112 PRACTICE OF PHYSIC. 



the pain increases, gradually ceases, and is succeeded by a hot 

 stage of pyrexia, which continues for the same time with the 

 pain itself. From the first attack, the pain becomes by degrees 

 more violent, and continues in this state, with great restlessness 

 of the whole body, till next midnight, after which it gradually 

 remits ; and after it has continued for twenty-four hours from 

 the commencement of the first attack, it commonly ceases very 

 entirely, and, with the coming on of a gentle sweat, allows the 

 patient to fall asleep. The patient, upon coming out of this 

 sleep in the morning, finds the pained part affected with some 

 redness and swelling, which, after having continued some days, 

 gradually abate. 



DX. When a paroxysm has thus come on, although the vio- 

 lent pain after twenty-four hours be considerably abated, the pa- 

 tient is not entirely relieved from it. For some days he has 

 every evening a return of more considerable pain and pyrexia, 

 and which continue with more or less violence till morning. 

 After continuing in this manner for several days, the disease 

 sometimes goes entirely off, not to return till after a long inter- 

 val. 



DXI. When the disease, after having thus remained for 

 some time in a joint, ceases very entirely, it generally leaves the 

 person in very perfect health, enjoying greater ease and alacrity 

 in the functions of both body and mind than he had for a long 

 time before experienced. 



DXII. At the beginning of the disease, the returns of it are 

 sometimes only once in three or four years : but, after some 

 time, the intervals become shorter, and the attacks become an- 

 nual ; afterwards they come twice each year, and at length recur 

 several times during the whole course of autumn, winter, and 

 spring ; and as it happens that, when the fits are frequent, the 

 paroxysms become also longer, so, in the advanced state of the 

 disease, the patient is hardly ever tolerably free from it, except 

 perhaps for two or three months in summer. 



DXIII. The progress of the disease is also marked by the 

 parts which it affects. At first, it commonly affects one foot 

 only ; afterwards every paroxysm affects both feet, the one after 

 the other ; and, as the disease continues to recur, it not only 

 affects both feet at once, but after having ceased in the foot 



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