3 Go DISEASES Class IV. i. 2. 15. 



rmal periods may depend on the fucceffion of great vicifiitudes 

 of cold and beat, and the diurnal ones on our increafed fenfibili- 

 ty to internal fenfations during fleep, as in the fits of afthma s 

 and of fome epilepfies. See Seel. XVIII. 15. 



In refpect to the pre-remote caufe or difpofition to the gout, 

 there can be no doubt of its individually arifing from the pota- 

 tion of fermented or fpirituous liquors in this country ; wheth- 

 er opium produces the fame effect in the countries, where it is 

 in daily ufe, I have never been well informed. See Sect. XXI. 

 10. where this fubject is treated of \ to which I have to add, 

 that I have feen fome, and heard of others, who have moderat- 

 ed their paroxyfms of gcut, by diminilhing the quantity of fer- 

 mented liquors, which they had been accuftomed to j and oth- 

 ers who, by a total abftinenee from fermented liquors, have en- 

 tirely freed themfelves from this excruciating malady ; which 

 otherwife grows with our years, and curtails or renders mifera- 

 ble the latter half, or third, of the lives of thofe, who are fub- 

 ject to it. The remote caufe is whatever induces temporary 

 torpor or weaknefs of the fyftem ; and the proximate caufe is 

 the inirritability, or defective irritation, of fome part of the fyf- 

 tem \ whence torpor and confequent inflammation. The great 

 Sydenham faw the beneficial effects of the abftinenee from fer- 

 mented liquors in preventing the gout, and adds, " if an empiric 

 " could give fmall-beer only to gouty patients as a noftrum, and 

 " perfuade them not to drink any other fpirituous fluids, he 

 " might refcue thoufands from this difeafe, and acquire a for- 

 " tune for his ingenuity." Yet it is to be lamented, that this 

 accurate obferver of difeafes had not refolution to practife his own 

 prefcription, and thus to have fet an example to the world of 

 the truth of his doctrine ; but, on the contrary, recommended 

 Madeira, the ftiongeft wine in common ufe, to be taken in the 

 fits of the gout, to the detriment of thoufands ; and is faid him- 

 felf to have periihed a martyr to the difeafe, which he knew 

 3iow to fubdue ! 



As example has more forcible effect: than fimple affertion, I 

 {hall now coneifely relate my own cafe, and that of one of my 

 moil refpected friends. E. D. was about forty years of age, 

 when he was firft feized with a fit of the gout. The ball of his 

 right great toe was very painful, and much fwelled and inflam- 

 ed, which continued five or fix days in fpite of venefection, a 

 a briik: cathartic with ten grains of calomel, and the application 

 of cold air and cold water to his foot. He then ceafed to drink 

 ale or wine alone -, confining himfelf to fmall-beer, or wine di- 

 luted with about thiice its quantity of water. In about a year 

 he fuffered two other fits of the gout, in lefs violent degree. He 



then 



