Dolæus upon the cure of the gout by milk-diet

Among the chronical Distempers, which owe their Origine to irregularities in Diet, the Gout is neither the least considerable nor frequent; though perhaps the best and least dangerous Way of clearing the Blood of the morbid Matter; for it naturally tends to the Extreams, and is generally so great a Tyrant, that it will suffer no other Distemper to rage but itself; upon this Account it is that People wish for, and are complimented upon the Gout, as an Indication of the vital Powers being in such Strength and Vigour, as to drive forth the gouty Matter; and it is no wonder that Persons should wish such active, fiery Particles, as the gouty Matter seems to consist of, fixed to a certain Joint, and expelled the Body, when they are floating through the Mass of Juices, and disorder the whole Machine, which is often the Case of gouty Persons before it fixes: The gouty Salts (if they be Salts, as most probably they are) appear to be active, sharp, pungent, fiery Principles, and when, by the Force and Heat of the Body, they are brought into Action, are not improperly termed concentrated Fire it self; and indeed the Effects of their Action manifest something not very different therefrom, by calcining the animal Substance into Chalk or Lime, or somewhat approaching thereto, in the Knots of gouty Joints: Their Volatility may Occasion their being more easily brought into a State of Action, but at the same Time makes their Expulsion out of the Body quicker and easier. A fit of the Gout is no other than an attempt of Nature to collect and expell these Salts out of the Body, which, if successfully performed, leaves the Person free from the Gout, till such Time as from the natural Course of the Food, or other Causes, the Blood and Juices become again overcharged with gouty Matter, to such Degree, that Nature attempts the same Way of Relief it before experienced, and occasions another Fit.

From this Account it appears, that if any thing be to be done during the Time of a Fit, which is the Season many Persons very preposterously attend a Cure, it can only be by supporting the Powers of the Body, to enable Nature, to go on with its Work: (For it must be considered, that the Symptoms of Pain arise from the Action of the Body in that Work, as well as from the Action of the gouty Salts;) and by promoting the natural Discharges from the Part affected, by gentle heat and Warmth; all external Applications, foreign to these Ends, are useless, and generally speaking dangerous. Indeed if any thing may safely be applied in this Case, for these Ends, some Preparation of the Poppy seems to me to be the most promising, and least hazardous. This Plant is endowed with Powers that soften and attenuate in a great Degree, gently promote and encrease the Motion of the Juices, and occasion in Bodies properly disposed, as great, if not greater Discharges by the Skin, than any other Medicine yet discovered. If we add to this its particular Property of easing Pain, may we not justly form great Expectations from it? Its Virtues given inwardly, in the Case we are speaking of, have been long known and experienced; its outward Application hath not, that I know of, been mentioned before; and I would be understood now rather to mention it, than recommend it. I have tried it in about half a Dozen Persons, the better half of which found immediate and wonderful Relief from it, and those who did not, found no inconvenience, to my thinking, chargeable upon the Medicine; though perhaps I am fond enough, like other Patrons of new Tryals, to impute the want of Success to other Causes, than to a Deficiency in the Medicine; I only mention the thing, not being thoroughly satisfied about it, for want of sufficient Tryal. But thus far I may venture to assert, that this, or any other external Applications, are neither to be unwarily or unskilfully ventured upon.

Some Authors of good Note have recommended purging the Bowels upon the Recess of the Gout, and during the Intervals of the Fit, as a proper preventive Cure in the Gout. That keeping the alimentary Passages clean, and in good Order, is of Use not only in the Gout, but in several other Distempers, is undoubtedly true; but how far this may be attended with a weakening of the Fibres of the Stomach, and how far the gouty Salts, already lodged in the Blood and Juices, may be drawn into these Parts, so as to act thereon, deserves very well to be considered. The Tendency of Nature is to drive the gouty Humour to the Extreams, and expell it forth of the Body; the Tendency of purging by the Bowels, further than cleansing the first Passages, is to draw the gouty Humour thither, and expell it by Siege. The Consonancy of these Tendencies may be seen without any Witchcraft; but a very accurate Judgment is necessary to distinguish at what Time, or in what Degree, the Juices of the Body are impregnated with the gouty Matter, so as to determine upon purging with Safety, or what Progress they have made in their Collection, and Tendency to the Joints, to venture to disturb Nature, in her own way of discharging them. Purging during the Time of a Fit is always avoided even by the Patrons of habitual gentle Purging out of it, and a Looseness is esteemed a very dangerous Symptom at that Time; sure I am from Experience, that many gouty Persons, who have run into the Practice of habitual Purging, even with those Medicines that are most strengthning, have found very bad Effects from that Custom, have been afterwards less able to withstand the Attacks of the Gout, have had more frequent and longer Returns, have at length sooner sunk under it, and fallen into worse Habits of Body, than others who have avoided that Practice: There may no doubt be a Necessity for the Use of evacuating Medicines, but they are always to be exhibited upon the maturest Consideration, and the best Advice. People that take up such Practices upon their own Opinions, will in the End find cause to repent it.

