Gutta Podagrica: A TREATISE OF THE GOUT. The several sorts thereof. What Diet is good for such as are troubled therewith. And some approved Medicines and Remedies for the same. Perused by P. H. Dr. in Physic.  
LONDON, Printed by THOMAS HARPER. 1633.   

TO ALL HONOURABLE, Reverend, and Worshipful Lords, Spiritual or Temporal, Ladies, Knights, Scholars, Gentlemen and Gentlewomen, of any degree, that are unwillingly acquainted with this frequent disease, especially of the Podagrick Gout: The Publisher hereof sendeth greeting.  
BFloved, the disease commonly called and usually felt and known, Podagra, or as a learned Writer saith, Gutta Podagrica, is (as I may say) a sly, subtle, and thievish Serpent. Which I prove; first, a sly and subtle Serpent, in as much as it creepeth not only into the Courts and secret Closets of the greatest Potentates and Princes of Christendom, but of the whole world, and their subordinate Magistrates, in Church and Commonwealth; and so consequently to the meanest subject: some say the Rich rather than the Poor. And some this Serpent biteth by the heel, and some by the foot, some by the great, and othersome by the lesser toes, and otherwhiles by the ankles. Secondly, it is thievish, for that it cometh always unawares, before it is thought on, or expected: yea, it commonly cometh as a thief in the night. Now what it is by definition, our learned Author saith sufficiently in the Discourse following: And certes, if I myself were a professed Physician, I should not be of Paracelsus his mind, who saith, that this Podagra is a gravel gathered between the joints, whereby the Gout is called And however it be, it is a disease subject to such as are of sedentary and studious lives: i. e. that sit much: as Counsellors of Estate, Senators of Cities, Bishops, judges and Scholars, (that study much) do: Nay, may we not sometimes see that even men of active lives and dispositions are surprised with this thievish serpenticall disease. For the benefit therefore of the Commonwealth, this Treatise not unlearnedly written, I hope is not unprofitably published: Especially considering, the like, to my knowledge, is not extant, either in English or Latin. I had it not many months past, from the hands of one near and dear unto me, who is since dissolved, and I hope in Heaven: And sithence it hath been perused by one more near and dear unto me, an ancient Professor of this Apollonian Art. Vouchsafe therefore ye Lords, Ladies, or of what degree soever, unto whose hands and sight this, though a Pamphlet, shall happen to come, to accept candidly, what is courteously, and not without some cost, published for you benefit.  
And so I betake you all to the supreme Physician of body and soul: and of you take my leave.  
Vale & fruere. H. H.   

A TREATISE OF THE Disease of the GOUT. The several sorts thereof, etc.  
THE word (GOUT) hath two significations. 
The first distinction of the word Gout.  The one general; the other particular. Generally, all such aches as are incident to any joint, we call the Gout; whereas in nature and deed they differ not; but only in respect of the part affected: and in respect thereof, they are distinguished in name. As the ache in the fingers is called Chiragra; the ache in the knees is called Gonagra; the ache in the hip is called S●●a●ica; in the ankles (some term) Talia I●alaria; and the ache in all the joints is called Arthritis, i. morbus articularis; which is the general name to all aches and griefs of the joints. Particularly the word Gout is taken for the pain and grief only of the feet, and from thence it assumeth a name distinct from the rest, Podagra, quasi pedum captura vel aegritu●o, the disease of the feet, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, sive 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 It hath also two other significations, 
The second.  the one proper, the other common. Properly the Gout is taken for a grievous pain in the joints of the feet, preceding either of some distemperature in the part affected, or of some humour bred in the part by the weakness or ill disposition thereof, or by the deflux of some humour descending from some other upper place unto that part. In the common signification all other aches proceeding of what cause soever may be called the Gout: such as come by contusion or bruising, or by dislocation of a joint: and so the French disease having an untolerable ache in the limbs, like a false fellow, being ashamed of his own 
Morbus Gallicus, i. Lues venerea.  name, termeth itself sometimes by the name of Ache or Gout. In this slender Discourse of the Gout, I will entreat of that which is particularly appropriate unto the feet, and properly is called the Gout. In the explication 
The general proposition.  whereof, I will first declare what the Gout is: Next what are the causes thereof. Thirdly, by what 
The general division.  signs each cause is to be known. Fourthly, whether it may be cured or no. Fiftly, what kind of cure belongeth unto it. And lastly, how a man may be preserved from it.  
Concerning the first. The Gout is a grief of the feet, occasioned by some distemperature, or irregular 
The definition of the Gout.  humour, which either is bred in the joints of the feet, and toes, by some weakness thereof, or by deflux hath descended from some upper part thereunto. That the nature of the Gout may the better appear, I will verbatim expound this definition. First it is a grief or pain. A grief (as concerning this purpose) is occasioned after four sorts: Either by way of oppressing a part, when as a gross humour weighing down a part 
Four sorts of griefs.  ponderously, causeth it to grieve in bearing the burden thereof: such kind of grief proceedeth of a phlegmatic, and melancholic humour, because they are heavy and weighty. Another kind of grief cometh by way of distension, when as the veins, and sinews, and arteries of some one part are fuller than they should be, then is that part greeved by distension. This kind of grief cometh sometimes of wind, and sometimes of fullness of blood, and of humours. Another kind of grief proceedeth of a distemperature of a part, as when it is colder or hotter than it should be, because each part doth rejoice in its natural state, and an unnatural is grievous unto it: such kind of grief cometh of inflammations. The fourth kind of grief is by way of erosion, when as the part affected doth feel a grievous gnawing and fretting; which kind of grief cometh either of a choleric humour, or else of a corruption and depravation of other humours. Now to apply: The Gout is a grief in some by 
The application of this fourfold distinction.  way of oppressing the part; when as it cometh of a cold humour, and this kind is incident most to old men, who abound in cold humours, by reason of the decay of natural heat. Also the Gout is a grief in some by way of distension, whereas the body being replete with abundance of humours, the upper and stronger parts put down their offending fullness unto the lower, which descending, the veins, and sinews, and arteries procure this pain of distension. This kind of grief is incident to men of middle age, and such as are of a sanguine complexion, and do use a full diet, with little exercise and much rest Thirdly, the Gout is a grief in some by way of distemperature, and this doth fall out as occasion is offered, as some by standing long in cold water, may have the Gout by reason of a cold distemperature, which is wrought into the part by the cold water. And some by much travel on foot in hot weather, may have the Gout by reason of a hot distemperature procured unto the feet by overmuch travel and heat. Lastly, in some the Gout is a grief by way of corrosion, not that it eateth the flesh, but in that it gnaweth and fretteth, that the patient sometimes thinketh that dogs do gnaw his bones. This kind befalleth choleric persons, and such as use an ill diet, breeding in them store of ill humours. So is it evident that the Gout is a grief, and what kind of grief, which is profitable to him that will give help thereunto, for by the manner of the grief we come unto the cause thereof, and so accordingly apply the remedy. It followeth that it is a grief of the feet. There are four reasons why the feet are more afflicted 
Four reasons wherefore the feet are subject to the Gout.  with these griefs than other parts are. First in respect of their place, for that they are the lowest parts in the body, the upper put down their superfluities to them, where they remaining, procure in some one manner or other (as is before specified) a pain. The second cause is, for that the feet are not of so compact or solid substance as some other parts are of, but have a thin composition, with many void and empty receptacles, and therefore in more abundant sort do receive and retain the superfluities of other parts. The third cause is, for that the feet are more in motion than other parts, and the nature of motion is, to make attraction of humours unto the moved part, and consequently a pain. The fourth is a debility naturally incident more to the feet than unto other parts; for that they are situate farthest from the fountain of heat, which is the heart. They also consist of such substance as is of a cold complexion; so that both for lack of the comfort they should have from the heat of the heart, as also in respect of their own composition, the feet are weaker than the other parts, and the weaker goeth still to the wall: for they receive the annoyances of the stronger, because they are not of strength to resist: and therefore must of necessity yield to their pain. Now why in the Gout the feet should feel such grievous pain, 
Wherefore in the Gout the feet should suffer pain.  this is the reason; for that they consist of many joints, and have for their motion and sense many nerves, which are the instruments of motion and sense; whatsoever part is most nervous, is also most sensible: and therefore the feet upon any little offence, are pained or greeved the more. Another reason is this, that about every joint is wrapped a skin, and when as a humour hath insinuated itself between that and the joint, in distending of that, until it be resolved, it worketh an intolerable grief; and it is so hard to resolve it, as that sometimes it doth indurate or grow into an hard substance, which is called nodosa Podagra, the knotted Gout. And these two causes of the dolorous state of the feet, are accidentally growing from the part itself affected. In respect of other causes I have given other reasons before in the fourfold distinction of griefs. Now it doth follow that this grief in the feet is occasioned by some distemperature. There are eight sorts of distemperatures; four simple, and four compound. 
