Gutta podrica: a treatise of the gout The severall sorts thereof. VVhat diet is good for such as are troubled therewith. And some approved medicines and remedies for the same. Perused by P.H. Dr. in Physick. This text is an enriched version of the TCP digital transcription A02409 of text S103571 in the English Short Title Catalog (STC 12539). Textual changes and metadata enrichments aim at making the text more computationally tractable, easier to read, and suitable for network-based collaborative curation by amateur and professional end users from many walks of life. The text has been tokenized and linguistically annotated with MorphAdorner. The annotation includes standard spellings that support the display of a text in a standardized format that preserves archaic forms ('loveth', 'seekest'). Textual changes aim at restoring the text the author or stationer meant to publish. This text has not been fully proofread Approx. 101 KB of XML-encoded text transcribed from 28 1-bit group-IV TIFF page images. EarlyPrint Project Evanston,IL, Notre Dame, IN, St. Louis, MO 2018 A02409 STC 12539 ESTC S103571 99839322 99839322 3731 2240896984

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Early English books online. (EEBO-TCP ; phase 1, no. A02409) Transcribed from: (Early English Books Online ; image set 3731) Images scanned from microfilm: (Early English books, 1475-1640 ; 1069:12) Gutta podrica: a treatise of the gout The severall sorts thereof. VVhat diet is good for such as are troubled therewith. And some approved medicines and remedies for the same. Perused by P.H. Dr. in Physick. Holland, Philemon, 1552-1637. Holland, William, 1592-1632. [6], 49, [1] p. Printed by Thomas Harper, London : 1633. Sometimes attributed to William Holland. "P.H." is probably Philemon Holland, the editor. Running title reads: A treatise of the gout. Reproduction of the original in the Folger Shakespeare Library. eng Gout -- Early works to 1800. eebo Gutta podagrica: a treatise of the gout. The severall sorts thereof. VVhat diet is good for such as are troubled therewith. And some approved medicine [no entry] 1633 56 19773 30 0 0 0 0 0 15.17 C The rate of 15.17 defects per 10,000 words puts this text in the C category of texts with between 10 and 35 defects per 10,000 words. 2003-04 Assigned for keying and markup 2003-05 Keyed and coded from ProQuest page images 2005-03 Sampled and proofread 2005-03 Text and markup reviewed and edited 2005-04 Batch review (QC) and XML conversion

Gutta Podagrica : A TREATISE OF THE GOVT . The severall sorts thereof . What Diet is good for such as are troubled therewith . And some approved Medicines and Remedies for the same . Perused by P. H. Dr. in Physick .

LONDON , Printed by THOMAS HARPER . 1633.

TO ALL HONORABLE , Reverend , and Worshipfull Lords , Spirituall or Temporall , Ladyes , Knights , Scholars , Gentlemen and Gentlewomen , of any degree , that are unwillingly acquainted with this frequent disease , especially of the Podagrick Gout : The Publisher hereof sendeth greeting .

BFloved , the disease commonly called and usually felt and knowne , Podagra , or as a learned Writer saith , Gutta Podagrica , is ( as I may say ) a slie , subtile , and theevish Serpent . Which I prove ; first , a slie and subtile Serpent , in as much as it creepeth not only into the Courts and secret Closets of the greatest Potentates and Princes of Christendome , but of the whole world , and their subordinate Magistrates , in Church and Commonwealth ; and so consequently to the meanest subject : some say the Rich rather than the Poore . And some this Serpent biteth by the heele , and some by the foot , some by the great , and othersome by the lesser toes , and otherwhiles by the anckles . Secondly , it is theevish , for that it commeth alwayes unawares , before it is thought on , or expected : yea , it commonly commeth as a theefe in the night . Now what it is by definition , our learned Author saith sufficiently in the Discourse following : And certes , if I my selfe were a professed Physitian , I should not be of Paracelsus his minde , who saith , that this Podagra is a gravell gathered between the joints , whereby the Gout is called And however it be , it is a disease subject to such as are of sedentary and studious lives : i. e. that sit much : as Councellours of Estate , Senators of Cities , Bishops , Iudges and Scholars , ( that study much ) do : Nay , may we not sometimes see that even men of active lives and dispositions are surprized with this theevish serpenticall disease . For the benefit therefore of the Commonwealth , this Treatise not unlearnedly written , I hope is not unprofitably published : Especially considering , the like , to my knowledge , is not extant , either in English or Latine . I had it not many moneths past , from the hands of one neere and deere unto me , who is since dissolved , and I hope in Heaven : And sithence it hath beene perused by one more neere and deere unto me , an ancient Professor of this Apollonian Art . Vouchsafe therefore yee Lords , Ladyes , or of what degree soever , unto whose hands and sight this , though a Pamphlet , shall happen to come , to accept candidly , what is courteously , and not without some cost , published for you benefit .

And so I betake you all to the supreme Physitian of body and soule : and of you take my leave .

Vale & fruere . H. H.
A TREATISE OF THE Disease of the GOVT . The severall sorts thereof , &c.

