A New way of curing the GOUT.  
And observations and Practices relateing to Women in Travel etc   
Sold by Moses Pitt at the Angel in St. Paul's Church yard.   

TWO TREATISES, The one Medical, Of the Gout, And its Nature more narrowly searched into than hitherto, together with a new way of discharging the same.  
By HERMAN BUSSCHOF Senior, of Vtrecht, residing at Batavia in the East-Indies, in the service of the Dutch East-India Company.  
The OTHER Partly Chirurgical, partly Medical; Containing Some Observations and Practices relating both to some extraordinary cases of Women in Travel; and to some other uncommon cases of Diseases in both Sexes.  
By HENRY VAN ROONHVYSE, Physician in Ordinary at Amsterdam.  
Englished out of Dutch by a careful hand.  
LONDON, Printed by H. C. and are to be sold by Moses Pitt at the Angel in St. Paul's Churchyard, 1676.   

TO THE READER.  
'tIS now about 14 years since I laboured under an extraordinary pain in both my knees and feet, not knowing whither to turn myself for pain, having used in vain all those means by which I formerly had found some ease. After I had passed five or six weeks in those excessive pains, which sometimes, in spite of my teeth, extorted tears from my eyes, and consumed my flesh as well as my strength, keeping me in a manner always sleepless; I was persuaded to suffer an Indian Doctress to come to me, which was of Quinam, (whom my Wife commonly employed for the curing of our slaves, and who also had been very successful in recovering my only daughter from a certain difficulty of breathing she had been troubled with for two years together). This Indian woman being demanded, whether she knew how to cure that painful disease which I was molested with; Answered, she did. But to tell you the truth, it was done by a way of Burning: Which means being by me rejected out of an apprehension I had of 〈◊〉 pain that must needs accompany such a remedy; she said, that then she would prepare something to mitigate the pains I suffered, and bring me such a medicine in the afternoon; repeating still, that if I would endure the Caustick or Burning remedy, the pain should ever after stay away: But, for all that, I could not then resolve upon it.  
The woman being gone, upon further consideration, I began to repent that I had refused the use of her Caustick; and thought with myself, that however this proposed remedy should operate, I could feel but one pain at a time, either that of the Gout, or that of the Caustick; longing to see my Doctress again; who being returned, and asked, whether she had ready her matter for the Caustick, answered smiling, she had: At the same time drawing it forth out of her pocket, and desiring me that I would suffer her to try her art and skill upon me; which having at last agreed unto, she went presently to work; having demanded a lighted candle, and solicitously searched for that part of the place affected where the greatest pain was: And thereupon she burned with her Moxa (of which hereafter) on my feet and knees, (to my best remembrance) about twenty little Escars, which looked like little grey specks, without raising any blisters, or causing any after-pain; whereupon also all the pain of the Gout vanished. All this operation was finished within less than half an hour, without any bodies hearing me complain of pain. And I herewith declare, that even whilst the burning lasted, I found myself much inclined to sleep; and that in such a manner, that after the operation was over, I was so overcome by sleep, that I slept very quietly near 24 hours together, without ever waking; whereas afore, by reason of the cruel pains. I had not been able to sleep at all for several days and nights together. Being awakened, I found, 'tis true, my feet and knees yet much swelled; but in a few days after I was also freed from those tumifying humours, by the little openings made by the same Caustick, so that I was able to return to the work of my vocation; most heartily thanking God Almighty for his goodness to me, and duly acknowledging the operation of this Indian woman, admiring withal the powerfulness of this remedy against so contumacious an evil, as is the Gout. There near passed full 27 months ere I heard any thing of a Gouty pain, and I began to be full of hope it would for ever have forgot and quitted me, according to the promise of my Doctress; which not long after, to my great sorrow, died. True it is, that after the time named, I had once, or at most twice in one year some grudge of that disease; but never any sore fit: Only about four years ago, when I fell into a very hot Fever of nine days continuance, without hope of life, that Fever changed, and ended in the Gout; all the pains of which, in a very short time, I freed myself from, by means of the said Caustick; so that I protest candidly, that being now in a Fever again, I long as much and more for a fit of the Gout, as I formerly was wont to dread it; knowing it to be an argument of the strength of the heart, when a Fever determines in the Gout: Upon which score the famous Crato, Physician to three Emperors, and the learned Sennertus, were wont to comfort Gouty men, by telling them that this evil tended to health.  
Now, from the day that I was so soon and with so slight pains cured of the Gout, I have given my thoughts liberty to expatiate upon the nature of the Gout: And first of all, to call in question, whether Physicians hitherto have had a right notion, and given a true account of the nature and qualities of this disease: And after a regorous enquiry into the matter, and upon the consideration of this sovereign remedy, I concluded, that this disease must needs have another immediate or proximate cause, seat, etc. than had been hitherto by any man clearly explained and proved.  
Whereupon I thought good to discover to the world my thoughts of this whole matter, although at first I intended to have kept them only for my best friends and nearest relations. I think, I have herein detected some things for the improvement of Physic, and for the relief of those that are subject to this disease, which else is by most men exclaimed against as incurable; and does so disfigure many a comely person, that he seems not to be the same he was before. In the doing whereof, my design is to do good to my fellow-creatures, and to lay out this talon for their ease and comfort; as also to open a way for intelligent and studious men to search into, and find out the nature not only of the Gout, but also of divers other diseases that have any affinity therewith; such as are Head-pains, Toothache, Pleurisies, Colic, and even the Falling-sickness itself. As I shall be able, in time, if God vouchsafe me life, more clearly to make out; especially, if the truth here delivered be embraced, and this small work encouraged, and the remedy here recommended put in practice; which I heartily wish may be done according to my prescript, before it be prejudged, and rejected.   