There are eight sorts of distemperatures.  The four simple are, too hot, too cold, too moist, too dry. The four compound, too hot and dry withal; too moist and cold withal; too hot and moist; too dry and cold with all. And these inequalities come by 
The causes thereof.  reason of some unequal mixture of the four elements in us, and the dominion of some one or other above the rest. The four elements whereof we are compounded are, the fire, the air, the water, the earth: 
The four elements.  the element of fire is hot and dry, the air hot and moist, the water cold and moist, the earth cold and dry. Of these four mixed together come the four temperaments or complexions. The choleric hot 
The four complexions, and whereof they proceed.  and dry, where the fire hath the dominion: the sanguine hot and moist, wherein wherein the air hath the dominion: the phlegmatic cold and moist, wherein the water hath the dominion: the melancholic, wherein the element of earth is predominant; and of these four temperaments come the four humours, to 
The four humours, and whence they proceed.  wit, choler, hot and dry; blood, hot and moist; phlegm, cold and moist; melancholy, cold and dry. Of these four humours are framed and maintained all the parts of man's body, so that if they offend either in the first composition in any inequality, or after, by disorder of 
How a distemperature may befall any part.  diet be made unequal, then do they breed either in the whole, or in some part, the like inequality. And hence it cometh that we have hot and dry diseases, as Fevers: and we have cold and moist diseases, as the Palsy, Apoplexy, the falling sickness, and diverse more: also we have diseases of the blood, as inflammations: and likewise of melancholy. Which all diseases, as some in some one part, and some in some other, may come of the distemperature of the same part, so the Gout may also come of a distemperature in the feet, either bred therein originally, or by some disorder procured unto them, as hereafter in the causes which procure the Gout shall appear. It followeth, that it is occasioned either by some distemperature, or irregular humour: The humours of the body are either good and 
Three sorts of humours.  natural, and then nature rejoiceth in them, for that they nourish the body, and maintain it in good health and long life. Or else they are naught and contrary to nature, for that they procure diseases and destruction unto it, as when they are possessed with putrefaction. Or else they are neither good altogether, neither bad, but semimali, half naught, and this state of the humours I call irregular, because they are not altogether overruled by nature, and that in three respects: 
A humour may offend in three respects. 1 Quantity. 2 Quality. 3 Substance. Three sorts of bodies considered in Physic.  for either they offend in quantity, in being in greater abundance than the nature of the body requireth: or they offend in quality, being too hot, or too cold, or too sharp, and rodent: or else they offend in substance, when as they are declining some what from a good and natural state unto an unnatural. There are three sorts of bodies considered in physic, the body healthful, the body diseased, and thirdly the body neither perfectly whole, neither diseased, but in a neutrality between both: which is after two sorts, either when a sick body recovereth and groweth toward health; than it is neither whole nor sick: or when a whole body is declining from a healthful state and groweth to be sick. By the 
* i e. good.  first sort of humours, the first kind of bodies is maintained: and by the 
* i e. naught.  second the second kind of bodies is corrupted: and by the 
* i e. neither good nor bad. The application of the former distinction of humours.  third kind the third sort of bodies are molested. Now for the Gout, it cannot come of good humours, for that they bring no pain to the body, but comfort. And of the second sort it cannot proceed, for then there should always a bad fever go with the Gout, for that such humours have always in them a putrefaction. Wherefore it remaineth, it come of the third sort, either through their overgreat quantity, or ill disposed quality, or some depravation of substance: and these are the humours which I call irregular, for that they are not obedient to nature, and yet not altogether repugnant to nature, but by some slender means may be corrected and reclaimed unto a good and natural state. It followeth that these humours are either bred in the feet, or by a deflux descend thereinto from some upper part. When ill humours breed in a part, it is through an imbecility and weakness of that part. The strength of all parts consisteth in a natural heat, grounded and settled 
The good estate of all parts in the body consisteth in the natural heat.  naturally in that part, by virtue whereof there is drawn to the part a competent food to maintain it, and by it that food is concocted and converted into a profitable nutriture for the same part, retaining that which is good, and expelling that which is excrementitious and nought. Now when this natural heat by any sinister means is infirmed and weakened, then do the functions of that part fail in their duty; for neither can there be good concoction in the part as should be, neither sufficient expulsion of the superfluities left of that concoction in the part, as should be. Wherefore three inconveniences follow through this infirmity of natural heat. First, good and profitable 
Three inconveniences through the infirmity of natural heat.  matter is not bred in the part so affected. And the bad is not expulsed. And thirdly, the part is made a sink to receive the dross of other parts. Now if by some means an imbecility happen to the feet, that neither 
The application.  they breed for themselves a profitable nutriture, and yet cannot expel that which is unprofitable, it must needs follow, that in keeping thereof, they cannot be well, but ill affected. This is to show, that the matter of the Gout may be bred in the feet through the weak state and condition of natural heat, appertaining unto them, whereupon doth grow humorum decubitus, (as we term it) that is, when for lack of good concoction in any part, ill humours by little and little are laid up in that part, which after some season, either by their overgreat quantity, or ill affected quality, and by some depravation of their substance, prove offensive and hurtful unto that part. It followeth now, how the 
The Gout proceeding from a deflux may be in two respects.  Gout may come by a deflux of some humour descending from some upper part into the feet: which is in two respects. For either it may proceed from the brain, or from other parts in the podagrical body. The deflux of an humour from the brain is called a rheum, which is the mother of many diseases. For sometimes 
The rheum is the mother of many diseases.  it taketh course to the eyes, and thereof cometh a dropping and inflammation of the eyes, and a dimness and loss of sight; sometimes it taketh course by the nose, and is called the pose; sometimes to the mouth, and causeth great expuition, and spitting, and the falling of the uvula, and toothache; sometimes to the windpipe, and thereof cometh raucedo, the hoarseness; sometimes to the lungs, and causeth exulceration or putrefaction thereof, or some great obstruction, which bringeth a difficulty of breathing and strangulation; sometimes it taketh course to the stomach, and causeth lack of appetite and ill digestion; and if to the guts, then falleth out the flux of the belly called a lask; sometime it settleth in the brain, and groweth into a gross and thick substance, either in the fore part, as in the nerves optic, which are the conducts whereby the power of seeing doth come unto the eyes, and causeth either dimness, or loss of sight; or in the conducts that convey the power of hearing unto the ears, and there causeth a dulness of hearing or deafness; or in the conducts that convey the power of smelling to the nose, and cause either a lack or loss of swelling; or in the conducts that come to the tongue, and there doth occasion the like imperfection in tasting: Also if it settle in the fore part, obstructing the cells or ventricles of the brains, three ill diseases do grow thereupon, called three of the dead sleeps, car●s, & coma, & apoplexia. Also in the fore part it causeth a hurt to imagination. The middle part of the head is the seat of understanding and reason, where if this gross● rheumatic matter do settle, it causeth stultitia, foolishness. In the hinder part it causeth the lethargy, another of the dead sleeps, and the palsy, and the falling sickness, and the convulsion, and oblivion or loss of memory. And if it come down backward into the neck, it causeth a kind of convulsion called tetanoes, when as the neck cannot turn to nor fro, but it standeth stiff and stark without motion. If it flow down to the back, it causeth another kind of convulsion called ●pisthotonos, wherein the head and the heels are made to meet backward. If it flow forward into the muscles of the breast, another convulsion is caused called emprosthotonos, wherein the head and the feet are drawn together forward. Now if it go to the joints, it is morbus articularis; if to the hands and fingers, it is chiragra; if to the knees, it is gonagra; if to the feet and toes, it is podagra, 
The reason why the rheum from the brain doth cause many diseases  the Gout. And the reason why the rheum should occasion all these diseases is this. The brain is the fountain of nerves, principium nervorum, and in the brain are made animal spirits, which do give the power of moving and feeling, and are conveyed by those nerves into every part of the body; so that when the brain is affected in rheumatic sort, partly by them, and partly by other meatus, as it were passages, the inferior parts shall feel the effects of this ill disposition of the brain. And between the head and the feet there is a great consent, by reason of many and great nerves and veins extended directly from the one to the other, so that many shall be ill affected in their head by taking cold in their feet. This deflux also which is in cause of the Gout, may proceed from other 
Four points to be considered in every deflux.  places, as the liver, and therefore in every deflux there are four points to be considered. The first is the mandant from whence it proceedeth. The second, the matter that floweth. The third, the passages whereby the matter descendeth. The fourth is the part recipient, wherein this matter settleth itself. Now when we are to deal with a disease that dependeth upon a 
The application thereof.  deflux, we must find out from whence it proceedeth, what it is, and by what ways it descendeth, so we shall the better find a relief to the part whereunto it descendeth. And so to conclude this point, the Gout is a pain of the feet, depending upon some distemperature 
The conclusion of the first general point  of the part, or of some irregular humour, either bred in the part by imbecility thereof, or derived from some other part, and that principally the brain; which definition how it is to be understood, I have for better declaration sake, verbatim expounded, so that this may suffice for the first point, to wit, what the Gout is.  
The second point containeth the causes. The causes 
The second general point, which containeth the causes of the Gout.  of the Gout are partly external, and partly internal. The external are 
* 1 Reason.  first too moist a state of the air, for that doth engender great store of rheum. 
* 2 Reason.  Also the use of many sorts of meats; and too great ingurgitation thereof, for that doth heap up great store of humours, which one way or other must have a vent. 
* 3 Reason.  Also ill digestion, for that doth engender ill humours. 