THE word ( GOVT ) hath two significations . The first distinction of the word Gout . The one generall ; the other particular . Generally , all such aches as are incident to any joynt , wee call the Gout ; whereas in nature and deed they differ not ; but only in respect of the part affected : and in respect thereof , they are distinguished in name . As the ach in the fingers is called Chiragra ; the ach in the knees is called Gonagra ; the ach in the hip is called S●●a●ica ; in the ankles ( some terme ) Talia I●alaria ; and the ach in all the joynts is called Arthritis , i. morbus articularis ; which is the generall name to all aches and greifes of the joynts . Particularly the word Gout is taken for the paine and griefe only of the feet , and from thence it assumeth a name distinct from the rest , Podagra , quasi pedum captura vel aegritu●o , the disease of the feet , 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 , sive 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 It hath also two other significations , The second . the one proper , the other common . Properly the Gout is taken for a grievous paine in the joynts of the feet , preceeding either of some distemperature in the part affected , or of some humor bred in the part by the weaknesse or ill disposition thereof , or by the deflux of some humor descending from some other upper place unto that part . In the common signification all other aches proceeding of what cause soever may bee called the Gout : such as come by contusion or brusing , or by dislocation of a joynt : and so the French disease having an untolerable ach in the limmes , like a false fellow , being ashamed of his owne Morbus Gallicus , i. Lues venerea . name , termeth it selfe sometimes by the name of Ach or Gout . In this slender Discourse of the Gout , I will entreat of that which is particularly appropriate unto the feet , and properly is called the Gout . In the explication The generall proposition . whereof , I will first declare what the Gout is : Next what are the causes thereof . Thirdly , by what The generall division . signes each cause is to be knowne . Fourthly , whether it may be cured or no. Fiftly , what kinde of cure belongeth unto it . And lastly , how a man may bee preserved from it .

Concerning the first . The Gout is a griefe of the feet , occasioned by some distemperature , or irregular The definition of the Gout . humor , which either is bred in the joynts of the feet , and toes , by some weaknesse thereof , or by deflux hath descended from some upper part thereunto . That the nature of the Gout may the better appeare , I will verbatim expound this definition . First it is a griefe or paine . A griefe ( as concerning this purpose ) is occasioned after foure sorts : Either by way of oppressing a part , when as a grosse humor weighing downe a part Foure sorts of griefes . ponderously , causeth it to greeve in bearing the burden thereof : such kinde of griefe proceedeth of a phlegmatick , and melancholick humor , because they are heavy and weighty . Another kinde of griefe commeth by way of distention , when as the veines , and sinewes , and arteries of some one part are fuller than they should be , then is that part greeved by distention . This kinde of griefe commeth sometimes of winde , and sometimes of fulnesse of blood , and of humors . Another kinde of greife proceedeth of a distemperature of a part , as when it is colder or hotter than it should be , because each part doth rejoyce in its naturall state , and an unnaturall is greevous unto it : such kinde of greefe commeth of inflammations . The fourth kinde of greefe is by way of erosion , when as the part affected doth feele a greevous gnawing and fretting ; which kinde of greife commeth either of a cholerick humor , or else of a corruption and depravation of other humors . Now to apply : The Gout is a greife in some by The application of this fourefold distinction . way of oppressing the part ; when as it commeth of a cold humor , and this kinde is incident most to old men , who abound in cold humors , by reason of the decay of naturall heat . Also the Gout is a greife in some by way of distention , whereas the body being replete with abundance of humors , the upper and stronger parts put downe their offending fulnesse unto the lower , which descending , the veines , and sinewes , and arteries procure this paine of distention . This kinde of greife is incident to men of middle age , and such as are of a sanguine complexion , and do use a full diet , with little exercise and much rest Thirdly , the Gout is a greife in some by way of distemperature , and this doth fall out as occasion is offered , as some by standing long in cold water , may have the Gout by reason of a cold distemperature , which is wrought into the part by the cold water . And some by much travell on foot in hot weather , may have the Gout by reason of a hot distemperature procured unto the feet by overmuch travell and heat . Lastly , in some the Gout is a greife by way of corrosion , not that it eateth the flesh , but in that it gnaweth and fretteth , that the patient somtimes thinketh that dogs do gnaw his bones . This kinde befalleth cholerick persons , and such as use an ill diet , breeding in them store of ill humors . So is it evident that the Gout is a greife , and what kinde of greife , which is profitable to him that will give help thereunto , for by the manner of the greife wee come unto the cause thereof , and so accordingly apply the remedy . It followeth that it is a greife of the feet . There are foure reasons why the feet are more afflicted Foure reasons wherefore the feet are subiect to the Gout . with these greifes than other parts are . First in respect of their place , for that they are the lowest parts in the body , the upper put downe their superfluities to them , where they remayning , procure in some one manner or other ( as is before specified ) a paine . The second cause is , for that the feet are not of so compact or solid substance as some other parts are of , but have a thinne composition , with many void and empty receptacles , and therefore in more abundant sort do receive and reteine the superfluities of other parts . The third cause is , for that the feet are more in motion than other parts , and the nature of motion is , to make attraction of humors unto the moved part , and consequently a paine . The fourth is a debility naturally incident more to the feet than unto other parts ; for that they are situate farthest from the fountaine of heat , which is the heart . They also consist of such substance as is of a cold complexion ; so that both for lack of the comfort they should have from the heat of the heart , as also in respect of their owne composition , the feet are weaker than the other parts , and the weaker goeth still to the wall : for they receive the annoyances of the stronger , because they are not of strenght to resist : and therefore must of necessity yeeld to their paine . Now why in the Gout the feet should feele such greevous paine , Wherefore in the Gout the feet should suffer paine . this is the reason ; for that they consist of many joynts , and have for their motion and sense many nerves , which are the instruments of motion and sense ; whatsoever part is most neruous , is also most sensible : and therefore the feet upon any little offence , are pained or greeved the more . Another reason is this , that about every joynt is wrapped a skinne , and when as a humor hath insinuated it selfe betweene that and the joynt , in distending of that , untill it bee resolved , it worketh an intolerable greife ; and it is so hard to resolve it , as that sometimes it doth indurate or grow into an hard substance , which is called nodosa Podagra , the knotted Gout . And these two causes of the dolorous state of the feet , are accidentally growing from the part it selfe affected . In respect of other causes I have given other reasons before in the fourefold distinction of greifes . Now it doth follow that this greife in