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
the nerves and sinewes And with meat that drink must be taken that will not hasten the meat out of the stomacâ— before it bee digested but white wine will do so for it is a drink not of concoction but of distribution Lastly at supper and at night if it bee to bee taken it will replenish the braine full of vapors and rheume for as of it selfe it is too apt to ascend so by sleep it will bee drawn up in more plentifull wise Betweene meales it is naught for it carrieth the remaines of the former concoction into the reines and kidneis to breed matter for the ague and for the stone wherefore I do not like of white wine but in the way of medicine being taken in some little quantity with some other things for some purpose Claret wine may be taken in moderate sort being neither too old because it peirceth too much neither too new but of a middle age being sweetned with sugar for then it peirceth not so much The sweet wines as Muscadell Malmsey Bastard are condemned They do fume too much to the braine If a good stomack can digest of it selfe it needeth no Sack but if occasion bee to use it it should be taken at supper before meat and at dinner in middest of our dinner for to drink it after our meat it is most hurtfull for that directly it fumes up to the braine and causeth indeed more speedy distribution than should be Now for the quantity of our drinke it must not bee so much as to make the meat swim in the stomack for that corrupteth the meat and carrieth it out of the stomack before it be concocted and if it be too little then will the meat burne in the stomack for lack of moisture so there must bee a moderation used herein wherefore these great tiplers offend much and breed their owne woe albeit I will not deny to out-lash now and then is not amisse especially if good evacuation by vomit or stoole do ensue As for the quality of our drink I have partly set downe before it must not be too stale neither too new but of a middle age well brewed and cleere with no sowre taste drinks of too hot a quality are not good as bragget which is made of ginger galingale and graines and cloves hung in a bag in the drink when it is new Alacras which is ale compounded with nutmegs and ginger and cinamon and sugar may bee permitttd sometime Ipocras is too hot a fellow I have before condemned small drink Some thinke that ale is better than beere because that beere doth fume more by reason of the hop And indeed wee finde by experience that ale is lesse rheumatick than beere and it is a more milde and temperate drink whereas the hop doth cause the beere to bee hotter and because it hath a power to open the liver and spleen and to digest cold matter in them and the braine and other places it becomes a greater searcher and stirrer of humors than ale The time when we should drink is cheefest with meat and the order to bee observed therein is first to eat and then to drinke and eating againe to drink againe observing an indifferent proportion between both As for drinking at unseasonable houres it is not commended in Physick especially for such as feare a deflux I have wrot of two points to be rightly observed in this preservation the ayre and food The next is how wee should order our selves in sleeping and waking We are not to sleep at all in the day time especially soon after meat except in the night we have taken no good rest And if wee do sleep we must observe these rules first that we sleep not immediatly after meat but use some intermission The second that we doe not lie down nor hang down our head but sit upright in a chaire The third that we take but a nap The fourth that wee bee not of a sudden awaked Also wee must put off our girdle and undoe the fore point and unbutton our dublet below all the belly And one giveth counsell to put off the shooes because that from the feet a reflex of vapors will strike up to the braine and hurt the eyesight and memory Our naturall sleep must bee in the night about two houres after meat first using some paces up and downe our chamber and lying downe first on the right side and then turning to sleepe on the left with our head lying somwhat high and covered with some night-cap having the windowes shut and other defences against the cold and moist ayre of the night To sleep upon the backe is hurtfull unto the kidneies and the ridge of the back And to sleep grovelling upon the belly is naught for the eyes How long wee shall sleep must bee measured by our concoction for if wee awake after five or six houres and finde our stomack lightsome and empty then have we slept sufficiently One Author giveth this rule that to sleep lesse than five houres is too little and to sleep seven houres is well but to sleep nine houres is too much so commonly seven houres may be sufficient In the night when we awake we must use to make water for that will be a good preservation from the stone in the bladder To watch much is hurtfull for it hindereth concoction it spendeth the spirits it decayeth naturall heat and it drieth the body it engendreth rheumes it weakneth the braine it hurteth the eyesight and is an enemy to all naturall animall and vitall operations and functions Now commethin another point in this preservation to wit what we must do concerning the moving or resting of the body and generally it is to be observed that exercise is good for all sorts of persons It reviveth and stirreth up the naturall heat and it strengtheneth the joynts and causeth expulsion of superfluities It maketh the body lusty and lightsome It is to be used for two purposes either to make the body fat or leane if to fat it then it must bee done ad ruborem untill the colour wax red if to make it leane then it must be done ad sudorem untill the body sweat this is for fat folks the other for leane The place should bee cleane and sweet the ayre pure and good for that in exercise our pores are open and wee breathe faster and thicker so that store of ayre doth enter into us which being not good may do us much harme For the time when we should exercise it is to be noted that upon meat wee should rest for exercise doth bring out the naturall heat from the stomack and so doth hinder concoction and procure raw humors wherefore the morning is best or in the afternoone when concoction is done There are sundry sorts of exercises which I will not speak of in this place for it would be too long But for
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