GOUT. 



• 



both by the affiftancc of others, which may be given him in wc are much difpofcd, with Dr. Cuflen and ctr.ers, t© be- 



the following manner : lot a handy aftive fervant or two be lieve the impoflibility of curing the gouty habit by me- 



emploved to rub him all over, as he lies in bed, with flannels, dicines, we (hall notice one or two known medicines, which 



or riannel gloves, fumigated with gums and fpices, which have been in vogue no long time ago. If the gouty corili- 



will contribute c^reatly to brace and ilrengthen his nsrves and tution is created by a feries of high-feeding and indolence, 



fibres, and move his blood without any fatigue to himfelf. how is it to be expefted that medicine can change that con- 



This may take up from five to ten minutes at firil, but ititution, efpecially while the caufe continues to operate ? 



muft be repeated five or fix times a day, fuppofing him totally The PorlL<;nii potudcr h a medicine which obtained con- 



un:ible to help himfelf. But if he cat walk a hundred yards fiderable reputation, as a cure for the gout, about the mid- 



only, it will forward him greatly to walk thoid hundred yards 

 every two hours; and if he can bear a carriage, let him go 

 out in it every day, tillh> begins to be tired. The firft 

 day or two all this may dlllurb and fatigue him a little ; biit 

 if he has patience to perfevere to the fourth, I dare promife 

 him feme amendment and increafe of ftreiigth ; which he 

 iiiuil employ, as young merchants do a little money, to get a 



die of the lall century. Tliis pov.'der derived its name fronz 

 the duke of Portland, who received fo much relief from it, 

 that he ordered the formula to be printed, and delivered to 

 all who {hould adc for it. It was brought from Switzerland 

 by a friend of the d;;ke's. The powder confiils of the roots 

 of ariftolochia rotunda and gentian, and of the tops and 

 leaves of germander, ground-pine, and centaury, well 



ttlc more. Thus he muft go on rubbing, walking, and dried and powdered, equal weights. This powder was or- 

 ridin^ a little more and more every day, flopping always on dered to be taken for a year or two, at firil in the dofe of a 

 the fi°ft fenfation of wearinefs to reft a little, till he be able drachm daily, but afterwards in fmallcr qtiantities. (See 



Medical Obf. and Inqiiir. vol. i. art. 14.) In the work 

 juft referred to. Dr. Clcphane has fhewn that a fimilar com- 

 pofition was ufed by the ancients for the cure of gout. 



to wolk tvv-o or three m.iles at a ftretch, or ride ten without 

 any v.-earinefs at all." He muft ever' remcsr.bcr, however, 

 that the habit of body is only to be corrcficd by liabitual 

 meafures ; and perfeverance, therefore, muft be his motto in 

 regard to exercife, not lefs than with refpecl to temperance 



Such a formula is given by Galen, in his treatife De Anti- 



dotis, lib. ii. cap. 17., which he fays he had ufed liimfelf. 



But it muft be obferved, in general, that the exercife Cxdius Aurelianus fpeaks of fimilar medicines, under the 



from their being taken 



denomination of annnlia mcdtcaiiuna, 



for the fpace of a year. Aetius gives, among other gout 

 medicines, an " antidotus podagrica ex duobus centaureae 

 generibus,"' which differs from the Portland pov.der in one 

 But feveral of the ancients confidcred the 



mgredient only 



Ihould not be violent ; for if violent, it cannot be long con- 

 tinued, and muft always endanger the produftion of atony 

 and debilitv in proportion to the degree of violence. " It 

 r.-iuft be moderate," to ufe the words of Dr. Cnllcn, " but 

 at the fame time conftant, and continued through life.'' 



