such like wee are to descend to the cure The Gout when it commeth of blood requireth some things inwardly to bee given and some things to bee done outwardly The order of both is after this sort First wee must give a lenitive medicine either by clyster or potion or in a solid substance which must be such as stir not the humors too much for that will encrease the deflux as by the mouth may bee given Cassia and Manna and the syrup of roses solutive or such compounds as consist of these and the pulp of damaske prunes and tamarinds and such like Next it is good to let blood especially at the first beginning of the Gout for that doth evacuate the matter thereof and the blood must bee let on the same side whereon the Gout is as if it be in the right foot wee must let blood in the right arme in the liver veine which by way of revulsion and plucking back the blood that is descending doth good And here Galen reporteth that by letting of blood in the spring in such as have been oft taken with the Gout hee hath preserved them from it a long time And Aetius is of the same opinion counselling not at the spring only but more often to let blood But Paulus Aegineta thinketh that such as are often troubled with the Gout shall receive more harme than good by letting of blood especially if the body be but of a weak constitution and inclining to a colder state And Alexander Trallianus is of the same opinion wherefore it must rest in the wisdome of the Physitian to consider of the state of the body and age of the person and times of the yeere and such like circumstances which may give him warrant for his action Next we may use some purgation if need bee so it be gentle And wee must apply to the foot somewhat to strengthen the part and to put back the deflux and to mitigate the paine To this purpose at the beginning of the fit wee do use old wine-vineger mixed with oyle of roses especially if the paine be setled any thing deep in the joynts for the vineger doth penetrate and having an astringent property doth strengthen the part and because it is cold in operation it doth repell the deflux and the oile of roses doth both comfort the part and mitigate the paine If the paine bee not grounded so deep and the inflammation not great then we must use oyle of roses and a little white wine in sommer not warmed in winter made a little warm And a stronger than this is to take of the pill of the Pomgranate and Sumach and Sengreen boyle them in water and vineger and adde thereunto the flower of barly or beanes and some oyle of roses and apply it unto the part Also a Pomgranate if it be boyled and brayed in a mortar is of it selfe good to bee applyed Also it is good to take of Goats milk and Ewes milk and boyle therein some flower of barly or beanes and some of the flower of Fenygreek seed or crummes of white bread and mix therewith the yolks of egges and the oyle of roses and a little saffron and vineger which must be applyed and often changed Also take Quinces well boyled and bray them in a mortar with the crummes of white bread and oyle of roses and apply it When the part must be washed wee must not take water only but water and vineger warmed or the decoction of some astringent thing Now when by these meanes the deflux is wholly restrained and the paine somwhat ceased then wee may apply things to resolve out that which is descended into the part affected Such are the oyles of white Lillies of Camomill of Dill either applied so or with a little virgin-wax made in forme of an ointment or the decoction of them with Mallowes and Hollyhock leaves and roots and the seeds of Fenygreek and Linseed with which decoction it shall bee good to bathe the part and the residence of the decoction being beaten in a mortar into a pulp with a little oyle of Roses and Camomill and Dill mixed together will bee good to bee applyed unto the part Much more might bee added unto this cure but it would be too tedious and I must expresse many things in Latine termes which would be obscure Wherefore I passe over unto the cure of the Gout proceeding of choler And first for the diet the ayre must be inclining to moisture and cold rest and sleep are to bee used for watching and labour are naught for that they increase the heat and cholerick quality of the humor in which sense abstinence is alike naught Wherefore it shall bee good for the patient to take his meat as a Ptisan or the pulp of a Ptisan or a Chicken boyled with Lettuce and Endive and Succory or other cold herbs Boyled meats are better than rosted Albeit Capon Hen Pullet Fesant Partridge Blackbird rosted are allowable In a cholerick state Fish is not disallowed so it bee such as do feed in sandy and gravelly water Some fruits are not forbidden as Pomgranate and Peares and Cherries and such as have some little astriction The drinke must bee small wherefore wine in this case is most hurtfull