The best Way of curing the Gout, (if it may be allowed that Name) is to prevent it, that is, to hinder the Generation of this gouty Humour in the Body; this is to be effected no other way, that I know of, but by Diet: While the digestive Powers of the Body are in such full Strength and Vigour, as perfectly to assimilate the Food into its own Substance, and they be not oppressed with greater Loads than they are able to manage, the Choice of particular kinds of Diet will be of little Consequence; but these are always defective in gouty Persons, and these Defects are productive of different Habits in different Constitutions, which must be attended to in Rules for Diet in general, as well as in the Gout. Long Habits are not suddenly changeable with Safety; and after the Ætas vergens, the human Body doth not freely admit of Changes. A Body always supported in an high Manner, with Flesh Meats, and Wine, will not well bear a sudden Change to a low Diet; and on the contrary, a Body fed upon Water and Vegetables, will not well bear a sudden Change to an high Diet; sudden Repletions or Evacuation is dangerous, and therefore Celsus well advises, Nullum cibi genus fugere, quo populus utatur, interdum in convictu esse, interdum ab eo se retrahere; modo plus justo, modo non amplius assumere, but this is to be understood of People in Health.

Milk seems to be the best Medium of Diet, and yet from what was before said of it, there must be many gouty Constitutions it will not agree with; the same may be said of Turneps, which have been in their Day reckoned Specifick to the Gout as well as Milk; and the Truth is, that many Persons have suffered irreparable Damage, and some lost their Lives, by attempting particular Diets in improper Habits of Body. It is utterly disagreeable either to Reason or Experience, to fix any one general Rule of Diet that shall agree with all Constitutions, or even all gouty Constitutions. The particular Constitutions of gouty Persons are hardly reducible to general Rules, and nothing but Observations, and accurate Judgment, can determine upon them so as to direct a proper Diet. Lewis Cornaro, who is one of the strongest Instances of the force of Diet, in the little Account he hath published, tells us that he found several Particularities in his own Constitution, which his Physicians could no way satisfy him in. One Instance is much to our purpose, old Wine disagreed so much with him, that in the Months of July and August, in his later Years, he was forced to abstain altogether from Wine, this generally brought him to Death’s Door every Year with perfect Weakness; for though he had been gouty, and cured of it by Diet, he never refrained from Flesh Meat or Wine in some small Quantities, nor could he relish or digest his Food without Wine: So soon as the Grapes began to turn, even before they were full Ripe, he had Wine pressed out for himself, whence he was wonderfully restored, in two or three Days, to the Admiration of his Physicians, who could not conceive, that new Wine, before thorough Defæcation, should have so good an Effect. Cornaro describes himself, and his own Diet very honestly; but when he comes to give Rules for others, leaves the Kinds of Food to its Agreement or Disagreement to every particular Constitution; and concludes with this Maxim, which is undoubtedly true with Regard to Diet in general, That for such Persons, to whom no kind of Food is offensive, the Regulation of the Quantity, and not the Quality of the Food is principally to be attended to; in which this Rule is always to be strictly observed, that no greater Quantity even of the most proper Food, be taken at a Time, than the Stomach is very well able to digest.