It has been fuppofed by fome perfons, that an abllemious long uninterrupted ufe of thefe medicines as dangerous; and 

 and aftive mode of life for a limited time, as for inftance, an alfure us that they are extremely hurtful in the hot and 

 abftineiice from animal food and fermented liquors, and a diet bilious, and are only proper in cold and phlegmatic confti- 

 «f milk and farinaceous matters alone, for the fpace of one tutions. The Portland powder has fallen into ncglefl, un- 

 year, might be fufficient for a radical cure of the gout, der a notion that it was ultimately prejudicial. " In every 

 Such an opinion was expreffed by Cclfus, v.-ho fays that inftance," fays Dr. Cullen, " whic1« I have knov.-n cf its 

 " fome, by cleanfing themfelves thoroughly by drinking exhibition for the length of time prefcribed, the perfons who 

 r.fits' milk, have for ever banifhed the difeafe ; and others, had taken it were indeed afterv,-arJs free from any inftamma- 



by abftaining, during a whole year, from wine, mulfe, and 

 venery, have obtained a fecurity from it for the remainder of 

 their lives." (De Medicina, lib. iv. cap. 22.) In a few 

 cafes, this plan may pofTibly have fucceedcd ; but it is well 



tory affeftion of the joints: but they wei-c affected with 

 many fymptoms of the atonic gout; and all, foon after 

 finifning their courfe cf medicine, have been attacked with 

 apoplexy, afthma, or dropfy, which proved fatal." (Firft 



are as far be3-ond the truth, as they formerly were in its fa- 

 vour. (Comment, p. 48.) He attributed to it ccnfidcrable 



mitted, occur in gouty habits, v.ould be probably accele- 

 rated, if not occafioncd, by the ufe cf a ftomachic pow- 



known that many perfons, wh.o, by entering on an ab- Liner, par. 557.) Dr. Heberdcn, however, is of opinion, 



ilemious courfe, had been delivered from the gout, have, on that the popular prejudices againft tliis medicine at prefent 

 i-etrrning to their former mode of living, had the difeafe 

 return with at leaft equal violence. 



While an abftemious regimen, combined with exercife, powers of alleviating the dileafe, by ftrengthening the i!c- 



will tend to correft the gouty habit, if Ifeadily purfued ; it mach and fupporting the funftion of digcftion ; and believes 



will be at the fame time advifable to avoid as much aspoffible that many of the evils (which, becaufe they followed its ex- 



fomeof thofe circum.ftances, which we have nientioncd above hibition, were imputed to its operation,) were in reality the 



as among the freauent exciting caufes of the diieafe ;' more confequences of the difeafe, and not of the remedy. That 



efpecially when the gouty habit has become eftabliftied by a thofe cafes, however, of apoplexy, S:c., which, it is ad- 

 repetition of the fits, or is hereditary in its origin. In fuch 

 cafes, the meafures, whiih we have propofed, are not ca- 



fily pnri'ued to the requifite extent, and are commonly at- der, while the full diet was continued, appears to be ex- 

 tempted even with reludlance : men, therefore, have been tremely probable ; for the plethora muil have been increafed 

 very defirous to find a medicine which might anfwer the pur- in proportion to the artificial incrcv.fe cf the digefiive 

 pofe, without rcqniring a reftramt on their m.anner of living, powers. We fliould, therefore, be di.^pcfed to conclude, 

 Of this defire numerous empirics and felf-intere-lcd pre- that the conftant ufe of fuch a mcdicir.e muft be pernicious, 

 tenders have taken advantage, and have been induced either unlefs it were combined with temperance in eating and drink- 

 to amufe the gouty wish inert medicines, or have ralhly em- ing ; and that, with fuch a regimen, it would in all prcbabi- 

 ployed thofe of the moft pernicious tendency. It is unne- lity be highly beneficial, if taken whenever the fympton-iS of 

 celTary for us to inquire into 'he nature cf thofe aileged_/2'^r;- indigeftion fhould appear. 



fie njfiri^ms, which, after being tor fome time in vogue. Another clafs of remedies has been employed in the in- 



wrre neglefted or exploded, as their inutility or injurious terval between the paroxyfm.s of gout, and in many in- 



<}ualitics were thus acknowledged. But alter premifing thut fiances with confiderable alleviation to the difeafe^ rendering 



the 