In meats and drinks that moderation must bee used as that the stomach be not overcharged As in the former it was tolerable to use but little Venery so here it is altogether forbidden It is also most hurtfull to bee angry and testy for it inflameth the humor and stirreth it more wherefore all meanes must bee used for musick or pleasant conceits to delight the patient These for the diet The administration of medicine hath this kinde of method First it shall bee good if the belly be too costive to use an emollitive clyster or some of those gentle things prescribed before as Cassia Manna syrup of Roses or Violets solutive or sugar of Violets or the pulp of Tamarinds or such like which work upon choler in gentle wise neither stirring nor heating the humor Then it shall be good to use a vomit as with warme water and vineger or syrup of Acetose or Oxymell mixed together and drunk for that by revulsion may do good by plucking back the humor descending Next some for the same cause do let blood but that must bee done with circumspection for that the blood is a bridle to choler repressing by the moystnesse thereof the drynesse and heat and acrimony of choler Wherefore therin the Physitian is to use good discretion whether in the person affected it shall be so expedient or no. After this the cholerick humor which causeth this Gout must be repressed somwhat that is his acrimony heat and fury must bee abated by cooling potions as of Endive and Succory and Lettuce and Violet leaves and Strawbery leaves or such like either decocted or made in syrup and taken with barly water or the boyling of a Chicken
or some other convenient liquor This being done the humor is to be purged with Rheubarb yellow Mirabolans and some of the former contrived into a potion As take of the decoction of cold herbs or of the distilled water of Endive foure ounces infuse therein all night two drammes of Rheubarb and of the yellow Mirabolans one dram in the morning straine it and expresse it som what then adde thereunto of Cassia one ounce and an halfe of the syrup of Roses solutive two ounces mixt altogether and drinke it in the morning fasting abstaining to eat by foure houres after then take some of the broth of a Chicken if the deflux continue then the purpation must bee taken againe untill the cause be somwhat stayed Next hereunto must bee used locall medicines to strengthen the part affected and to coole it and to appease the greife that the part abideth Take oile of roses the yolkes of two egges and a little vineger it shall both coole and comfort and mitigate the paine Or take the juyce or decoction of cooling and astringent herbs as of Plantaine Polygonum Sorrell Purslaine Nightshade Singreen or such like which being grreene and stamped in a mortar may bee applyed to the part for the cooling thereof and repelling of the humor If hereunto bee added some oyle of roses and some barley flower it shall bee better Also the seeds of Psyllium being boyled in water and brayed in a mortar untill it come to a pulp with the flower of barly and so applyed to the part doth in excellent sort both coole and mitigate the pain Aetius reporteth of one that being in most intolerable pain of the Gout put his feet into cold water and received singular reliefe The pulp of Cassia with the powder of Camomill flowers is well commended to be applyed to the part Now if the paine be so outragious that nothing can asswageit then we do use some things to dull the sense of the part which are to bee used with great circumspection Such are Henbane and Poppy and Hemlock and juyce of black Poppy called opium This must bee used in little quantity and must not lie long to the part And when the part is amended then some warme things must bee applyed to recover the cold disposition which by these extreme cooling things is got into the part Now to come to the cure of the Gout proceeding of a phlegmatick humor And first for the diet The aire must be hot and dry whereunto if the time of the yeere doe not serve then it must bee procured by art Much sleepe is not good but some watching is better because it doth dry And for the same cause fasting is good in this kinde of Gout moist meats are hurtfull as Veale Lamb Pig Conies and such birds as are rehersed before are better Fish is not good but if it bee taken it must bee boyled with Hysop and Thyme and winter Savory and some such hot dry herbs to correct the moistnes therof Wine is forbidden but yet it may be best tolerated in this kind of Gout All fruits cold herbs must be avoyded The manner of cure is to procure a vomit if the patient be apt thereunto and do it with some facility Next the humor must bee prepared with such things as doe extenuate and rarifie the humor as hony made with roses and hony made with vineger called oxymell or with the syrup or decoction of staechas and betony and such like Then