380 DISEASES CLASS IV. i. 2. 15. 



nual periods may depend on the fucceflion of great viciflitudes 

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

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

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



In reipect to the pre-remote caufe or difpofition to the goutj 

 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 Seel:. XXI. 

 jo. 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 gout, by diminifhing the quantity of fer- 

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

 ers who, by a total abftinence 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 5 and the proximate caufe is 

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

 tem $ xvhence torpor and confequent inflammation. The great 

 Sydenham faw the beneficial effects of the abftinence 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 

 periuade 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 obierver of difeafes had not refolution to practife his own 



fc iptiun, and thus to have fet an example to the world of 

 e truth cf his doctrine ; but, on the contrary, recommended 



deira, the itrongeil wine in common ufe, to be taken in the 

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

 felf to have perilhed a martyr to the diieaie, which he knew 

 how to fubdue ! 



As example has more forcible effect than fimple affertion, I 

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

 moft reipected friends. E. D. was about forty years of age, 

 when he was firit 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 brifk 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 thrice its quantity of water. In about a year 

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



then 



