth I haue discoursed of the preservation from the Gout by order of diet Somewhat remaineth to bee set downe in respect of medicinall matters for twice in a yeere we are to use some evacuation to disburden the body of such superfluous matter as may occasion the Gout for few men do live so temperately but that they heap up sufficient matter for many diseases if by good meanes it may not bee prevented And this evacuation is cheifly to bee used at the Spring and at the fall At the Spring because the Sunne rising to some elevation hath more power upon these inferiour bodies so that the blood and humors are stirred and begin to flow and to bee dispersed so that they search every place and if they finde any one weaker than another there they settle themselves causing either inflammations or Gouts or some one imperfection or other Now the Autumne is a bad time of the yeere which of it selfe by the ill disposition of the ayre and autumnall fruits doth engender many bad humors which humors are also then apt for defluxes by reason the passages are dilated and opened too much by the former heat of the Summer wherefore at this time of the yeere prevention must bee used in taking away this defluxible matter And this is to bee done by purgation wherein the Physitian is to consider the humor like to offend the age of the person and his complexion and his manner of diet and custome of life and strength of his body and accordingly to determine what is to bee purged and by what things and by what waies and how much or little If blood be like to offend then that is to be let out If choler then that is to bee purged so likewise if phlegme or melancholy or if mo humors are like to be mixed and to concurre then in our purgation wee must lay for them and using such purgatives as do respect them and convey them out of the body And these purgative medicines must not be too strong for that such do stir the humor too much and cause an attraction or deflux thereof unto some part which is weakned by that strong and violent evacuation Montanus doth alwaies avoid them giving this reason quia destruunt munera virtutum that is they destroy the very foundation or groundworke of naturall operations and functions But here we may use a distinction of purgative medicines some are called lenitives only as Cassia Manna small raysins damask prunes great raysins tamarinds syrup of roses and violets solutive and such like which are most gentle in working and if they work not are not unwholsome for that they turne into no ill humor Some are called benedicta medicamenta which are stronger in operation than the former and yet are but milde and gentle because they cause no great disturbance in working and if they worke not they turne into that humor which they should have purged such are Rheubarb Agarick Sena the five sorts of Mirabolans and such like The third kinde is called vehementer purgantia such as purge vehemently as Turbith and Hermodactill c. The fourth are called deleteria medicamenta because they have a venenosity and do purge most extremely as Scamony Coloquintida Heleborus Elaterium Stibium c. which require to be most exactly corrected for the great danger they bring and therefore of themselves they are seldome given but being compounded and mixed with others and that in no great