Having premised thus much about the Regard to be had to particular Constitutions, in ascertaining a Diet in the Gout, we may very well enquire, what Diet is most proper to prevent the Collection of gouty Salts in the Juices of the Body? From what hath been already said, and from pretty certain Experience, we may conclude this to be the Milk of an healthy young Animal, fed upon Vegetables; the next eligible is a vegetable Diet; and if animal Diet be absolutely Necessary, (as no doubt, some Part of it may be to many Constitutions) the Flesh of such Animals, as feed upon Vegetables, is preferable to such as feed upon other Animals. I prefer Wines to vegetable Diet, because all fermented Liquors are produced from Vegetables; of these the softest and smoothest are always to be preferred to the harder and rougher, though none should be used farther than as an help to Digestion; for Water is the Drink proper to all Animals. To assign Reasons for these Assertions would be only to repeat what I have said before; for if that be true, these evidently follow from it.

But so it is, that through the Difference of Constitutions, or different Habits superinduced, many cannot bear a strict Attendance upon one kind of Food; it shall disagree with the Body, be nauseous to the Stomach, fail in giving proper Nourishment, or if too strictly persisted in, may Cure the Gout, and bring on some other more fatal Distemper, or bad Habit, and even this hath been the Case of Milk it self. It is not within the Compass of my present Design, nor indeed, I am afraid, within my Power to enumerate all the several different Constitutions of gouty Persons, and the different Modifications of Diet necessary for them: A Constitution that will bear living upon Bread and Milk, will no doubt be in an happier Way of being cured of the Gout, than one that cannot. But what will not bend, must not be broke; vegetable Food is too flatulent, and gives too little Nourishment to many Constitutions, who require Food already assimilated into animal Substance. Stomachs long used to Wine, require it in Digestion, and in many Cases and gouty Constitutions, even while a Cure is attempting by Diet, a little Flesh Meat must be allowed at certain Times, and the Powers of the Body kept up, by the Moderate use of Wine, chusing the easiest of Digestion, and the softest of each Kind; taking especial Care never to overload the digestive Powers, by too great Quantities; which is a Rule that will hold at all Times, and in all Constitutions; and is of so great Consequence, that if not attended to, it will invalidate the Force of any other Rules that can be given for Diet in the Gout, or any other Distemper.

The Necessity of varying from the strict Milk-Diet, in which the Cure of the Gout absolutely consists, according to the Unhappiness of particular gouty Constitutions; must be left to the Observations of the Patient, of the Agreement or Disagreement he shall have experienced of particular Kinds of Food, to his own Body; and to the Judgment and Advice of a skilful and diligent Physician.

CHAP. I

Before I explain this Method of Cure, I would have my Reader take Notice, that he is not to expect any thing perfectly new: I only propose to confirm, by fresh Experience, what hath been long enough known. The Method of Cure here advanced consists in the proper Use of Milk for a Year and upwards. Many will perhaps wonder at my Endeavours to revive a Method so long known and exploded by Physicians, as hurtful to gouty Constitutions, and shortening the Period of Life itself: But being fully satisfied from Reason, and certain Experience, that this most excellent Remedy is the Gift of Providence, for the Relief of Persons afflicted with this cruel Distemper, I could not help drawing up and communicating my Experience and Observations for the Relief of others.

Cornelius Celsus, the celebrated Roman Physician, speaking of the Pains and Evil that gouty People suffer, tells us of some Persons who entirely avoided this Distemper by a strict Adherence to the Use of Asses Milk, and of others that by abstaining a whole Year from the Use of Wine and Women, were never afterwards troubled with it.

Among the Moderns, John George Grezzell hath wrote a very learned Treatise upon the Cure of the Gout by Milk, wherein many curious and useful Observations are delivered; that excellent Physician Dr. James Sacks hath inserted, in the German Ephemeris, a Method for the Use of Milk, communicated to him by a noble Baron, wherein many useful and elegant Observations, founded upon Experiment, are contained. The late learned Waldsmid hath published a learned Dissertation upon the Relief of gouty Persons by Milk, wherein he agrees with the Authors now mentioned as to the Cure. I have lately received a Letter from a French Gentleman my Friend, who having been for many Years afflicted in a most terrible Manner with the Gout, hath been now by the Use of Milk, free for some Years. From these Examples I had Occasion to admire the wonderful Effects of this Diet, and therefore advised it to many gouty Persons here at Cassell, who have all recovered a perfect State of Health, by a strict Adherence to the Regimen Necessary in the Use of this Remedy: Even some whose Limbs were before perfectly crippled, are now able to walk and exercise. Colonel Nicholas Dumont hath experienced the Efficacy of this Method here at Cassell, for his Limbs were so entirely contracted that he was forced to use Crutches, but having confined himself strictly to the Use of this Diet for an Year and an half, he walks very well without a Cane, and hath performed several Journies. I have been free from the Gout my self upwards of an Year, notwithstanding I had three or four Fits every Year for Sixteen foregoing. Colonel Haste hath been restored by the same Means, though he hath had some mild Returns at several Times.