* 4 Reason.  Also the often use of strong wines, especially fasting, because they do send up many vapours unto the brain, and fill it full of rheumatic matter, and do withal procure a weakness to the nerves and sinews, whereupon must needs follow, that nothing can be worse for the Gout, than to be often drunken. The immoderate use of Venery is wonderful ill, for that it spendeth the spirits, 
5 Reason.  and decayeth natural heat, and so procureth a weakness to all parts of the body. Also the Gout may come of overmuch sleep, especially in the afternoon, and 
6 Reason.  that immediately after meat; for that doth fill the brain full of rheumatic matter. Also overmuch watching, and fasting, and study, and labour, and sorrow, and 
7 Reason.  care, because they spend the body, and cause a weakness in the parts thereof, may occasion the Gout. It may come also of too much rest and ease, for that such 
8 Reason.  superfluities are retained in the body as should be discussed by exercise. Also much walking and travel on foot, because it draweth a deflux to the feet, may procure 
9 Reason.  the Gout. Also the use of cold and moist meats, 
10 Reason.  as Cucumbers, Gourds, Lettuce, Endive, and such like. Also it may come when any usual evacuation 
11 Reason.  is stopped, for then the matter wanting an usual vent, will flow into other parts of the body. And because exercise doth evacuate by sweat, much superfluous and 
12 Reason.  excrementitious matter, the omission or long intermission of any accustomed exercise may be an occasion of the Gout. Also too much cold in the feet, because it 
13 Reason.  dulleth the natural heat of the part. And too hot keeping of the feet, because it resolveth forth the natural 
14 Reason.  heat of the part, and so weakeneth the feet, may procure the Gout. Sometimes the Gout cometh by inheritance. 
15 Reason. How diseases may come by our parents.  The reason whereof is this. The seed whereof conception is made, is taken principally from the principal parts. For the liver giveth the blood whereof it is made, the heart giveth the vital spirit, whereby it receiveth life, the brain giveth the animal spirit, whereby it receiveth motion and sense; and secondarily it is taken from all parts of the body, so that if any imperfection be in any one part of the parents, the inconvenience thereof often befalleth the child. These and such like may be the causes of the Gout external, and they are to be found out by the inquisition of the Physician, and relation of the patient. All which do not one way procure the Gout, but some by breeding the matter thereof, some by procuring the deflux of the matter, some by weakening the joints, making them subject to the deflux. Now to come to the internal 
The internal causes of the Gout, which are four.  causes, they are either blood, or choler, or phlegm, or melancholy, and that simply some one, or more mixed together. Blood is of all humours the best. First, for that it is the matter or substance whereof the spirits are made, wherein do consist all actions and functions either vital, or animal, or natural. Next, for that it is that that doth nourish the body; for it is the treasure 
The first, to wit, blood.  of nature, and the upholder and maintainer of life, and therefore Moses said, that anima omnis carnis est in sanguine, the life of all flesh is in the blood. This blood 
How blood is made.  is made after this sort: The food which we receive into our stomach is there converted into a white substance called chylus, which being put over into the guts, is from thence sucked out by certain veins called venae mesaraicae, which are dispersed all over the upper guts and bottom of the stomach, and by them is conveyed into a vein entering into the liver, called vena p●rta; a●d by that it goeth to the liver, wherein it is converted to blood by a peculiar property and faculty naturally given unto the liver. Wherefore blòod 
The definition of blood.  is a humour hot and moist, made ex chylo, that is, a substance of food concocted in the stomach, being from thence and the guts, by certain veins conveyed into the liver. It is after two sorts, either good or bad: The 
Two sorts of blood.  good is known first by his substance, it is not too thick, nor too thin, but of an indifferent substance. 
The signs to know good blood.  Next by the colour, it is very red. Thirdly by the taste, it is sweet. Lastly by the smell, for it is of no ill savour or sent. The bad is, when it declineth from these conditions, and that either in respect of itself, or of other 
Ill blood is caused after sundry sorts.  humours mixed therewith. In respect of itself, it is sometimes not good, either for that the substance thereof is thicker, or thinner than is convenient, or because it is adust or burnt blood, the thicker part whereof goeth into melancholy, and thinner into choler. By admistion with other humours it may be made naught after sundry sorts, in respect of great variety of many other humours as may be mixed therewith. As being mixed with melancholy, it is made thick, and gross, and black: being mixed with phlegm, it is made cold and whitish: with choler it is made thin and pale, or yellowish, and hot, and fretting, and bitter. And being mixed with putrified humours, it is wholly corrupted in substance, in colour, in taste, and is of an ill savour. This blood amongst the rest is one internal 
The application how blood may be a cause of the Gout.  cause of the Gout, when as it is good, but in too great quantity, whereof I have given a reason before: but most of all when it is bad, either in itself, or by admistion with other humours: for being once made in the liver, it is put over into a great master vein, out of the which a great multitude of other veins, some big, some less, do ramifie, whereby this blood is conveyed into all parts of the body, and such as it is, good or bad, so doth it affect the parts of the body, either in good sort, or in bad. The second internal cause of the Gout is the humour phlegmatic, which is next unto blood, for 
The second internal cause of the Gout.  that it is indeed a crude or inconcocted blood, and in time of hunger and hard fare it is by better concoction converted into a profitable blood for the maintenance of the body. And therefore next unto blood it is of all humours in greatest abundance in the body, and hath no proper place allotted unto it, but doth converse 
This humour hath no proper place, but doth converse with the blood for three causes.  with the blood in the veins, and that for three causes. The first is to make the blood more current in the veins, which of itself otherwise would be too thick. The second is, for that with the blood it should pass to such phlegmatic parts as are to be nourished therewith. The third, that it should go into the joints for the suppling and moistening thereof, for they are compounded of dry substances, which without that kind of suppling, would be unapt to any ready motion: wherefore this humour may be defined after this sort. That it is an humour in quality cold and moist, in substance 
The definition of the humour phlegmatic.  crude and inconcocted, in colour inclining to white, or either of no taste, or somewhat sweet, which being bred in the stomach, is from thence conveyed to the liver, and from thence by the veins with the blood, is distributed into all parts of the body. This humour is either natural or unnatural: to the natural 
Two sorts of phlegm in general.  belongeth that which is before. The unnatural is made either in respect of itself, or by admistion of other humours. Of itself sometimes it is too thick, sometimes 
The particulars of the first.  too thin, sometimes roping like birdlime, sometimes like to molten glass called vitrea pituita. There is also a phlegm which is sour, which likewise is very crude; another of no taste, which is not so crude; and another is salt, and that in respect of itself. Now by admistion of other humours the like depravation ariseth, 
The particulars of the second.  being mixed with choler it is salt, or being mixed with some putrified humour, it hath the like taste; and being mixed with melancholy, it is of a sour taste. But in all these sorts of phlegm we must speak after two 
A distinction.  sorts: either properly, or improperly. Properly that is to be understood for the humour phlegmatic, which with the blood goeth into the veins. Improperly all the cold and gross matter that cometh out of the brain, and out of the lungs, and stomach, is called phlegm. Now for the Gout, it may come either of the humour itself, or being mixed with other humours. 
How the Gout may come of phlegm.  If it come of itself, then must it not be thick or gross, for that is not apt for a deflux, but it must be a thin phlegm, which may be fluent, and this doth happen to old men and such as are of a cold constitution, which through weakness of natural heat do breed it, and therefore in such we shall often see towards night their legs to swell; for the humour being not good, the heart and stronger parts put it down to the lower, where it doth settle and swell. But in younger persons we shall seldom see the Gout to come of this humour alone, but being mixed with choler, which maketh it more fluent, and more to afflict the patient Wherefore 
The third cause internal of the Gout.  now I will entreat of the third cause internal of the Gout, which is the humour choleric. It it is to be understood, that the food whereon we feed, is not of one simple condition, and nature, and therefore is not in us converted into one only humour, but more. And as in the liver this food is turned into blood, so in the same part is there a purification of the blood by separation of other humours, and by taking of them to their proper places, wherefore with blood there are made in the liver both choler and melancholy, for the thinner part and hotter is turned into choler, and the thicker and grosser into melancholy. The choler is drawn from the blood by the gall, and the melancholy by the spleen, which two places are the receptacles of these two humours. This choleric humour as the 
The choleric humour is of two sorts.  former is either natural or unnatural: the natural is an humour in quality hot and dry, but not actually dry, for that in touching it is felt to be moist, but potentially, for that it hath the power of drying, and in substance thin, in colour yellow, and in taste bitter. This 
The definition.  being bred in the liver, is divided into two parts; the unprofitable part is passed over unto the gall, and the profitable goeth with the blood into the veins, which is for two causes, the one that it may go to nourish such parts as in whose composition and complexion this humour hath aught to do, the other that by the sharpness and thinness thereof the blood may pass the better through the small veins. That which is in the gall, is evacuated by a conduct into a gut called jejunum, the empty or hungry gut, for that the choler coming into it doth cleanse and scour it, and so keep it empty. And it is evacuated into the guts for two causes; the one to cleanse and scour them from slimy and gross phlegm, the other to excitate and stimulate them to expel the excremental dross of the guts. The unnatural humour of choler is made of itself by adustion 
The unnatural choler is of two sorts.  or by admistion of other humours, as with thin phlegm, and it is thin choler, and of the colour of the pill of pome citron, called cholera citrina; or with 
more sorts of choler.  thick phlegm, and then it is thicker, called cholera vitellina, because it is like the yolks of eggs, which as they are some of a paler, some of an higher colour, so is this kind of choler: this choler by the action of greater heat doth become green, and is called cholera porraria, because it is green like to leek blades, and by greater heat it doth become black like unto rust, and therefore is called oeruginosa cholera. Of all these sorts of choler the fittest to breed the Gout is that which 
What kindé of choler is in cause of the Gout.  with the blood doth pass into the veins; for together with the blood it goeth into all parts, and according to the disposition thereof affecteth such parts as are offended therewith: the signs whereof shall be declared hereafter. The last cause internal of the Gout is the humour melancholy, which humour is in quality 
Melancholy the fourth internal cause of the Gout. The definition  cold and dry, in substance thick, and somewhat slimy, in colour black, in taste sour. The original whereof is in the liver, and the thinner part goeth with the blood into the veins for the nourishing of such parts as are by constitution melancholic: and the grosser 
Two sorts of natural melancholy.  part is drawn from the liver by the spleen, which is the proper seat of melancholy, and from thence is put over into the stomach, and that because it should in the mouth of the stomach procure the sense of hunger. For hunger is a want of food, the feeling or sense whereof is in the mouth of the stomach, and that sense is made of the sourness of this humour, whereby the orifice or mouth of the stomach is shrivelled and wrinkled, and drawn together, whereof is made a desire of food. And these two sorts of melancholy are natural. There are also some unnatural, as when by excess of heat the natural melancholy receiveth adustion, then is it unnatural, and called adust, which if withal it hath any putrefaction, it breedeth bad melancholy fevers. There is another melancholy humour 
The unnatural melancholy.  unnatural, which cometh by the adustion of choler, which is a most evil humour, whereof cometh dementia ferina, a belluine madness, when one is as mad as a wild beast. Another unnaturrall humour melancholic, doth proceed of the adustion of other humours, as of blood and of salt phlegm. The fourth is when in the unskilful cure of tumours there is left an hard substance, for this if it should come to exulceration, would prove a cancer, a kind of ulcer which is hardly cured, or not at all. Now the Gout doth indeed seldom proceed of the melancholic humour: first for that there is no great store thereof in man's body: secondly, for that this humour is not apt for a deflux, because it is gross. Notwithstanding sometimes it falleth out, being mixed with some other humour it may communicate with it in the procuring of the Gout. And thus far forth concerning the causes external and internal of the Gout.  