the feet is occasioned by some distemperature . There are eight sorts of distemperatures ; foure simple , and foure compound . There are eight sorts of distemperatures . The foure simple are , too hot , too cold , too moist , too dry . The foure compound , too hot and dry withall ; too moist and cold withall ; too hot and moist ; too dry and cold with all . And these inequalities come by The causes thereof . reason of some unequall mixture of the foure elements in us , and the dominion of some one or other above the rest . The foure elements whereof wee are compounded are , the fire , the ayre , the water , the earth : The foure elements . the element of fire is hot and dry , the ayre hot and moist , the water cold and moist , the earth cold and dry . Of these foure mixed together come the foure temperaments or complexions . The cholerick hot The foure complexions , and whereof they proceed . and dry , where the fire hath the dominion : the sanguine hot and moist , wherein wherein the ayre hath the dominion : the phlegmatick cold and moist , wherein the water hath the dominion : the melancholick , wherein the element of earth is predominant ; and of these foure temperaments come the foure humors , to The foure humors , and whence they proceed . wit , choler , hot and dry ; blood , hot and moist ; phlegm , cold and moist ; melancholy , cold and dry . Of these foure humors are framed and maintained all the parts of mans body , so that if they offend either in the first composition in any inequality , or after , by disorder of How a distemperature may befall any part . diet be made unequall , then do they breed either in the whole , or in some part , the like inequality . And hence it commeth that we have hot and dry diseases , as Fevers : and we have cold and moist diseases , as the Palsey , Apoplexie , the falling sicknesse , and divers moe : also we have diseases of the blood , as inflammations : and likewise of melancholy . Which all diseases , as some in some one part , and some in some other , may come of the distemperature of the same part , so the Gout may also come of a distemperature in the feet , either bred therein originally , or by some disorder procured unto them , as hereafter in the causes which procure the Gout shall appeare . It followeth , that it is occasioned eyther by some distemperature , or irregular humor : The humors of the body are either good and Three sorts of humors . naturall , and then nature rejoyceth in them , for that they nourish the body , and maintaine it in good health and long life . Or else they are naught and contrary to nature , for that they procure diseases and destruction unto it , as when they are possessed with putrifaction . Or else they are neither good altogether , neither bad , but semimali , halfe naught , and this state of the humors I call irregular , because they are not altogether over-ruled by nature , and that in three respects : A humor may offend in three respects . 1 Quantity . 2 Quality . 3 Substance . Three sorts of bodies considered in Physick . for either they offend in quantity , in being in greater abundance than the nature of the body requireth : or they offend in quality , being too hot , or too cold , or too sharp , and rodent : or else they offend in substance , when as they are declining some what from a good and naturall state unto an unnaturall . There are three sorts of bodies considered in physick , the body healthfull , the body diseased , and thirdly the body neither perfectly whole , neither diseased , but in a neutrality between both : which is after two sorts , either when a sick body recovereth and groweth toward health ; then it is neither whole nor sick : or when a whole body is declining from a healthfull state and groweth to bee sick . By the * * i. e. good . first sort of humors , the first kinde of bodies is maintained : and by the * * i. e. naught . second the second kinde of bodies is corrupted : and by the * * i. e. neither good nor bad . The application of the former distinction of humors . 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 overgrea● 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 The good estate of all parts in the body consisteth in the naturall heat . 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 Three inconveniences through the infirmity of naturall heat . 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 The application . 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 The Gout proceeding from a deflux may be in two respects . 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 The rheume is the mother of many diseases . 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 , car●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 gross● 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 ●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 reason why the rheume from the braine doth cause many diseases 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 Foure points to be considered in every deflux . 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 The application thereof . 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 The conclusion of the first generall point 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 The second generall point , which containeth the causes of the Gout . of the Gout are partly externall , and partly internall . The externall are * * 1 Reason . first too moist a state of the aire , for that doth engender great store of rheum . * * 2 Reason . 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 . * * 3 Reason . Also ill digestion , for that doth engender ill humors . * * 4 Reason . 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 , 5 Reason . 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 6 Reason . 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 7 Reason . 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 8 Reason . 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 9 Reason . the Gout . Also the use of cold and moist meats , 10 Reason . as Cucumbers , Gourds , Lettuce , Endive , and such like . Also it may come when any usuall evacuation 11 Reason . 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 12 Reason . 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 13 Reason . dulleth the naturall heat of the part . And too hot keeping of the feet , because it resolveth forth the naturall 14 Reason . heat of the part , and so weakneth the feet , may procure the Gout . Sometimes the Gout commeth by inheritance . 15 Reason . How diseases may come by our parents . 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 The internall causes of the Gout , which are foure . 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 The first , to wit , blood . 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 How blood is made . 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 p●rta ; a●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 The definition of blood . 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 Two sorts of blood . good is knowne first by his substance , it is not too thick , nor too thinne , but of an indifferent substance . The signes to know good blood . 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 Ill blood is caused after sundry sorts . 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 The application how blood may be a cause of the Gout . 