The Table of the First Part, Treating of the Description of the GOUT.  
CHap. 1. Of the Gout, and its Nature.  
Ch. 2. Of the internal swelling of the Gout, and that for the most part invisible.  
Ch. 3. Of the next and always accompanying cause of the Gout.  
Ch. 4. Of the qualities of the Damps which cause the Gout.  
Ch. 5. Of the part affected, and the seat of the Gout-making matter.  
Ch. 6. That the Gout is a common disease of the limbs, taking its denomination from the limb it seizeth on; together with the place in which the peccant matter of the Gout is bred.  
Ch. 7. How, and by what ways the peccant matter of the Gout comes to the several limbs.  
Ch. 8. Of the expelling part.  
Ch. 9 Of the marks or signs of the Gout.  
Ch. 10. Of the symptoms of the Gout.  
Ch. 11. Of the external Serous swelling, which often manifests itself in the Gout.  
Ch. 12. Of the dislocation caused by the Gout.  
Ch. 13. Of Schirrus' and Nodes.   

The TABLE of the Second Part, Treating of the Cure of the Gout.  
CHap. 1. Of the Cure of the Gout in general.  
Ch. 2. That the Gout is curable by burning with Moxa.  
Ch. 3. How this Remedy is to be used.  
Ch. 4. What Moxa is, and where to be had.  
Ch. 5. More particularly of the manner of the application of this Remedy.  
Ch. 6. What is to be done after the burning is over.  
Ch. 7. Of the admirable effects of this burning.  
Ch. 8. That this way of burning goes beyond all Remedies of Europe, against the Gout.  
Ch. 9 That this kind of bruning is very tolerable.  
Ch. 10. Of the qualifications requisite in the person that shall perform this operation.  
Ch. 11. Of the Aromatic sticks to be used in this operation.  
Ch. 12. Of the place where this burning is to be made.  
Ch. 13. Of the inconveniences and dangers attending a faultive operation.  
Ch. 14. Of the Serous swellings of the Gout, and their Cure.  
Ch. 15. Of the Nodes and stony Tumours, and their Cure.  
Ch. 16. Whether there be divers sorts of the Gout, and whether there be an essential difference betwixt them.  
Ch. 17. Of the means conducive to prevent the Gout.  
Ch. 18. Of the Gout of the Teeth, and its Cure.   