It followeth now that I deliver the signs whereby 
The third general point containing the signs of each cause of the Gout.  each cause is to be known. And first for the causes external, they are to be found out by the inquisition of the Physician, and relation of the party, for the Physician must ask the patient of each one, and the patient must answer particularly, so shall it appear by what external means he hath gotten his Gout. Wherefore ●ereof I surcease to speak, because it standeth in the private conference of the Physician and patient. But concerning the causes internal, they do only stand in the skill of the Physician to judge of, and to discern by the signs. Wherefore first of the first internal 
The sign●s of the Gout proceeding o● blood.  cause of the Gout, which is blood. Whereof when it proceedeth, it is to be known by these signs, first of the manner of the tumour, for when the Gout proceedeth of blood, then doth there concur a tumour or swelling, and that very big. Next of the colour, for the tumour will be very red. Thirdly, of the heat of the part, for it will be but of a tolerable heat. Fourthly, of the manner of the grief, for it will not be extreme, and that by distension, for that the fullness of blood in the part, doth by dissevering such parts as are united, cause in the part affected a distending grief. Hereunto must be added the complexion of the patient, which if it be sanguine, it confirmeth with the former evidence, that the Gout proceedeth of blood. Also the age is to be considered, whether the patient be young; and his manner of diet, whether he doth use to eat liberally, and that of the best and most nourishing meats and drinks. Also his custom of life, whether he live at ease and much rest, enjoying many delights, which if they concur to the former, it is the greater confirmation of blood. And if any usual evacuation of bleeding by the nose or otherwise be suppressed, after that the Gout befall to the person, it is an argument that it is of blood. If the Gout proceed of choler, then is it 
The signs of the Gout proceeding of choler.  known by these signs, first the tumour is not so big: The colour thereof is pale. The heat that followeth this humour is most vehement. The pain it procureth is untolerable. It is greatly relieved by application of cooling things. Hereunto must be added the complexion of the patient, whether it be choleric. Also his age, whether he be in the middle age, which is from five and thirty to five and forty, the hot and dry time of man's age. And whether his diet hath been of choleric meats, and hot and dry wines. And whether he hath led his life in sorrow and care, or watching, or study, or fasting, or hath used great labour and travel: which all, or some, if they concur; because they are the breeders of the choleric humour, they signify unto us the cause of that Gout to be the said humour. But when the Gout proceedeth of a phlegmatic 
The signs of the Gout proceeding of the humour phlegmatic.  humour, than the tumour thereof will be very big and soft? The colour thereof white. The pain not great, except so great quantity of the humour possess the part as that by distension the pain is augmented. The heat it procureth is little, and it is relieved by application of hot things. The complexion of the party is phlegmatic, or having used meats of a cold and moist constitution, and lived in much rest, without competent exercise, giving himself to much sleeping, or bathing, and that immediately after meat. Also the old age is a sign of this humour, and the cold time of the year, as winter, a cold and moist-habitation, which are both causes and signs of a phlegmatic humour. Now if the Gout proceed of a salt phlegm, than together with the other signs, there will be in the part affected a great itching, which is caused through the saltness of the humour. The Gout doth seldom come of a melancholy humour, but when it 
The signs of the Gout proceeding of melancholy.  befalleth, it is known by the tumour, for it is little and hard, and in colour black. The pains will be as if the part were bored with a percer. There will appear little heat, but rather a cold. The person is in the declining age, as from forty five to fifty five. His complexion is melancholic, and hath used to eat of melancholic meats, and to give himself to much labour and travel, even to overgreat defatigation, his habitation is in a cold and dry place, and commonly it haunteth him in autumn. Thus far of the signs of such particular causes internal as occasion the Gout: which causes being sometimes confounded, as blood and choler, or blood with phlegm, or melancholy; or melancholy with blood, choler, or phlegm, the signs are more hard to be seen, and therefore the cause more hard to be known, and the cure very hard to be performed; for in a confusion it is hard for a man to determine upon a certainty, and that which may be good for one, is hurtful to another, whereas things of contrary natures and dispositions are confounded together; wherefore herein doth chiefly consist the skill of a good Physician, as by the signs to judge whereof the confusion is made, and to discern the one from the other, and so to moderate his medicine, that in doing good to some one which principally hath the dominion, it may not work any inconvenience to the rest. This because it is a curious piece of work, and standeth upon many terms of our Art, it will be but obscure and tedious, if I entreat thereof, wherefore here an end of this point, which containeth the signs of such causes as procure the Gout:  
Now to the next point, whether the Gout may be cured or not? I would I could warrant the cure, for I 
The fourth general point that is, whether the Gout can be cured or no?  might be the richest Physician in England. Many make many vain brags to win them a name, but if a man will show himself honest, and good, and to profess a troth without collusion or dissimulation, he must needs confess that he cannot radically cure the Gout, with warrant that it shall never return. First, 
The reasons why the Gout is hard to be cured.  for that Gout which is by inheritance, it is altogether impossible to remove it, for that imperfection which cometh by kind may be relieved, but not removed by Art. And that Gout that cometh by surfeiting and banqueting, it is most hard for such persons to keep a good diet, wherein indeed the whole preservation consisteth. And when the joints are once weakened, it is an hard matter to reclaim them to a natural state, because they are far from the heart, the fountain of heat, which should be their comforter. Likewise such parts as by their depravation do breed the matter of the Gout, will hardly be reform; for both the part that breedeth, and the parts that receive the matter, are so far distant from the stomach, whereinto the helping medicines are to be received, that before they can approach either part, they suffer so great alteration, as that they lose their proper effect, and cannot work to that purpose upon those parts as they should. I add hereunto, that when a water taketh a course, it is hardly restrained, so when a deflux hath once took a course, it is hardly restrained, for the stronger parts will evermore disburden themselves by the same course. In ancient time the 
Why in ancient time the Gout was not so common  matter was not so hard, for that people were of a more temperate and orderly diet. Then was it true that Hypocrates saith, that eunuchs were not subject to the Gout, for that they used no venery; which because it weakeneth the joints and other principal parts, if it be used too often, doth procure the Gout. And that women, except their natural terms were suppressed, were not subject to the Gout; for by that evacuation their bodies were cleansed and preserved from superfluous matter. And that no young man before he had betook himself to venery, could be possessed with them Gout. But now because of excessive and disordered diet, or some other disorder whereinto this age is incident (I know not who can be exempted from the Gout, except he can overrule his affections, and direct himself by great moderation) and having once got it, it will be hard for him to remove it. Paulus Aegineta saith, that the Gout by reason of so manifold causes whereof it may come, and are hard to be known, doth bring with it a very heavy conceit, to wit, that it can no way be cured by the Art of Physic. And Tralli●nus saith, that when a humour is once confirmed in a joint, there is no hope that the part can be reclaimed to a natural state. And Galen is of the same opinion, which is to be understood of the perfect and radical cure of the Gout. As for the fit, no doubt there are many good means to relieve and remove it. Wherefore thereof I will entreat, coming now to that point which containeth the cure of the Gout.  
The cure of the Gout must be referred to the causes thereof; for except the cause be removed, the effect 
The fifth general point, that is, the cure of the Gout. The cure in respect of the causes external.  will still continue. I have said before, that the causes of the Gout are either internal or external. Now for the cure of the causes external, as they are to be understood by the patient, so he being warned of the Physician to forsake and avoid the same, shall find a good relief to his Gout. If he live in such an air as may procure it, the counsel of the Physician is to change. If by overmuch feeding and ingurgitation of meats of sundry sorts, than he must use a more temperate diet. If it come by excessive use of drinking, that must be avoided. If it come by ill digestion, than the patient must be careful of better. If it come by overmuch venery, that is to be used in more moderation. If it come by too much labour, or fasting, or watching, or sorrow, or care, than the ground of the cure is to abandon the cause. If it come of too much ease, then let the patient use more exercise. If of too much walking and travel on foot, then let him avoid it. If any usual evacuation be stopped, let the Physician procure it again, or derive it by some other course. And so if the patient can tell from whence his Gout either beginneth, at the first; or afterward doth come to a fit, let him avoid that cause, and it shall be a great help unto him: for except the patient be obedient herein, no good cure can be done. The cure of the Gout in respect of the causes internal, have two principal scopes, the one is 
Two principal scopesin the cure of the Gout to be observed.  an order of diet, the other consisteth in administration of medicines; and neither of these can be general, but particularly must be appropriated unto the cause. Wherefore first I will begin the cure of the Gout proceeding from blood.  