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 The second internal cause of the Gout . that it is indeed a crude or inconcocted blood , and in time of hunger and hard fare it is by better concoction converted into a profitable blood for the maintenance of the body . And therefore next unto blood it is of all humors in greatest abundance in the body , and hath no proper place allotted unto it , but doth converse This humor hath no proper place , but doth converse with the blood for three causes . with the blood in the veines , and that for three causes . The first is to make the blood more current in the veines , which of it selfe otherwise would be too thick . The second is , for that with the blood it should passe to such phlegmatick parts as are to be nourished therewith . The third , that it should go into the joynts for the suppling and moistning thereof , for they are compounded of dry substances , which without that kinde of suppling , would bee unapt to any ready motion : wherefore this humor may bee defined after this sort . That it is an humor in quality cold and moist , in substance The definition of the humor phlegmatick . crude and inconcocted , in colour inclining to white , or either of no taste , or somewhat sweet , which being bred in the stomach , is from thence conveyed to the liver , and from thence by the veines with the blood , is distributed into all parts of the body . This humor is either naturall or unnaturall : to the naturall Two sorts of phlegm in generall . belongeth that which is before . The unnaturall is made either in respect of it selfe , or by admistion of other humors . Of it selfe sometimes it is too thick , somtimes The particulars of the first . too thin , sometimes roping like birdlime , sometimes like to molten glasse called vitrea pituita . There is also a phlegm which is sowre , which likewise is very crude ; another of no taste , which is not so crude ; and another is salt , and that in respect of it selfe . Now by admistion of other humors the like depravation ariseth , The particulars of the second . being mixed with choler it is salt , or being mixed with some putrified humor , it hath the like taste ; and being mixed with melancholy , it is of a sowre taste . But in all these sorts of phlegme wee must speake after two A distinction . sorts : eyther properly , or improperly . Properly that is to be understood for the humor phlegmatick , which with the blood goeth into the veines . Improperly all the cold and grosse matter that commeth out of the braine , and out of the lungs , and stomach , is called phlegme . Now for the Gout , it may come either of the humor it selfe , or being mixed with other humors . How the Gout may come of phlegme . If it come of it selfe , then must it not be thick or grosse , for that is not apt for a deflux , but it must bee a thinne phlegme , which may be fluent , and this doth happen to old men and such as are of a cold constitution , which through weaknesse of naturall heat do breed it , and therefore in such wee shall often see towards night their legs to swell ; for the humor being not good , the heart and stronger parts put it downe to the lower , where it doth settle and swell . But in yonger persons we shall seldome see the Gout to come of this humor alone , but being mixed with choler , which maketh it more fluent , and more to afflict the patient Wherefore The third cause internall of the Gout . now I will entreat of the third cause internall of the Gout , which is the humor cholerick . It it is to bee understood , that the food whereon wee feed , is not of one simple condition , and nature , and therefore is not in us converted into one only humor , but moe . And as in the liver this food is turned into blood , so in the same part is there a purification of the blood by separation of other humors , and by taking of them to their proper places , wherefore with blood there are made in the liver both choler and melancholy , for the thinner part and hotter is turned into choler , and the thicker and grosser into melancholy . The choler is drawn from the blood by the gall , and the melancholy by the spleen , which two places are the receptacles of these two humors . This cholerick humor as the The cholerick humor is of two sorts . former is either naturall or unnaturall : the naturall is an humor in quality hot and dry , but not actually dry , for that in touching it is felt to be moist , but potentially , for that it hath the power of drying , and in substance thin , in colour yellow , and in taste bitter . This The definition . being bred in the liver , is divided into two parts ; the unprofitable part is passed over unto the gall , and the profitable goeth with the blood into the veines , which is for two causes , the one that it may go to nourish such parts as in whose composition and complexion this humor hath ought to do , the other that by the sharpnesse and thinnesse thereof the blood may passe the better through the small veines . That which is in the gall , is evacuated by a conduct into a gut called jejunum , the empty or hungry gut , for that the choler comming into it doth clense and scoure it , and so keep it empty . And it is evacuated into the guts for two causes ; the one to clense and scoure them from slimy and grosse phlegm , the other to excitate and stimulate them to expell the excrementall drosse of the guts . The unnaturall humor of choler is made of it selfe by adustion The unnaturall choler is of two sorts . or by admistion of other humors , as with thinne phlegm , and it is thin choler , and of the colour of the pill of pome citron , called cholera citrina ; or with Mo sorts of choler . thick phlegm , and then it is thicker , called cholera vitellina , because it is like the yolks of egges , which as they are some of a paler , some of an higher colour , so is this kinde of choler : this choler by the action of greater heat doth become green , and is called cholera porraria , because it is greene like to leek blades , and by greater heat it doth become black like unto rust , and therefore is called oeruginosa cholera . Of all these sorts of choler the fittest to breed the Gout is that which What kindé of choler is in cause of the Gout . with the blood doth passe into the veines ; for together with the blood it goeth into all parts , and according to the disposition thereof affecteth such parts as are offended therewith : the signes whereof shall bee declared hereafter . The last cause internall of the Gout is the humor melancholy , which humor is in quality Melancholy the fourth internall cause of the Gout . The definition cold and dry , in substance thick , and somwhat slimy , in colour black , in taste sowre . The originall whereof is in the liver , and the thinner part goeth with the blood into the veines for the nourishing of such parts as are by constitution melancholick : and the grosser Two sorts of naturall melancholy . part is drawn from the liver by the spleen , which is the proper seat of melancholy , and from thence is put over into the stomach , and that because it should in the mouth of the stomach procure the sense of hunger . For hunger is a want of food , the feeling or sense whereof is in the mouth of the stomach , and that sense is made of the sowernesse of this humor , whereby the orifice or mouth of the stomach is shriveled and wrinckled , and drawn together , whereof is made a desire of food . And these two sorts of melancholy are naturall . There are also some unnaturall , as when by excesse of heat the naturall melancholy receiveth adustion , then is it unnaturall , and called adust , which if withall it hath any putrifaction , it breedeth bad melancholy fevers . There is another melancholy humor The unnaturall melancholy . unnaturall , which commeth by the adustion of choler , which is a most euill humor , whereof commeth dementia ferina , a belluine madnesse , when one is as mad as a wild beast . Another unnaturrall humor melancholick , doth proceed of the adustion of other humors , as of blood and of salt phlegme . The fourth is when in the unskilfull cure of tumors there is left an hard substance , for this if it should come to exulceration , would proue a cancer , a kinde of ulcer which is hardly cured , or not at all . Now the Gout doth indeed seldome proceed of the melancholick humor : first for that there is no great store thereof in mans body : secondly , for that this humor is not apt for a deflux , because it is grosse . Notwithstanding sometimes it falleth out , being mixed with some other humor it may communicate with it in the procuring of the Gout . And thus farre forth concerning the causes externall and internall of the Gout .

