142 PRACTICE OF PHYSIC. 



these at least repeated after short intervals ; though at length 

 the great irregularities of this patient brought the disease into 

 a state that resisted all remedies. M.M. 



DLXXXI. When the retrocedent gout shall affect the 

 lungs, and produce asthma, this is to be cured by opiates, by 

 antispasmodics, and, perhaps, by blistering on the breast or 

 back. 



DLXXXIL When the gout, leaving the extremities, shall 

 affect the head, and produce pain, vertigo, apoplexy, or palsy, 

 our resources are very precarious. The most probable means 

 of relief is blistering the head; and if the gout shall have re- 

 ceded very entirely from the extremities, blisters may be ap- 

 plied to these also. Together with these blisterings, aromatics, 

 and the volatile alkali, may be thrown into the stomach. 



DLXXXIII. The third case of the irregular gout is what I 

 have named the Misplaced, that is, when the inflammatory affec- 

 tion of the gout, instead of falling upon the extremities, falls 

 upon some internal part. In this case, the disease is to be 

 treated by blood-letting, and by such other remedies as would 

 be proper in an idiopathic inflammation of the same parts. 



" What I call the misplaced is more immediately connected 

 with the regular gout : it is where an inflammatory state takes 

 place, and that inflammation is not in the joints, but in some of 

 the internal parts, whose functions are of more immediate 

 importance. What I have to say with regard to it, is, that 

 as far as writers upon this subject have been clear and dis- 

 tinct and I have been told that they are not so always that 

 this case of misplaced gout is attended with the same symptoms 

 as attend the idiopathic inflammation of the same viscera ; and 

 so we have the peripneumonia arthritica of Sydenham and 

 Musgrave ; and at the same time we learn that it is attended 

 with all the ordinary symptoms of inflammatory peripneurnony ; 

 and as that is generally and universally the case, I can discuss 

 the matter by further adding, that they also agree in this, that 

 it is to be treated by the same remedies, chiefly by venesection. 

 I have given the difficulties which occur with regard to vene- 

 section in regular gout (DLXIII.) ; perhaps somewhat of the 

 same doubts might occur here ; but we are not thus to de- 

 liberate, we are under the strongest temptation and necessity of 