And first for the diet of the patient, which in all 
The cure of the Gout proceeding of blood. What diet must be observed.  diseases is a principal point, the air must be somewhat disposed to coldness and dryness; sleeping and watching must be used moderately. If the belly be costive, it must be made soluble with gentle clysters, when as the flux doth begin, the patient must rest and hold up his leg on a stool, for the motion would draw down the greater deflux, and laying up doth resist the deflux, but when it is in declination, a little motion is good, for that it doth evacuate that which remaineth. All sorrows and cares, and great perturbations of the mind must be avoided. Little meat must be used. especially if it nourish much, and breed store of blood, because that increaseth the cause. Wherefore in the fit of this kind of Gout the patient should altogether abstain from flesh, or if that cannot be by reason of his weakness, then let him eat of birds, especially such as live in the hills, as Feldefares, Thrushes, Black birds. And wine in this cause must altogether be avoided, for that it is an increaser of blood, and through the heat and thinness, and peercing property, it searcheth each part of the body, and both breedeth and stirreth defluxes. Wherefore many by abstaining from wine have had more speedy recovery, and longer intermission of the Gout. Here also the use of Venus must be omitted, or seldom and moderately used; for there is nothing worse to procure the Gout, especially if it be used daily, and out of season, as when the stomach is full, for than it destroyeth concoction, or when the body is too empty, for than it spendeth and weakeneth the body. And here because eating and drinking too much, breedeth great store of raw humours, the patient must give himself to a moderate and sober diet, for as Hypocrates saith, the principal point. of maintaining good health, is not to stuff the stomach too full, and to be ready to put the body to exercise. This order being observed in respect of the air, and eating, and drinking, and sleeping, and watching, and resting, and stirring, and such like, we are to descend to the cure. The Gout when it cometh of blood, requireth 
The administration of medicines.  some things inwardly to be given, and some things to be done outwardly. The order of both is after this sort. First we must give a lenitive medicine, either by clyster or potion, or in a solid substance, which 
internal.  must be such as stir not the humours too much, for that will increase the deflux: as by the mouth may be given Cassia, and Manna, and the syrup of roses solutive, or such compounds as consist of these and the pulp of damask prunes, and tamarinds, and such like. Next it is good to let blood, especially at the first beginning of the Gout, for that doth evacuate the matter thereof, and the blood must be let on the same side whereon the Gout is; as if it be in the right foot, we must let blood in the right arm in the liver vein, which by way of revulsion and plucking back the blood that is descending, doth good: And here Galen reporteth that by letting of blood in the spring in such as have been oft taken with the Gout, he hath preserved them from it a long time. And Aetius is of the same opinion, counselling not at the spring only, but more often to let blood. But Paulus Aegineta thinketh that such as are often troubled with the Gout, shall receive more harm than good by letting of blood, especially if the body be but of a weak constitution, and inclining to a colder state. And Alexander Trallianus is of the same opinion, wherefore it must rest in the wisdom of the Physician, to consider of the state of the body, and age of the person, and times of the year, and such like circumstances, which may give him warrant for his action. Next we may use some purgation if need be, so it be gentle. And we must apply to the foot somewhat to strengthen the part, and to put back the deflux, and to mitigate the pain. To this purpose at the beginning 
external or local medicines. To repel the descending humour.  of the fit, we do use old wine-vineger mixed with oil of roses, especially if the pain be settled any thing deep in the joints; for the vinegar doth penetrate, and having an astringent property, doth strengthen the part, and because it is cold in operation, it doth repel the deflux: and the oil of roses doth both comfort the part, and mitigate the pain. If the pain be not grounded so deep, and the inflammation not great, than we must use oil of roses, and a little white wine in summer not warmed, in winter made a little warm. 
Partly to repel, and a little to resolve.  And a stronger than this is, to take of the pill of the pomegranate, and Sumach, and Sengreen, boil them in water and vinegar, and add thereunto the flower of barley or beans, and some oil of roses, and apply it unto the part. Also a pomegranate if it be boiled and brayed in a mortar, is of itself good to be applied. Also it is good to take of Goat's milk, and Ewes milk, and boil therein some flower of barley or beans, and 
To ease the pain, and to resolve, and a little to repel.  some of the flower of Fenygreek seed, or crumbs of white bread, and mix therewith the yolks of eggs, and the oil of roses, and a little saffron, and vinegar, which must be applied and often changed. Also take Quinces well boiled, and bray them in a mortar, with the crumbs of white bread, and oil of roses, and apply it: When the part must be washed, we must not take water only, but water and vinegar warmed, or 
An observation.  the decoction of some astringent thing. Now when by these means the deflux is wholly restrained, and the pain somewhat ceased, than we may apply things to resolve out that which is descended into the part affected. Such are the oils of white Lilies, of Camomile, 
Medicines to resolve.  of Dill, either applied so, or with a little virgin-wax made in form of an ointment: or the decoction of them with Mallows and Holy-hock leaves, and roots, and the seeds of Fenygreek, and Linseed, with which decoction it shall be good to bathe the part, and the residence of the decoction being beaten in a mortar into a pulp, with a little oil of Roses, and Camomile, and Dill mixed together, will be good to be applied unto the part. Much more might be added unto this cure, but it would be too tedious, and I must express many things in Latin terms, which would 
The cure of the Gout pro ceeding of choler.  be obscure. Wherefore I pass over unto the cure of the Gout proceeding of choler: And first for the diet, the air must be inclining to moisture and cold: rest 
The order of diet.  and sleep are to be used, for watching and labour are naught, for that they increase the heat and choleric quality of the humour, in which sense abstinence is alike naught: Wherefore it shall be good for the patient to take his meat, as a Ptisan, or the pulp of a Ptisan, or a Chicken boiled with Lettuce, and Endive, and Succory, or other cold herbs. Boiled meats are better than roasted. Albeit, Capon, Hen, Pullet, Fesant, Partridge, Blackbird roasted, are allowable. In a choleric state Fish is not disallowed, so it be such as do feed in sandy and gravelly water. Some fruits are not forbidden, as pomegranate, and Pears, and Cherries, and such as have some little astriction. The drink must be small, wherefore wine in this case is most hurtful. In meats and drinks that moderation must be used, as that the stomach be not overcharged. As in the former it was tolerable to use but little Venery, so here it is altogether forbidden. It is also most hurtful to be angry and testy, for it inflameth the humour, and stirreth it more: wherefore all means must be used for music, or pleasant conceits to delight the patient. These for the diet. The administration of medicine hath this kind of method. First it shall be good if 
The order of administration of medicines.  the belly be too costive, to use an emollitive clyster, or some of those gentle things prescribed before, as Cassia, Manna, syrup of Roses, or Violets solutive, or sugar of Violets, or the pulp of Tamarinds, or such like, which work upon choler in gentle wise, neither stirring nor heating the humour. Then it shall be good to use a vomit, as with warm water and vinegar; or syrup of Acetose or Oxymell, mixed together, and drunk: for that by revulsion may do good by plucking back the humour descending. Next some for the same cause do let blood, but that must be done with circumspection, for that the blood is a bridle to choler, repressing by the moistness thereof, the dryness, and heat, and acrimony of choler. Wherefore therein the Physician is to use good discretion, whether in the person affected, it shall be so expedient or no. After this, the choleric humour which causeth this Gout must be repressed somewhat, that is, his acrimony, heat, and fury must be abated by cooling potions, as of Endive, and Succory, and Lettuce, and Violet leaves, and Strawberry leaves, or such like, either decocted or made in syrup, and taken with barley water: or the boiling of a Chicken, or some other convenient liquor. This being done, the humour is to be purged with Rheubarb, yellow Mirabolans, and some of the former contrived into a potion. As take of the decoction of cold herbs, or of the distilled water of Endive four ounces, infuse therein all night two dams of Rheubarb, and of the yellow Mirabolans one dram, in the morning strain it, and express it some what, then add thereunto of Cassia one ounce and an half, of the syrup of Roses solutive two ounces mixed altogether; and drink it in the morning fasting, abstaining to eat by four hours after; then take some of the broth of a Chicken, if the deflux continue, than the purpation must be taken again, until the cause be somewhat stayed. Next hereunto must be used local medicines to strengthen the part affected, 