It followeth now that I deliver the signes whereby The third generall point contayning the signes of each cause of the Gout . each cause is to bee knowne . And first for the causes externall , they are to bee found out by the inquisition of the Physitian , and relation of the party , for the Physitian must aske the patient of each one , and the patient must answer particularly , so shall it appeare by what externall meanes he hath gotten his Gout . Wherfore ●ereof I surcease to speake , because it standeth in the private conference of the Physitian and patient . But concerning the causes internall , they do only stand in the skill of the Physitian to judge of , and to diserne by the signes . Wherefore first of the first internall The sign●s of the Gout proceeding o● blood . cause of the Gout , which is blood . Whereof when it proceedeth , it is to bee known by these signes , first of the manner of the tumor , for when the Gout proceedeth of blood , then doth there concurre a tumor or swelling , and that very big . Next of the colour , for the tumor will be very red . Thirdly , of the heat of the part , for it will be but of a tolerable heat . Fourthly , of the manner of the greife , for it will not be extreme , and that by distention , for that the fulnesse of blood in the part , doth by dissevering such parts as are united , cause in the part affected a distending greife . Hereunto must bee added the complexion of the patient , which if it be sanguine , it confirmeth with the former evidence , that the Gout proceedeth of blood . Also the age is to be considered , whether the patient be yong ; and his manner of diet , whether he doth use to eat liberally , and that of the best and most nourishing meats and drinks . Also his custome of life , whether he live at ease and much rest , enjoying many delights , which if they concurre to the former , it is the greater confirmation of blood . And if any usuall evacuation of bleeding by the nose or otherwise bee suppressed , after that the Gout befall to the person , it is an argument that it is of blood . If the Gout proceed of choler , then is it The signes of the Gout proceeding of choler . known by these signes , first the tumor is not so bigge : The colour thereof is pale . The heat that followeth this humor is most vehement . The paine it procureth is untolerable . It is greatly releeved by application of cooling things . Hereunto must bee added the complexion of the patient , whether it bee cholerick . Also his age , whether hee bee in the middle age , which is from five and thirty to five and forty , the hot and dry time of mans age . And whether his diet hath been of cholerick meats , and hot and dry wines . And whether hee hath led his life in sorrow and care , or watching , or study , or fasting , or hath used great labour and travell : which all , or some , if they concurre ; because they are the breeders of the cholerick humor , they signifie unto us the cause of that Gout to bee the said humor . But when the Gout proceedeth of a phlegmatick The signes of the Gout proceeding of the humor phlegmatick . humor , then the tumor thereof will bee very big and soft ? The colour thereof white . The paine not great , except so great quantity of the humor possesse the part as that by distention the paine is augmented . The heat it procureth is little , and it is releeved by application of hot things . The complexion of the party is phlegmatick , or having used meats of a cold and moist constitution , and lived in much rest , without competent exercise , giving himselfe to much sleeping , or bathing , and that immediatly after meat . Also the old age is a signe of this humor , and the cold time of the yeere , as winter , a cold and moist-habitation , which are both causes and signes of a phlegmatick humor . Now if the Gout proceed of a salt phlegme , then together with the other signes , there will bee in the part affected a great itching , which is caused through the saltnesse of the humor . The Gout doth seldome come of a melancholy humor , but when it The signes of the Gout proceeding of melancholy . befalleth , it is known by the tumor , for it is little and hard , and in colour black . The paines will be as if the part were bored with a percer . There will appeare little heat , but rather a cold . The person is in the declining age , as from forty five to fifty five . His complexion is melancholick , and hath used to eat of melancholick meats , and to give himselfe to much labour and travell , even to overgreat defatigation , his habitation is in a cold and dry place , and commonly it haunteth him in autumne . Thus farre of the signes of such particular causes internall as occasion the Gout : which causes being somtimes confounded , as blood and choler , or blood with phlegme , or melancholy ; or melancholy with blood , choler , or phlegme , the signes are more hard to bee seene , and therefore the cause more hard to be known , and the cure very hard to bee performed ; for in a confusion it is hard for a man to determine upon a certainty , and that which may be good for one , is hurtfull to another , whereas things of contrary natures and dispositions are confounded together ; wherefore herein doth cheifly consist the skill of a good Physitian , as by the signes to judge whereof the confusion is made , and to discerne the one from the other , and so to moderate his medicine , that in doing good to some one which principally hath the dominion , it may not work any inconvenience to the rest . This because it is a curious peece of work , and standeth upon many termes of our Art , it will bee but obscure and tedious , if I entreat thereof , wherfore here an end of this point , which containeth the signes of such causes as procure the Gout :