must the humor bee purged with such purgatives as do respect phlegm as with Agarick and the seeds of Cartamus and the great Mirabolans and Diaphenicon and Electuarium Indum and such like infused and mixed in a convenient liquor After purgation if the person do much abound in cold humors it shall bee good to give him Treacle or Mithridate After this wee may come to the locall medicines which in the beginning must bee somewhat discussive and more astrictive in the encrease of it they must be lesse astrictive and more discussive and in the very rigor thereof they must be such as ease the paine and discusse and in the declination they must be wholly discussive to resolve out that matter which by deflux is descended into the part But therein this observation must bee used that things of too hot operation bee not applied for the thinner part of the humor will be resolved and the grosser will grow into a hard substance whereof commeth that incurable Gout called nodosa the knotted Gout Wherefore in the beginning it may bee good to take Thyme and Penyrioll and winter Savory with Mallowes and Holly-hocks the roots of white Lettuce and Fenygreek and Linseed boyle them in sharpe vineger and being throughly boyled take of the decoction poure it upon the part and also bathe it therewithall In the encrease Neats dung or Goats dung with barly meale and Barrowes grease all mixed together over the fire with a little vineger being applied to the part will do it good In the vigor this may bee used take the oyle of white Lettuce and the oyle of Roses and oyle of Camomill and Dill and some May-butter and of Deare-suet and of Ammoniacum and Galbanum dissolved in vineger and with wax make thereof a plaster and lay it upon the part If there bee no great heat in the part it may be made stronger In all sorts of Gouts some do use a defensive of bole armoniack and whites of egges binding it hard below the knee to straighten the passages whereby the deflux descendeth and so to prohibite any further deflux as in the toothach by a rheume wee use a plaster to the temple to prohibite the falling down of the rheume To this kinde of Gout the Bath is most good especially when it declineth for otherwise it may be too hot and so procure a greater deflux and augmentation of heat Also Snailes being brused in a mortar and layd to the part is excellent good Take of Castory and Frankincense of the marrow of a Hart and of Goose grease of the oyle of Dill and Nard oyle of Baellium and Galbanum dissolved in vineger and of the meale of Linseed and Fenygreek and so much Vigin-wax as will serve to make a stiffe plaster This doth resolve very well as many mo which I omit to set downâ— because it would be too long When the Gout consisteth on a melancholy humor which chanceth seldome then the diet must be accordingly prescribed As the ayre must incline to moysture and heat sleeping and watching must be in moderate sort The meat must be of the best as Partridge Fesant Capon Chicken and such like All wilde fowle is naught as also Venison Hares flesh and Beefe and all salt and burnt meats Such fish as doth live in gravelly sandy and stony waters being boyled with some of the hot herbs and Burrage and Buglosse is not
amisse Vineger and all sowre sauces and drinks are not good for that they turne to melancholy It is most hurtfull herein to be sad and carefull Concerning the cure Neither this humor neither the former of themselves require any emission of blood for that the state of those bodies which they possesse is already too cold but if it chance to be mixed with blood then at the very beginning it shall bee convenient to let blood premising some solutive clyster or lenitive medicine Next the humor and body must bee prepared with such syrups or decoctions as do respect melancholy as with Burrage and Buglosse and Fumitory and tops of Hops and Cetrach and such like Then the humor must bee purged with such purgative medicines as respect the humor as with Sena Polipody the black Mirabolans Epithymum with Catholicon and if need be Diasenâ—a and confectio Hamech When as the humor is somwhat stayed by purging then must we come to locall medicines which first must be to repell next to resolve Such as repell must bee moderately hot because the humor is cold of it selfe as the leaves of the Terebinth tree and of the Cipres tree and the roots of Cyprus boyled in vineger wherewith the part is to bee bathed To resolve this or such like may do well Take of the tender Bay leaves and of Camomill Dill Penyrioll of Basill and the roots of the Flower-de-luce boyle all together and with the water bathe the part and stamp the herbs into a pulp whereunto adde the flower of Barly and Fenygreek and Linseed with some Capons grease or oesipus or Goose grease and May-butter and apply it warme to the place and so change it often And if one thing cannot doe good wee