Local medicines.  and to cool it, and to appease the grief that the part abideth. Take oil of roses, the yolks of two eggs, and a little vinegar, it shall both cool, and comfort, 
To repel and mitigate pain.  and mitigate the pain. Or take the juice or decoction of cooling and astringent herbs, as of Plantain, Polygonum, 
To cool and repel.  Sorrell, Purslane, Nightshade, Singreen, or such like, which being grreene and stamped in a mortar, may be applied to the part for the cooling thereof, and repelling of the humour. If hereunto be added some oil of roses, and some barley flower, it shall be better. Also the seeds of Psyllium being boiled in 
To cool and mitigate pain.  water, and brayed in a mortar until it come to a pulp, with the flower of barley, and so applied to the part, doth in excellent sort both cool and mitigate the pain. Aetius reporteth of one, that being in most intolerable 
An experiment.  pain of the Gout, put his feet into cold water, and received singular relief. The pulp of Cassia with the powder of Camomile flowers is well commended to be applied 
To mitigate pain, and to resolve.  to the part. Now if the pain be so outrageous that nothing can asswageit, than we do use some things to dull the sense of the part, which are to be used with great circumspection. Such are Henbane, and Poppy, 
Stupefactives  and Hemlock, and juice of black Poppy called opium. This must be used in little quantity, and must not lie 
A caution to be observed.  long to the part. And when the part is amended, than some warm things must be applied to recover the cold disposition which by these extreme cooling things is got into the part. Now to come to the cure of the Gout proceeding of a phlegmatic humour. And first 
The cure of the Gout proceeding of the humour phlegmatic.  for the diet: The air must be hot and dry, whereunto if the time of the year do not serve, than it must be procured by art. Much sleep is not good, but some watching is better, because it doth dry. And for the same cause fasting is good in this kind of Gout: moist 
The order of diet.  meats are hurtful, as Veal, Lamb, Pig: Coneys, and such birds as are rehearsed before are better: Fish is not good, but if it be taken, it must be boiled with 
The method of cure.  Hyssop, and Thyme, and winter Savory, and some such hot & dry herbs, to correct the moistness thereof. Wine is forbidden, but yet it may be best tolerated in this kind of Gout. All fruits & cold herbs must be avoided. The manner of cure is to procure a vomit, if the patient be apt thereunto, and do it with some facility. Next the humour must be prepared with such things as do extenuate and rarify the humour, as honey made with roses, and honey made with vinegar, called oxymell; or with the syrup or decoction of staechas and betony, and such like. Then must the humour be purged with such purgatives as do respect phlegm: as with Agarick, and the seeds of Cartamus, and the great Mirabolans, and Diaphenicon, and Electuarium Indum, and such like infused and mixed in a convenient liquor. After purgation, if the person do much abound in cold humours, it shall be good to give him▪ Treacle or Mithridate: 
The order to be used in applying medicines.  After this we may come to the local medicines, which in the beginning must be somewhat discussive, and more astrictive; in the increase of it they must be less astrictive, and more discussive; and in the very rigour thereof they must be such as ease the pain, and discuss: and in the declination they must 
A caution to be observed.  be wholly discussive to resolve out that matter which by deflux is descended into the part. But therein this observation must be used, that things of too hot operation be not applied; for the thinner part of the humour will be resolved, and the grosser will grow into a hard substance, whereof cometh that incurable Gout called nodosa, the knotted Gout. Wherefore in the beginning it may be good to take Thyme, and Pennyroyal, and winter Savory, with Mallows, and Holly-hocks, the roots of white Lettuce, and Fenygreek, and 
This is to dis●●sse and repel.  Linseed, boil them in sharp vinegar, and being throughly boiled, take of the decoction, pour it upon the part, and also bathe it therewithal. In the increase Neat's dung, or Goat's dung, with barley meal 
This is more discussive.  and Barrowes grease, all mixed together over the fire, with a little vinegar, being applied to the part, will do it good. In the vigour this may be used; take the oil 
This is more discussive.  of white Lettuce, and the oil of Roses, and oil of Camomile, and Dill, and some May-butter, and of Deare-suet, and of Ammoniacum and Galbanum, dissolved in vinegar, and with wax make thereof a plaster, and lay it upon the part. If there be no great heat in the part, it may be made stronger. In all sorts of Gouts some do use a defensive of bowl armoniac and whites 
A defensive.  of eggs, binding it hard below the knee to straighten the passages whereby the deflux descendeth, and so to prohibit any further deflux: as in the toothache by a rheum, we use a plaster to the temple to prohibit the falling down of the rheum. To this kind of Gout the Bath is most good, especially when it declineth, for otherwise it may be too hot, and so procure a greater deflux, and augmentation of heat. Also Snails being bruised in a mortar, and laid to the part, is excellent good. Take of Castory, and Frankincense, of the marrow of a Hart, and of Goose grease, of the oil of Dill, and Nard, oil of Baellium and Galbanum, dissolved in vinegar, and of the meal of Linseed, and Fenygreek, and so much Vigin-wax as will serve to 
This is good in the declination of the fit. The cure of the Gout proceeding of the humour melancholic.  make a stiff plaster: This doth resolve very well, as many more which I omit to set down because it would be too long. When the Gout consisteth on a melancholy humour, (which chanceth seldom) then the diet must be accordingly prescribed. As the air must incline to moisture and heat, sleeping and watching must be in moderate sort. The meat must be of the best, as Partridge, Fesant, Capon, Chicken, and such like. All wild fowl is naught, as also Venison, Hare's flesh, and Beef, and all salt and burnt meats. Such fish as doth live in gravelly, sandy, and stony waters, being boiled 
The diet.  with some of the hot herbs and Borage, and bugloss, is not amiss. Vinegar and all sour sauces and drinks are not good, for that they turn to melancholy. It is most hurtful herein to be sad and careful. Concerning the cure: Neither this humour, neither the former 
The method of the cure by medicines.  of themselves require any emission of blood, for that the state of those bodies which they possess, is already too cold, but if it chance to be mixed with blood, then at the very beginning it shall be convenient to let blood, premising some solutive clyster, or lenitive medicine. Next the humour and body must be prepared with such syrups or decoctions as do respect melancholy, as with Borage, and bugloss, and Fumitory, and tops of Hops, and Cetrach, and such like. Then the humour must be purged with such purgative medicines as respect the humour, as with Sena, Polipody, the black Mirabolans, Epithymum, with Catholicon, and if need be, Diasen●a, and confectio Hamech. When as the humour is somewhat stayed by purging, then must we come to local medicines, which first must be to repel; next to resolve. Such as repel must be moderately hot, because the humour is cold of itself, as the 
The local medicines.  leaves of the Terebinth tree, and of the Cipres tree, and the roots of Cyprus boiled in vinegar, wherewith the part is to be bathed. To resolve this or such like may do well: Take of the tender Bay leaves, and of Camomile, Dill, Pennyroyal, of Basill, and the roots of the Flower-de-luce, boil all together, and with the water bathe the part, and stamp the herbs into a pulp, whereunto add the flower of Barley, and Fenygreek, and Linseed, with some Capon's grease, or oesipus, or Goose grease, and May-butter, and apply it warm to the place, and so change it often. And if one thing cannot do good, we must devise some other; for it falleth out oftentimes that some one thing may do good at some times, and sometimes it can do no good; 
An observation.  and being applied a little while, it doth good; and being longer to the part, it doth harm.  
Now if the Gout come not of any several humour, 
The method of cure when the Gout pro ceedeth upon a mixture of humours.  but by the mixture of more, then is there a great discretion to be used of the Physician, either to judge of the predominant humour, or of the manner of their mixture, and accordingly to apply his remedy. As if choler, or blood, or phlegm, or melancholy be predominant, than the medicines or cure must chiefly be appropriated to that, somewhat respecting the rest; or if there be an equal mixture of all (which doth seldom befall) then there must be such a mixture of things for the cure as shall respect all, not doing harm to any, but good unto all. And this makes the Gout so hard to be cured; for if in a deflux one only humour would descend, we should easily know it, and sooner amend it; but it falleth out for the most part, that one brings down another, and more do concur, and such as are of a contrary nature, as choler and phlegm, then groweth it out to be hard both to judge of the cause, and determine of the medicine, for that that doth good to the one, may do harm to another. Thus in rude manner 
A conclusion of the five general points antecedent.  I have gone over the Gout, first showing the nature, and essence thereof. Next in giving the causes thereof. Thirdly in delivering the signs whereby each cause is to be known. Then in discussing whether it may be cured or no. And lastly what method or kind of cure is convenient for the Gout in respect of such causes whereof it proceedeth.  