Now to the next point , whether the Gout may bee cured or not ? I would I could warrant the cure , for I The fourth generall point that is , whether the Gout can be cured or no ? might bee the richest Physitian in England . Many make many vaine brags to win them a name , but if a man will shew himselfe honest , and good , and to professe a troth without collusion or dissimulation , hee must needs confesse that he cannot radically cure the Gout , with warrant that it shall never returne . First , The reasons why the Gout is hard to be cured . for that Gout which is by inheritance , it is altogether impossible to remove it , for that imperfection which commeth by kinde may bee releeved , but not removed by Art . And that Gout that commeth by surfetting and banquetting , it is most hard for such persons to keepe a good diet , wherein indeed the whole preservation consisteth . And when the joynts are once weakned , it is an hard matter to reclaime them to a naturall state , because they are farre from the heart , the fountaine of heat , which should bee their comforter . Likewise such parts as by their depravation do breed the matter of the Gout , will hardly bee reformed ; for both the part that breedeth , and the parts that receive the matter , are so farre distant from the stomach , whereinto the helping medicines are to bee received , that before they can approach either part , they suffer so great alteration , as that they lose their proper effect , and cannot work to that purpose upon those parts as they should . I adde hereunto , that when a water taketh a course , it is hardly restrained , so when a deflux hath once tooke a course , it is hardly restrained , for the stronger parts will evermore disburden themselves by the same course . In ancient time the Why in ancient time the Gout was not so common matter was not so hard , for that people were of a more temperate and orderly diet . Then was it true that Hippocrates saith , that eunuches were not subject to the Gout , for that they used no venery ; which because it weakneth the joynts and other principall parts , if it bee used too often , doth procure the Gout . And that women , except their naturall termes were suppressed , were not subject to the Gout ; for by that evacuation their bodies were clensed and preserved from superfluous matter . And that no yong man before hee had betooke himselfe to venery , could be possessed with them Gout . But now because of excessive and disordered diet , or some other disorder whereinto this age is inc●dent ( I know not who can be exempted from the Gout , except he can overrule his affections , and direct himselfe by great moderation ) and having once got it , it will bee hard for him to remove it . Paulus Aegineta saith , that the Gout by reason of so manifold causes whereof it may come , and are hard to be known , doth bring with it a very heavy conceit , to wit , that it can no way be cured by the Art of Physick . And Tralli●nus saith , that when a humor is once confirmed in a joynt , there is no hope that the part can be reclaimed to a naturall state . And Galen is of the same opinion , which is to bee understood of the perfect and radicall cure of the Gout . As for the fit , no doubt there are many good meanes to releeve and remove it . Wherefore thereof I will entreat , comming now to that point which conteineth the cure of the Gout .

The cure of the Gout must bee referred to the causes thereof ; for except the cause bee removed , the effect The fift generall point , that is , the cure of the Gout . The cure in respect of the causes externall . will still continue . I have said before , that the causes of the Gout are either internall or externall . Now for the cure of the causes externall , as they are to be understood by the patient , so he being warned of the Physitian to forsake and avoid the same , shall finde a good releefe to his Gout . If hee live in such an aire as may procure it , the counsell of the Physitian is to change . If by overmuch feeding and ingurgitation of meats of sundry sorts , then hee must use a more temperate diet . If it come by excessive use of drinking , that must bee avoided . If it come by ill digestion , then the patient must be carefull of better . If it come by overmuch venery , that is to be used in more moderation . If it come by too much labour , or fasting , or watching , or sorrow , or care , then the ground of the cure is to abandon the cause . If it come of too much ease , then let the patient use more exercise . If of too much walking and travell on foot , then let him avoid it . If any usuall evacuation be stopped , let the Physitian procure it again , or derive it by some other course . And so if the patient can tell from whence his Gout either beginneth , at the first ; or afterward doth come to a fit , let him avoid that cause , and it shall bee a great help unto him : for except the patient bee obedient herein , no good cure can bee done . The cure of the Gout in respect of the causes internall , have two principall scopes , the one is Two principall scopesin the cure of the Gout to be observed . an order of diet , the other consisteth in administration of medicines ; and neither of these can be generall , but particularly must bee appropriated unto the cause . Wherefore first I will begin the cure of the Gout proceeding from blood .