must devise some other for it falleth out oftentimes that some one thing may doe good at some times and sometimes it can do no good and being applyed a little while it doth good and being longer to the part it doth harme Now if the Gout come not of any severall humor but by the mixture of mo then is there a great discretion to be used of the Physitian either to judge of the predominant humor or of the manner of their mixture and accordingly to apply his remedy As if choler or blood or phlegm or melancholy be predominant then the medicines or cure must cheifly be appropriated to that somewhat respecting the rest or if there be an equall mixture of all which doth seldome befall then there must be such a mixture of things for the cure as shall respect all not doing harme to any but good unto all And this makes the Gout so hard to bee cured for if in a deflux one only humor would descend we should easily know it and sooner amend it but it falleth out for the most part that one brings downe another and mo do concurre and such as are of a contrary nature as choler and phlegm then groweth it out to bee hard both to judge of the cause and determine of the medicine for that that doth good to the one may do harme to another Thus in rude manner I have gone over the Gout first shewing the nature and essence thereof Next in giving the causes thereof Thirdly in delivering the signes whereby each cause is to bee known Then in discussing whether it may bee cured or no. And lastly what method or kind of cure is convenient for the Gout in respect of such causes whereof it proceedeth Now because hee that hath once had the Gout and he that feareth lest he shall have it would gladly have some meanes how to avoid it It remaineth that I set down an order of preservation which albeit I cannot do so absolutely for that it must cheifly be referred to the person affected so that one only rule cannot serve all because we are not all alike in constitution in diet and such like yet I will endevor a generall order which shall bee good for all such to observe as would bee willing to avoid the Gout And first in these diseases that are reciditive and chronicall long lasting diseases the the cheifest and principall point is to observe a good diet This diet must concerne certaine points first that it bee such as doth not breed distillations and rheumes Next that it bee such as doth not frait the body too full of humors Thirdly that it be such as doth not breed any weaknesse in any principall part or in the joynts To these purposes first we must take choice of the ayre avoyding a moist and cold situation as by some river and standing poole or marrish ground or moted habitation Cloudy or rainy and misty weather is naught wherein we must keep within and keep a good fire Hippocrates saith that the Southerne winds do fill the braine full of rheumatick matter because from the meridionall point they blow crosse over the seas and by the vapours thereof are made moist so that being hot of themselves and moist by the sea they become unwholsome disposing things to putrifaction and filling them with too great store of moisture wherefore they in this case must bee avoyded A cleare ayre wherein the Sunne shineth the wind standing somwhat Eastward or Northward is best In meats and drinks wee must observe certaine points as the substance the quantity the quality the time of taking them and the order how they are to be taken First for the substance the meat should bee of a good substance breeding good humors and of no hard digestion as Mutton Veale Capon Chicken Partridge Feasant Pullet Rabbet Wilde fowle is held but of a grosse substance but Woodcock Snight Mallard Teale Whinder Heathcock and generally such as have the whiter flesh may be taken but Goose Duck and such as are of a black flesh are reproved Beefe is of a hard grosse substance Hart Hinde Buck and Doe are the like And because they are prepared with much pepper and salt and thereupon wee poure in great store of wine they procure much inconuenience Salt meats breed no good juyce nor humor Fish is a moist meat but being such as wee call petrosas or saxatiles that live by rocks or upon gravelly waters being boyled with some of the hot herbs Whiting-gurnat Haddock are good Sammon if it bee boyled in water and vineger with rosemary may bee eaten Pike is not amisse especially if it bee taken in a scowre or put into a stew to be clensed So Bream and Carp should be used and generally such fish as live in muddy or in grosse water either is to be rejected or to bee corrected in the keeping or dressing Herbs breed no good substance especially in our Climate for that the heat of the Sunne is not sufficient to concoct their watery moisture and to bring them to a perfection wherefore wee use them for sauces and not for food Some roots may bee good as Carrot Skirwirt and the Parsnep if hee