Now because he that hath once had the Gout, and 
The last point which is a preservation from the Gout.  he that feareth lest he shall have it, would gladly have some means how to avoid it: It remaineth that I set down an order of preservation, which albeit I cannot do so absolutely, for that it must chiefly be referred to the person affected, so that one only rule cannot serve all, because we are not all alike in constitution, in diet, and such like; yet I will endeavour a general order, which shall be good for all such to observe, as would be willing to avoid the Gout. And first in these diseases that are reciditive and chronical, long lasting diseases, the 
The order of diet to be used of such as will be preserved from the Gout which doth consist upon three general points.  the chiefest and principal point is to observe a good diet. This diet must concern certain points; first, that it be such as doth not breed distillations and rheums. Next, that it be such as doth not frait the body too full of humours. Thirdly, that it be such as doth not breed any weakness in any principal part or in the joints. To these purposes, first we must take choice of the air, avoiding a moist and cold situation, as by some river, and standing pool, or marish ground, or moted habitation. Cloudy or rainy and 
The air.  misty weather is naught: wherein we must keep within, and keep a good fire. Hypocrates saith that the Southern winds do fill the brain full of rheumatic matter, because from the meridional point they blow cross over the seas, and by the vapours thereof are made moist, so that being hot of themselves, and moist by the sea, they become unwholesome; disposing things to putrefaction, and filling them with too great store of moisture: wherefore they in this case must be avoided. A clear air wherein the Sun shineth, the wind standing somewhat Eastward or Northward is best. In meats and drinks we must observe certain 
Of meat and things to be considered therein. Substance. Quantity. Quality. Time. Order. Concerning the substance. Mutton, veal, Capon, Chickken, Partridge pheasant, Pullet, Rabbit. Uenison. Wildfowl. Beef▪ Salt meats. Fish.  points, as the substance, the quantity, the quality, the time of taking them, and the order how they are to be taken. First for the substance, the meat should be of a good substance, breeding good humours, and of no hard digestion, as Mutton, Veal, Capon, Chicken, Partridge, pheasant, Pullet, Rabbit. Wild fowl is held but of a gross substance, but Woodcock, Snight, Mallard, Teal, Whinder, Heathcock, and generally such as have the whiter flesh, may be taken, but Goose, Duck, and such as are of a black flesh are reproved. Beef is of a hard, gross substance, Hart, Hind, Buck and Do are the like. And because they are prepared with much pepper and salt, and thereupon we pour in great store of wine, they procure much inconvenience. Salt meats breed no good juice, nor humour. Fish is a moist meat, but being such as we call petrosas or saxatiles, that live by rocks, or upon gravelly waters, being boiled with some of the hot herbs, Whiting-gurnat, Haddock, are good; Salmon if it be boiled in water and vinegar with rosemary, may be eaten, Pike is not amiss, especially if it be taken in a scour, or put into a stew to be cleansed; So Bream and Carp should be used: and generally such fish as live in muddy or in gross water, either is to be rejected, or to be corrected in the keeping or dressing. Herbs breed no good substance, especially in 
Herbs.  our Climate, for that the heat of the Sun is not sufficient to concoct their watery moisture, and to bring them to a perfection, wherefore we use them for sauces, and not for food: Some roots may be good, as 
Roots.  Carrot, Skirwirt, and the Parsnep if he were not so windy: the Radish breeds an ill humour; Cucumbers, Melons, Pepons, do soon putrify in the stomach. Lettuce, Purslain, and other cold herbs do thicken the spirits too much, and causeth dulness of eyesight, Capres and Olives may be eaten as sauces. Apples are naught as we use them, that is, after meat, for they 
Fruits.  trouble the stomach, and do put up moist rheumatic matter unto the brain: they should rather be used before meats, for than they make the belly soluble. Pears, Quince, Orange, Limon, Citron, Peach, and all such fruits as are tart, or have some astringent property, are to be used after meat, but not in any great quantity, for they are of no good juice, but are only taken to close up the mouth of the stomach, and to prohibit thereby the ascension of vapours to the brain. Milk, and all things made of milk are hurtful for the 
Milk and all things made of milk are to be avoided.  Gout. Only this, take old and hard cheese that is not strong of the rennet, and dissolve it in oil of Roses, white Lilies, and Camomile, being laid to the hard knob bred in the joints by the Gout, it is said to be very effectual in resolving of the same. Otherwise cheese, butter, cream, custard, and other compounds hereof are condemned; for in some stomaches they quickly corrupt, in some they turn into choler, in some stomaches they are sour, and in all they sum plenteously into the brain. Now for the quantity of 
The quantity, that is to wit, how much we are to eat.  of our meat this is a general rule, that we use that in moderate sort, shutting up the bag before it be full. Our moderation herein we shall know by our concoction, for if the stomach be not oppressed, but have in it competent food, than it agreeth well with it, and against the next meal it will have a good desire to meat, and will like very well of that it taketh, and hath no heaviness nor ill disposition in it. The quantity also may be set down in respect of the meats, for of meats of light digestion we may eat more, and of such as are of hard digestion we must eat less. Also in respect of the person, for a strong man and a choleric stomach must take more. Also in respect of the age, for young men must be allowed more than old men. And in respect of the time of the year, for in winter we may eat more than in summer. Also in respect of our labour and rest, for a man given to motion may eat more than another given to rest. And so by these and such like observations a man may determine what a quantity of meat is most convenient for him. And when we trespass herein it is to be known by an oppression that 
How we shall know when we have eaten too much.  the stomach shall feel, and by a dislike of that we have eaten. There is nothing more hurtful than such repletion. Wherefore all surfeiting is to be avoided. Notwithstanding this is my counsel, that a man rather 
It is better to eat a little too much than much too little.  offend in eating a little too much, than much too little; for natural heat is as a fire, it must have a subject to work on, or else it will work upon the good humours, and spending the body, will also itself decay, than it will be too late to yield more store of food, because than it can neither receive it, neither digest it; whereas by using a little too much, we may amend that fault by fasting some time, or purging. Touching the quality of meats, in this case I have said before, 
The quality of meats.  that too moist meats are hurtful, and such as do easily putrify. Summer fruits therefore are naught, as Cherries, and Plums; summer apples and such like; it is a most hurtful thing to feed too much on them. For the time of taking our meat, it should be a seasonable 
The time of taking our meat.  time, and usual to us, intermitting so much between our meals, as that the former may be well digested before the other be received, neither drinking nor eatting between, nor too late except necessity urge. The order to be observed in eating our meats is, first to feed on the meats of hard digestion, and the lightest at 
The order therein.  the last, albeit it is not good to feed upon many dishes, for they trouble the stomach in digesting them, being 
To eat of many sorts of meats is not good.  of sundry natures, some hard, some easy to digest; for natural heat cannot work a like effect upon both. And here I utterly mislike of banqueting dishes served 
Banqueting dishes are hurtful after meat. Curious Cooks mar good meat. Concerning our drink.  in after meat, for they corrupt the rest that was received before, and the curious cookery is not so good, for good meat is best when it is in his kind, with some convenient sauce, without so many ingredients as if it were a confection out of the Apothecary's shop. Now concerning our drink, I could wish it should not be too new, for that it is inflative; neither too stale, for that it is too peercing and fretting. And here I utterly dislike of small drink, for it doth nothing comfort 
Small drink is not good.  natural heat, and being of a thin and weak substance, it doth evaporate unto the brain, and bringing no comfort thereunto, it falleth down, and voideth by spitting, or some other rheumatic sort, whereas a good indifferent drink doth help concoction in fortifying natural heat, and comforting the stomach, and the vapours thereof that ascend to the brain, because they be warm, do comfort and recreate the brain, being cold, and cause it to work the better concoction, and retention, and expulsion, and they do convert into a profitable nutriture; for the brain which being a part moist of itself, requireth great store of moist matter, for the maintenance and sustenance thereof. As for wine it is altogether forbidden to them that fear 
Wine. Some allow of white wine in preservation from the Gout.  the Gout. Yet some Physicians allow of white wine, saying, that because it it a peercing and scouring wine, it deriveth the course of podagrical matter by urine, and so doth greatly avail in the way of preservation from the Gout. Of this opinion is Montanus, a learned Physician: but I mislike it, for in my opinion there is nothing more hurtful to the Gout than the use of white 
But nothing can be worse. The reason's.  wine and Rhennish: For first whatsoever is hurtful to the nerves and sinews, is most hurtful to the Gout, but these wines are such; for they have two properties that hurt the nerves and sinews: a peercing property, and a cooling and moistening property; for albeit generally all wines are hot, yet white wine is but cold, for it comes of a raw and incocted grape. Also what doth evaporate much to the brain is not good for the Gout, but white wine doth so, for it is of so thin a substance that so soon as it is in the stomach, it is either in the brain, or in the bladder. I add hereunto that if white wine were good in this case, than it were to be taken either fasting, or at dinner, or supper. But fasting no wine is good, when the stomach is empty, for it runs to the head, and going into the veins, heateth the blood; but white wine is most hurtful fasting, for it fretteth the stomach, and offendeth the brain in peercing and moistening the nerves and sinews. And with meat that drink must be taken that will not hasten the meat out of the stomach before it be digested, but white wine will do so, for it is a drink not of concoction, but of distribution. Lastly, at supper and at night if it be to be taken, it will replenish the brain full of vapours and rheum; for as of itself it is too apt to ascend, so by sleep it will be drawn up in more plentiful wise. Between meals it is naught, for it carrieth the remains of the former concoction into the reins and kidneys to breed matter for the ague, and for the stone, wherefore I do not like of white wine, but in the way of medicine, being taken in some little quantity with some other things, for some purpose. Claret wine may be taken in moderate sort, being neither too 
Claret wine.  old, because it peirceth too much, neither too new, but of a middle age, being sweetened with sugar, for than it peirceth not so much. The sweet wines as Muscadel, Malmsey, Bastard, are condemned. They do fume too 
Of sweet wines.  much to the brain. If a good stomach can digest of itself, it needeth no Sack, but if occasion be to use it, it should be taken at supper before meat, and at dinner 
Sack, and how it is to be used.  in midst of our dinner; for to drink it after our meat it is most hurtful, for that directly it fumes up to the brain, and causeth indeed more speedy distribution than should be. Now for the quantity of our drink, it 
What quantity of drink is convenient with meat.  must not be so much as to make the meat swim in the stomach, for that corrupteth the meat, and carrieth it out of the stomach before it be concocted; and if it be too little, then will the meat burn in the stomach for lack of moisture, so there must be a moderation used herein, wherefore these great tiplers offend much, and breed their own woe: albeit I will not deny to out-lash now and then is not amiss, especially if good evacuation by vomit or stool do ensue. As for the quality 
The quality of our drinks.  of our drink I have partly set down before, it must not be too stale, neither too new, but of a middle age, well brewed, and clear, with no sour taste: drinks of too hot a quality, are not good, as bragget, which is made of ginger, galingale, and grains, and cloves, 