I shall in the first Place communicate the Letter I just now mentioned; next I shall lay down the Rules Necessary to be observed in the Use of this Milk-Diet; I shall then demonstrate from undeniable Principles, that this Method is the most convenient to asswage and cure the Gout, and that no bad Consequences can attend the Constitution, if it be taken with the proper Regulations. The Letter is as Follows.

To Monsieur de Collet

SIR,

Nothing can be more agreeable to me, than to satisfy the Desire of my Friends afflicted with the Gout, in communicating the Method of Diet, by which the Marquis de Bongi, Mons. Chamar, and my self were relieved from the Gout; you will please to take Notice, that the Milk we used was fresh drawn from the Cow, Morning and Evening, without other Art than that we both eat and supped it, as warm as we could well bear it; my Reason for mentioning eating and supping the Milk, is, because as soon as we arose in the Morning we supped a large Bowl of warm Milk; but the Milk which was brought us at Dinner and Supper, we eat with fine light Bread, cut thin and put therein; this is all our Secret in this Matter. Persons afflicted with the Gout may promise themselves Relief, provided that once a Month, during the Course of this Diet, or at least once in two Months, they take a gentle Purge, which we made Use of, and were so strict in our Regimen, that we neither drank Wine nor, eat other Food, than Biscuits made of very fine Flower, Eggs, and Sugar, and some sweet Fruits, as Strawberries in Summer, but we chiefly avoided Raspberries. For my own Part, I never sweetned my Milk with Sugar, though some Friends who were in the same Course did, yet without any bad Effect. The Marquis de Bongi used to mix Crabs Eyes with his Milk before Dinner, upon a Presumption, that it would prevent any Sourness in his Stomach, but neither Monsieur Chamar or I ever used that Remedy. When we had strictly adhered to this Diet for a Year, we began to hope we might eat Fish, or indulge our Appetites in some varieties of Food, which one or other of us did, more or less, occasionally, and without any bad Effects. At the End of Nine Months I apprehended my Stomach to be somewhat weakened, which made me resolve to use a Glass of Wine after my Milk, and accordingly after Dinner and Supper every Day, I drank one Glass of Wine, in which I sopped a bit of Bread; this was very delicious to me while I used it. At length as we found the State of our Healths to mend, we began to eat and drink with our Friends. This Method hath succeeded so well, that we live hitherto in our common Way upon Milk, yet not so strictly, but that we dine or sup, once, twice or thrice a Week with our Friends in their Manner, and return afterwards to our Milk without Ceremony; and by the Blessing of God we are wonderfully well. We dont here pretend to say, that none of us have been since afflicted with the Gout, for the Marquiss de Bongi hath had two or three pretty sharp Fits; but both he and I know the Difference between having two or three Fits in nine or ten Years, and of being perpetually oppressed, and confined to Bed with this cruel Distemper, which was our Case before; especially the Marquiss de Bongi, who at Six and Thirty was almost continually confined to his Bed, deprived of the Use of his Limbs, and the Joints of his Hands and Feet knotted and chalky; instead of which, he now uses his Limbs without any Marks of Infirmity, insomuch that any one who had seen him in his former bad State, and compares it with his present, would look on him as one raised from Death to Life. As for Monsieur Chamar, and my self, who are more advanced in Years, considering our Age, we are mighty well; ’tis true indeed that sometimes, as upon Changes of Weather, or of the Moon, we find (or at least we fancy so) that we have some Threatnings of Pain, especially about those Joints where the Gout used to ravage, but a little Exercise soon dissipates those Apprehensions.