And first for the diet of the patient , which in all The cure of the Gout proceeding of blood . What diet must be observed . diseases is a principall point , the aire must be somwhat disposed to coldnesse and drinesse ; sleeping and watching must be used moderately . If the belly bee costive , it must bee made soluble with gentle clysters , when as the flux doth begin , the patient must rest and hold up his leg on a stoole , for the motion would draw downe the greater deflux , and laying up doth resist the deflux , but when it is in declination , a little motion is good , for that it doth evacuate that which remaineth . All sorrowes and cares , and great perturbations of the minde must be avoyded . Little meat must bee used . especially if it nourish much , and breed store of blood , because that encreaseth the cause . Wherefore in the fit of this kinde of Gout the patient should altogether abstaine from flesh , or if that cannot bee by reason of his weaknesse , then let him eat of birds , especially such as live in the hils , as Feldefares , Thrushes , Black birds . And wine in this cause must altogether bee avoyded , for that it is an increaser of blood , and through the heat and thinnesse , and peercing property , it searcheth each part of the body , and both breedeth and stirreth defluxes . Wherefore many by abstaining from wine have had more speedy recovery , and longer intermission of the Gout . Here also the use of Venus must bee omitted , or seldome and moderately used ; for there is nothing worse to procure the Gout , especially if it bee used dayly , and out of season , as when the stomack is full , for then it destroyeth concoction , or when the body is too empty , for then it spendeth and weakneth the body . And here because eating and drinking too much , breedeth great store of raw humors , the patient must give himselfe to a moderate and sober diet , for as Hippocrates saith , the principall point . of maintaining good health , is not to stuffe the stomach too full , and to bee ready to put the body to exercise . This order being observed in respect of the aire , and eating , and drinking , and sleeping , and watching , and resting , and stirring , and such like , wee are to descend to the cure . The Gout when it commeth of blood , requireth The administration of medicines . 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 ●nternall . 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 Externall or locall medicines . To repell the descending humor . 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 . Partly to repell , and a little to resolve . 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 To ease the paine , and to resolve , and a little to repell . 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 An observation . 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 , Medicines to resolve . 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 The cure of the Gout pro ceeding of choler . 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 The order of diet . 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 order of administration of medicines . 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 , Locall medicines . 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 , To repell and mitigate pain . and mitigate the paine . Or take the juyce or decoction of cooling and astringent herbs , as of Plantaine , Polygonum , To coole and repell . 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 To coole and mitigate pain . 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 An experiment . 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 mitigate paine , and to resolve . 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 , Stupefactives and Hemlock , and juyce of black Poppy called opium . This must bee used in little quantity , and must not lie A caution to be obserued . 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 The cure of the Gout proceeding of the humor phlegmatick . 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 The order of diet . 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 The method of cure . 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 : The order to be used in applying medicines . 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 A caution to be observed . 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 This is to dis●●sse and repell . 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 This is more discussive . 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 This is more discussive . 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 A defensive . 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 This is good in the declination of the fit . The cure of the Gout proceeding of the humor melancholick . make a stiffe plaster : This doth resolve very well , as many mo which I omit to set down● 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 The diet . 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 The method of the cure by medicines . 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 , Diasen●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 The locall medicines . 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 ; An observation . 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 , The method of cure when the Gout pro ceedeth upon a mixture of humors . 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 A conclusion of the five general points antecedent . 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 The last point which is a preservation from the Gout . 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 order of diet to be used of such as will be preserved from the Gout which doth consist upon three generall points . 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 The ayre . 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 Of meate and things to bee considered therein . Substance . Quantity . Quality . Time . Order . Concerning the substance . Mutton , veal , Capon , Chickken , Partridge Fesant , Pullet , Rabbet . Uenison . Wilde-fowle . Beefe ▪ Salt meats . Fish . 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 Herbs . 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 Roots . Carrot , Skirwirt , and the Parsnep if hee were not so windy : the Radish breeds an ill humor ; Cucumers , Melons , Pepons , doe soone putrifie in the stomack . Lettuce , Purslain , and other cold herbs do thicken the spirits too much , and causeth dulnesse of eyesight , Capres and Olives may bee eaten as sauces . Apples are naught as wee use them , that is , after meat , for they Fruits . trouble the stomack , and do put up moyst rheumatick matter unto the braine : they should rather bee used before meats , for then they make the belly soluble . Peares , Quince , Orange , Limon , Citron , Peach , and all such fruits as are tart , or have some astringent property , are to bee used after meat , but not in any great quantity , for they are of no good juyce , but are only taken to close up the mouth of the stomack , and to prohibite thereby the ascention of vapours to the braine . Milk , and all things made of milk are hurtfull for the Milk and all things made of milk are to be auoyded . Gout . Only this , take old and hard cheese that is not strong of the rennet , and dissolve it in oyle of Roses , white Lillies , and Camomill , being laid to the hard knob bred in the joynts by the Gout , it is said to bee very effectuall in resolving of the same . Otherwise cheese , butter , cream , custard , and other compounds hereof are condemned ; for in some stomacks they quickly corrupt , in some they turne into choler , in some stomacks they are sowre , and in all they sume plenteously into the braine . Now for the quantity of The quantity , that is to wit , how much we are to eat . of our meat this is a generall rule , that wee use that in moderate sort , shutting up the bag before it bee full . Our moderation herein wee shall know by our concoction , for if the stomack be not oppressed , but have in it competent food , then it agreeth well with it , and against the next meale it will have a good desire to meat , and will like very well of that it taketh , and hath no heavinesse nor ill disposition in it . The quantity also may be set downe in respect of the meats , for of meats of light digestion we may eat more , and of such as are of hard digestion wee must eat lesse . Also in respect of the person , for a strong man and a cholerick stomack must take more . Also in respect of the age , for yong men must bee allowed more than old men . And in respect of the time of the yeere , for in winter we may eat more than in summer . Also in respect of our labour and rest , for a man given to motion may eat more than another given to rest . And so by these and such like observations a man may determine what a quantity of meat is most convenient for him . And when wee trespasse herein it is to be known by an oppression that How we shall know when we have eaten too much . the stomack shall