274

GOUT.

The patient is always worse towards night, and easier in themorning. The paroxysms, however, generally grow milder everyday, till at length the disease is carried off by perspiration, urine,and the other evacuations. In some patients this happens in a fewdays ; in others, it requires weeks, and in some, months to finishthe fit. Those whom age and frequent fits of the gout have great-ly debilitated, seldom get free from it before the approach of sum-mer, and sometimes not till it be pretty far advanced.

Regimen. — As there are no medicines yet known that will curethe gout, we shall confine our observations chiefly to regimen, bothin and out of the fit.

In the fit, if the patient be young and strong, his diet ought tobe thin and cooling, and his drink of a diluting nature ; but wherethe constitution is weak, and the patient has been accustomed tolive high, this is not a proper time to retrench. In this case hemust keep nearly to his usual diet, and should take frequently acup of strong negus, or a glass of generous wine. "Wine-whey isa very proper drink in this case, as it promotes the perspirationwithout greatly heating the patient. It will answer this purposebetter if a tea-spoonful of spirits of hartshorn be put into a cupof it twice a-day. It will likewise be proper to give at bed-time atea-spoonful of the volatile tincture of guaiacum, in a large draughtof warm wine-whey. This will greatly promote perspirationthrough the night : equally with any of those advised below.*

As the most safe and efficacious method of discharging the goutymatter is by perspiration, this ought to be kept up by all means,especially in the affected part. For this purpose the leg and footshould be wrapt in soft flannel, fur, or wool. The last is mostreadily obtained, and seems to answer the purpose better than anything else. The people of Lancashire look upon wool as a kind ofspecific in the gout ■, they wrap a great quantity of it about the legand foot affected, and cover it with a skin of soft dressed leather.This they suffer to continue for eight or ten days, and sometimesfor a fortnight or three weeks, or longer, if the pain does not cease.I never knew any external application answer so well in the gout.I have often seen it applied when the swelling and inflammationwere very great, with violent pain, and have found all these symp-toms relieved by it in a few days. The wool which they use isgenerally greased, and carded or combed. They choose the soft-est which can be had, and seldom or never remove it till the fit beentirely gone off.

The patient ought likewise to be kept quiet and easy during thefit. Every thing that affects the mind disturbs the paroxysm,and tends to throw the gout upon the nobler parts. All externalapplications that repel the matter are to be avoided as death. They

* Take Antimonial Powder, 2 grains.

Subcarbonate of Ammc nia, 8 grs.Confection of Roses, enough'to make abolus, to be taken every third or fourthhour.

orTake Solution of Acetated Ammonia,

3 drachms.Camphor Mixture, 12 drachms.

Solution of'Tartarized Antimony,12 drops.Syrup of Orange-peel, 1 drachm.Make a draught.