It is now Seven Years, that Monsieur Chamar and I have adhered to this Diet, in all which Time we have neither of us been so far oppressed by the Gout, as to be confined to our Beds, or even to our Chambers, so much as one whole Day; notwithstanding before we fell into this Method (though we were not perpetually under actual Fits of the Gout) we had a continued Weakness in our Limbs, we walked very infirmly and with difficulty, and if we chanced to make a wrong Step, or to slip in walking, we suffered Extremity of Pain; our Case is now so far altered, that we walk as firm, as if we had never had the Gout. I must confess indeed that both the Marquiss and I used the Diet for a good while, before we perceived any manifest Change, but afterwards our Pain diminished by Degrees, and the Strength of our Limbs returned. The Milk must be used a good while, that the natural Temper and Vigour of the Constitution may have Time and Leisure to come to itself; for though this Diet may be often used Six Months or even Twelve before the Patient can use his Limbs free from Pain, yet let him not despair, for if once he begins to gather Strength, it will daily increase. As to Purging, and Evacuation of the Humours, if possible it should be done once a Month, in the Decrease of the Moon: I hold purging extremely Necessary; for my own Part, it was what I did for the first Seven or Eight Months of this Diet constantly, till I grew tired of it. This is truly the Method I used, and though I afterwards remitted, I found no bad Consequence. The Marquiss and I, at present, take a Bowl of Warm Milk every Morning, but for the Rest of the Day drink and eat as usual. The Marquiss indeed, for the Space of Eight Years, hath had at Times several small Fits of the Gout, but for my self I have hardly had any, except sometimes upon Changes of the Weather, or of the Moon, I have perceived a Numbness and Weakness in my Knees and Joints, like Threatenings of the Gout; but I thank God, it never confined me, and as it came on easily, it as easily went off. The following is the Method of purging: Take of Scammony, white Turbith, Hermodactyls, Leaves of Sena, Sarsaparilla, Cinamon, and Sugar, of each one Drachm, powder them very fine, and divide the whole into Seven equal Parts, one of which is a Dose, and may be taken in white wine or a little Broth. It is necessary to purge once a Month, especially in the Decline of the Moon. If it be thought necessary to purge twice in the Month, let the first Dose be taken in the last Quarter, the second the last Day of the Quarter. The Day I took Physick, I used Milk after it as usual. When I had pursued this Course about Seven or Eight Months, I found my Stomach so much weakened from the Milk, that I was forced to take a Glass of Red Wine every Day after Dinner, which agreed mighty well with me, and I have continued it ever since; so that I am often impatient to finish my Milk, that I may have the Pleasure of regaling my self with a Glass of Wine, and a bit of Bread.

CHAP. II

In the foregoing Letter are contained many useful Observations about the Use of Milk, and its wonderful Efficacy in the Cure of the Gout, from uncontestable Facts, in the Account of the Persons there named. I shall next lay down the Method of this Diet, by which many Persons here at Cassell were relieved. Whoever expects Benefit by this Method, must observe the following Rules. No one ought to go into this Diet without having his Body duly prepared; he must take Care by Degrees to change his Habit, and for the first Month to regulate his Diet, by strictly avoiding all Salt or smoaked Meats; Legumes, and stale, acid or feculent Liquors, and to eat white Meats sparingly, with clear small Drink, as small Beer or Barley Water, or Decoctions of the Woods: A Glass of Moselle or French Wine free from Acidity, may be allowed at Dinner, and Gruels and Broths made of white Meats. There is a necessary Caution to be used, that both in Meat and Drink, the Quantity taken be rather within the Appetite than beyond it; for from overloading the digestive Powers, arise Crudities, Flatulencies, and acid Humours, which are the Origine of many Disorders. Upon this Account it is necessary to purge the Bowels, two or three Times a Month, with Tincture of Jalap, Elixir Proprietatis, Rhubarb, some of the purging Pills, as the Arthritick or Mastich Pills; that the Viscidity arising from indigestions may be carried forth of the Bowels, and the Stomach be better disposed to receive and digest the Milk. I am of Opinion, the first Dose should be taken the first Day of the Month, preparatory to this Diet, the second after some few Weeks of this first Regimen, and the third the last Day of the Month; after this I advice the taking an Ounce of Crabs-Eyes, or prepared calcined Hartshorn, especially if there yet remains any Marks of Acidity in the first Passages. This further Caution is very absolutely Necessary, that not only in the first Month, but in all subsequent, all Passion, chiefly Anger and Grief be avoided, because of their pernicious Consequences; more especially the Use of Women during the whole Year.