feele , and by a dislike of that we have eaten . There is nothing more hurtfull than such repletion . Wherefore all surfetting is to bee avoided . Notwithstanding this is my counsell , that a man rather It is better to eat a little too much than much too little . offend in eating a little too much , than much too little ; for naturall heat is as a fire , it must have a subject to work on , or else it will work upon the good humors , and spending the body , will also it selfe decay , then it will be too late to yeeld more store of food , because then it can neither receive it , neither digest it ; whereas by using a little too much , wee may amend that fault by fasting some time , or purging . Touching the qualitie of meats , in this case I have said before , The quality of meats . that too moist meats are hurtfull , and such as do easily putrifie . Summer fruits therefore are naught , as Cherries , and Plums ; summer apples and such like ; it is a most hurtfull thing to feed too much on them . For the time of taking our meat , it should be a seasonable The time of taking our meat . time , and usuall to us , intermitting so much betweene our meales , as that the former may bee well digested before the other be received , neither drinking nor eatting between , nor too late except necessity urge . The order to bee observed in eating our meats is , first to feed on the meats of hard digestion , and the lightest at The order therein . the last , albeit it is not good to feed upon many dishes , for they trouble the stomack in digesting them , being To eat of many sorts of meats is not good . of sundry natures , some hard , some easie to digest ; for naturall heat cannot worke a like effect upon both . And here I utterly mislike of banquetting dishes served Banquetting dishes are hurtfull after meat . Curious Cookes mar good meat . Concerning our drink . in after meat , for they corrupt the rest that was received before , and the curious cookery is not so good , for good meat is best when it is in his kinde , with some convenient sauce , without so many ingredients as if it were a confection out of the Apothecaries shop . Now concerning our drink , I could wish it should not bee too new , for that it is inflative ; neither too stale , for that it is too peercing and fretting . And here I utterly dislike of small drink , for it doth nothing comfort Small drink is not good . naturall heat , and being of a thin and weak substance , it doth evaporate unto the braine , and bringing no comfort thereunto , it falleth down , and voideth by spitting , or some other rheumatick sort , whereas a good indifferent drink doth help concoction in fortifying naturall heat , and comforting the stomack , and the vapours thereof that ascend to the brain , because they be warme , do comfort and recreate the braine , being cold , and cause it to worke the better concoction , and retention , and expulsion , and they doe convert into a profitable nutriture ; for the braine which being a part moist of it selfe , requireth great store of moist matter , for the maintenance and sustenance thereof . As for wine it is altogether forbidden to them that feare Wine . Some allow of white wine in preservation from the Gout . the Gout . Yet some Physitians allow of white wine , saying , that because it it a peercing and scouring wine , it deriveth the course of Podagricall matter by urine , and so doth greatly availe in the way of preservation from the Gout . Of this opinion is Montanus , a learned Physitian : but I mislike it , for in my opinion there is nothing more hurtfull to the Gout than the use of white But nothing can be worse . The reason● . wine and Rhennish : For first whatsoever is hurtfull to the nerves and sinewes , is most hurtfull to the Gout , but these wines are such ; for they have two properties that hurt the nerves and sinewes : a peercing property , and a cooling and moistning property ; for albeit generally all wines are hot , yet white wine is but cold , for it comes of a raw and incocted grape . Also what doth evaporate much to the braine is not good for the Gout , but white wine doth so , for it is of so thin a substance that so soone as it is in the stomack , it is either in the braine , or in the bladder . I adde hereunto that if white wine were good in this case , then it were to be taken either fasting , or at dinner , or supper . But fasting no wine is good , when the stomack is empty , for it runs to the head , and going into the veines , heateth the blood ; but white wine is most hurtfull fasting , for it fretteth the stomack , and offendeth the braine in peercing and moistning the nerves and sinewes . And with meat that drink must be taken that will not hasten the meat out of the stomac● 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 Claret wine . 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 Of sweet wines . 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 Sack , and how it is to be used . 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 What quantity of drink is convenient with meat . 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 The quality of our drinks . 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 , Bragget . hung in a bag in the drink when it is new . Alacras 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 Hipocras . small drink . Some thinke that ale is better than beere , because that beere doth fume more , by reason of the Ale is better than Beere . 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 The time to drink . 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 Of sleepe . To sleepe in the day is not good . What rules are to bee observed if wee sleepe in the day time . 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 Our night sleepe is most naturall , and requireth some observations . 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 How long we are to sleep . 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 An observation . 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 , Of watching & how hurtfull it is to watch too much . 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 , Of our exercise , and of the commodities thereof . 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 , The ends of exercise . 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 The place wherein wee are to exercise . 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 The time when . 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 What kind of exercise is best for such as feare the Gout . 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 Of rest and ease and the discommodities thereof . 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 The fift point of this preservative diet . 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 Bleeding too much is hurtfull . So is Sweating too much . 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 discommended , for being So is often use of Uenery . used as it should bee , it lightneth the body , and cheereth the senses , and edgeth the stomack ; and gladdeth The commodities of seasonable and moderate Venery . 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 A continuall lask is hurtfull , or any other immoderate evacuation . 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 Competent evacuation of superfluities is requisite . 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 Costivenesse is hurtfull . 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 Of the passions of the minde . 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 Concerning medicinall matters what is to bee done in this preservation . 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 Why at the Spring and at the Fall we are to purge in this preservation . 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 , What is to be respected in this evacuation . 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 A caution . 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 , A distinction of purgative medicines . 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 quantity , of which compositions the Apothecaries shop wanteth no store . Now the best writers would have a man not passe benedicta , or using the other it should bee in some The application thereof . of the gentlest confections , wherein they were in no great quantity , and perfectly corrected . After this it shall bee good to use some lotion or bath for the feet , wherein are boyled some things of an astringent property , to roborate the joynts , that they may bee more able to resist the deflux of any humor . And throughout all the yeere it shall bee good to keepe the body in soluble state , and rather by meats that have that property , than by medicines . Or if by medicines , then by the gentlest , as such as may bee given with meat , or a little before or after . But if nature it selfe doe worke sufficient expulsion , then wee may abstaine from any farther attempt .

FINIS .
Notes, typically marginal, from the original text
Notes for div A02409-e210