Bragget.  hung in a bag in the drink when it is new. Alacras 
Alacras.  which is ale compounded with nutmegs, and ginger, and cinnamon, and sugar, may be permitttd sometime. hippocras is too hot a fellow. I have before condemned 
Hippocras.  small drink. Some think that ale is better than beer, because that beer doth fume more, by reason of the 
Ale is better than Beer.  hop. And indeed we find by experience, that ale is less rheumatic than beer, and it is a more mild and temperate drink, whereas the hop doth cause the beer to be hotter, and because it hath a power to open the liver and spleen, and to digest cold matter in them, and the brain, and other places, it becomes a greater searcher and stirrer of humours than ale. The time when 
The time to drink.  we should drink is chiefest with meat, and the order to be observed therein is first to eat, and then to drink, and eating again, to drink again, observing an indifferent proportion between both. As for drinking at unseasonable hours, it is not commended in Physic, especially for such as fear a deflux. I have wrote of two points to be rightly observed in this preservation, the air and food. The next is how we should order ourselves in sleeping and waking. We are not to sleep at all in the day time, especially soon after meat, except 
Of sleep. To sleep in the day is not good. What rules are to be observed if we sleep in the day time.  in the night we have taken no good rest. And if we do sleep, we must observe these rules, first that we sleep not immediately after meat, but use some intermission. The second, that we do not lie down, nor hang down our head, but sit upright in a chair. The third, that we take but a nap. The fourth, that we be not of a sudden awaked. Also we must put off our girdle and undo the fore point, and unbutton our doublet below all the belly. And one giveth counsel to put off the shoes, because that from the feet a reflex of vapours will strike up to the brain, and hurt the eyesight and memory. Our natural sleep must be in the night about 
Our night sleep is most natural, and requireth some observations.  two hours after meat, first using some paces up and down our chamber, and lying down first on the right side, and then turning to sleep on the left, with our head lying somewhat high, and covered with some nightcap, having the windows shut, and other defences against the cold and moist air of the night. To sleep upon the back is hurtful unto the kidneys and the ridge of the back. And to sleep grovelling upon the belly is naught for the eyes. How long we shall sleep must be measured by our concoction, for if we 
How long we are to sleep.  awake after five or six hours and find our stomach lightsome and empty, then have we slept sufficiently. One Author giveth this rule, that to sleep less than five hours is too little, and to sleep seven hours is well, but to sleep nine hours is too much; so commonly 
An observation.  seven hours may be sufficient. In the night when we awake we must use to make water, for that will be a good preservation from the stone in the bladder. To watch much is hurtful, for it hindereth concoction, 
Of watching & how hurtful it is to watch too much.  it spendeth the spirits, it decayeth natural heat, and it drieth the body, it engendereth rheums, it weakeneth the brain, it hurteth the eyesight, and is an enemy to all natural, animal, and vital operations and functions. Now commethin, another point in this preservation; to wit, what we must do concerning the moving or resting of the body; and generally it is to be observed, 
Of our exercise, and of the commodities thereof.  that exercise is good for all sorts of persons. It reviveth and stirreth up the natural heat, and it strengtheneth the joints, and causeth expulsion of superfluities; It maketh the body lusty and lightsome: It is to be used for two purposes, either to make the body fat or lean: if to fat it, than it must be done ad ruborem, 
The ends of exercise.  until the colour wax red: if to make it lean, than it must be done ad sudorem, until the body sweat: this is for fat folks, the other for lean. The place should be clean and sweet, the air pure and good, for that 
The place wherein we are to exercise.  in exercise our pores are open, and we breathe faster and thicker, so that store of air doth enter into us, which being not good, may do us much harm. For the time when we should exercise, it is to be noted, that 
The time when.  upon meat we should rest, for exercise doth bring out the natural heat from the stomach, and so doth hinder concoction, and procure raw humours; wherefore the morning is best, or in the afternoon when concoction is done. There are sundry sorts of exercises, which I will not speak of in this place, for it would be too long. But for such as are subject to the Gout, it 
What kind of exercise is best for such as fear the Gout.  shall be best, most to exercise with the upper parts, to pluck back such humours as are ready to take their course downward. As by listing of weights, or by tossing a ball at a wall, or by shooting, or having a pulley with a cord put into it, and a little stick tied at each end, and so holding each stick in each hand, to reach up and down, and to swing up and down: In this case I take this to be a most excellent exercise. But to exercise the feet overmuch, or the legs, will but draw humours unto them. Now for rest and ease, and too much sitting 
Of rest and ease and the discommodities thereof.  still, it heapeth up great store of superfluous matter fit for the Gout, and dulleth natural heat, and maketh the body heavy and unwieldy; wherefore it must not be used too much in this case. Another point in 
The fifth point of this preservative diet.  this preservative diet concerneth all such things as should be retained in the body, and such as should be put forth. For the first, any great bleeding is hurtful, for that it decayeth natural heat, and weakeneth the 
Bleeding too much is hurtful. So is Sweeting too much.  body too much. And oft sweeting is not good, for sweat being but an excrement, must be avoided in a competent quantity, and time convenient; for otherwise it spendeth the good humours of the body, and drieth and weakeneth the body too much. Hereupon often and immoderate Venery is discommended, for being 
So is often use of venery.  used as it should be, it lighteneth the body, and cheereth the senses, and edgeth the stomach; and gladdeth 
The commodities of seasonable and moderate Venery.  the mind, and this is when it is used upon a fullness of seed, than nature being disburdened thereof as of an unprofitable matter, it is greatly relieved and lightened. But to do it more often, it doth occasion a great decay unto the principal parts, and to the rest, for that from them that matter is taken whereof the seed is made, as I have declared before. To have a continual lask is in this case hurtful also, and any such 
A continual lask is hurtful, or any other immoderate evacuation.  evacuation as wasteth the good humours, and spendeth the spirits, and enfeebleth natural heat, or weakeneth the body, or any part thereof. As those things should be kept in the body, so some things there are which should be put forth, as emission of urine, and an orderly going to stool, and a competent sweeting, and such like, which being under the name of excrements, they 
Competent evacuation of superfluities is requisite.  are unprofitable to nature, and therefore nature should use thereupon the power of expulsion, which if of itself it do not, than it must be relieved by art. And here it is very hurtful to have the belly costive, for it 
costiveness is hurtful.  doth force up to the brain great store of vapours, and fills the body otherwise full of bad humours; wherefore such a one must now and then be dealing with some gentle mollitive clyster, or other medicine: it must be gentle, and not too often, lest we make nature too slothful, and then it will look for a stronger, and that more often? Now remaineth the last point of this preservative diet, which containeth the passions and 
Of the passions of the mind.  the perturbations of the mind, wherein we shall do well enough, if we give ourselves to be merry, avoiding pensiveness, sorrow, and care; not giving our minds to great meditation, and matters of study, but using our time of recreation, solace, and pastime. Which counsel Benedictus Victorius doth give to all sick men and whole men, Laetetur (saith he) praesertim cum medico crebrò offerendo illi pecunias, citius quoniam sanabitur. Thus far forth I have discoursed of the preservation from the Gout by order of diet. Somewhat 
Concerning medicinal matters what is to be done in this preservation.  remaineth to be set down in respect of medicinal matters, for twice in a year we are to use some evacuation, to disburden the body of such superfluous matter as may occasion the Gout; for few men do live so temperately, but that they heap up sufficient matter for many diseases, if by good means it may not be prevented. And this evacuation is chiefly to be used at the Spring, and at the fall. At the Spring because 
Why at the Spring and at the Fall we are to purge in this preservation.  the Sun rising to some elevation, hath more power upon these inferior bodies, so that the blood and humours are stirred, and begin to flow, and to be dispersed, so that they search every place, and if they find any one weaker than another, there they settle themselves, causing either inflammations, or Gouts, or some one imperfection or other. Now the Autumn is a bad time of the year, which of itself by the ill disposition of the air and autumnal fruits, doth engender many bad humours, which humours are also then apt for defluxes by reason the passages are dilated and opened too much by the former heat of the Summer: wherefore at this time of the year prevention must be used in taking away this defluxible matter. And this is to be done by purgation, wherein the Physician is to consider the humour like to offend, the age of the person, 
What is to be respected in this evacuation.  and his complexion, and his manner of diet, and custom of life, and strength of his body, and accordingly to determine what is to be purged, and by what things, and by what ways, and how much or little. If blood be like to offend, then that is to be let out. If choler, then that is to be purged: so likewise if phlegm, or melancholy; or if more humours are like to be mixed, and to concur, then in our purgation we must lay for them, and using such purgatives as do respect them, and convey them out of the body. And these purgative medicines must not be too strong, for 
A caution.  that such do stir the humour too much, and cause an attraction or deflux thereof unto some part which is weakened, by that strong and violent evacuation. Montanus doth always avoid them, giving this reason, quia destruunt munera virtutum, that is, they destroy the very foundation or groundwork of natural operations and functions. But here we may use a distinction of purgative medicines: some are called lenitives only, 
A distinction of purgative medicines.  as Cassia, Manna, small raisins, damask prunes, great raisins, tamarinds, syrup of roses and violets solutive, and such like, which are most gentle in working, and if they work not, are not unwholesome, for that they turn into no ill humour. Some are called benedicta medicamenta, which are stronger in operation than the former, and yet are but mild and gentle, because they cause no great disturbance in working, and if they work not, they turn into that humour which they should have purged, such are Rheubarb, Agarick, Sena, the five sorts of Mirabolans, and such like. The third kind is called vehementer purgantia, such as purge vehemently, as Turbith and Hermodactill, etc. The fourth are called deleteria medicamenta, because they have a venenosity, and do purge most extremely, as Scamony, Coloquintida, Heleborus, Elaterium, Stibium, etc. which require to be most exactly corrected, for the great danger they bring: and therefore of themselves they are seldom given, but being compounded and mixed with others, and that in no great quantity, of which compositions the Apothecary's shop wanteth no store. Now the best writers would have a man not pass benedicta, or using the other it should be in some 
The application thereof.  of the gentlest confections, wherein they were in no great quantity, and perfectly corrected. After this it shall be good to use some lotion or bath for the feet, wherein are boiled some things of an astringent property, to roborate the joints, that they may be more able to resist the deflux of any humour. And throughout all the year it shall be good to keep the body in soluble state, and rather by meats that have that property, than by medicines. Or if by medicines, then by the gentlest, as such as may be given with meat, or a little before or after. But if nature itself do work sufficient expulsion, than we may abstain from any farther attempt.  
FINIS.