An Appendix.  
Of three very remarkable Cases.    

THE GOUT, More narrowly SEARCHED, and FOUND out; Together with The certain CURE thereof.  

CHAP. I.  
Of the Gout, and what it is.  
Theoph. I Have understood with joy, Theodidactus, that you have a singular opinion of the Gout, its Cause, Seat, Passages and Ways; as also, that you know the true and genuine Remedy against this cruel Disease, which is also come to your door, no less than it had assaulted your Father and Father-in-Law, who were so grievously tormented therewith, that they became altogether helpless, and were so spent and consumed thereby, that before they arrived to any considerable old age, they fell into their graves. Whereas I see you, to admiration, advanced to so great an age, and in so much vigour, as if you had never known or had any Podagrical person in your Family, or among your Relations, or had never been subject yourself to that merciless disease. Hence it is, that I most heartily entreat you, that you would be pleased to explain this matter to me, according to the good inclinations, which I have always perceived in you, of doing good to your Neighbour.  
Theodid. My dear Theophilus, although in doing this I step somewhat out of my Vocation; yet Christian charity constrains me to comply with your desires herein, and 10 to confine this knowledge of mine to my particular Friends and Relations; on condition only, that at this time you do ask me no more questions, than what shall be pertinent to make us come to the knowledge of the Gout and the Remedy thereof.  
Theoph. I most kindly thank you for your goodness, and promise you to contain myself within the bounds prescribed.  
Theodid. Very well; be pleased therefore to propose your questions in that order, and I shall answer you to the best of my knowledge.  
Theoph. To recover gouty persons, and to free them from their pains (without which all the blessings of this life are insignificant,) what is above all things necessary?  
Answ. To have a thorough knowledge of the Disease and of the true Remedy thereof; both which are equally necessary, insomuch that the one without the other is not valuable.  
Quest. Why is it, that for accomplishing a happy Cure, there is first of all required a well-grounded knowledge of the Disease?  
An. Because 'tis impossible to cure a disease according to Art, if the nature thereof be hid from the Artist: And the want of this is the chief reason, why the care and pains taken by so many learned Physicians hath proved so ineffectual in the Gout.  
Qu. What then are the Requisites to attain to the true knowledge of this Disease?  
An. There is required a solid knowledge of these following particulars:  
1. Of the next and ever-concomitant Cause of the Gout.  
2. Of the Seat of this Evil.  
3. Of the Part affected.  
4. Of the Ways and Passages, through which this Evil takes its course.  
5. What are the inseparable signs thereof?  
6. What Symptoms commonly accompany it?  
7. That the Symptoms of this Disease be rightly distinguished.  
If you err not in these main points, you are in the right way of arriving to a happy cure of this Malady.  
Qu. Do you understand by the name of Gout, all pain in the Limbs?  
An. No; but that pain which in sharpness and fierceness exceeds all other, and that which I mean to describe.  
Qu. To let pass the name of the Gout, pray give me a full and plain description of the Disease itself?  
An. The Gout is a preternatural, inward, deep-lurking, and for the most part invisible little swelling within in the periostium, that is, the membrane that enwraps all Bones; caused from a dry and cold ill-natured damp or vapour, which out of the arteries, by the expelling virtue of the heart, is driven out into the place that is between the bone and the periostium, for the most part into such Limbs of the Body as are about the Joints; in which this vapour being and remaining impacted and enclosed, and distending that most sensible membrane, produces those violent and intolerable pains, whereby the motion of those Limbs is encumbered and despoiled, and many other grievous accidents occasioned.  
Qu. Doth this description differ much from that which hath been hitherto delivered of this Disease?  
An. It doth: Whence it is, that I exceedingly apprehend, I shall incur sharp censures from many.  
Qu. But let this pass; let us weigh rather your description in its principal parts. And, First, I do remember, that you make the Gout to be a preternatural swelling; whereby you doubtless imply, that the Gout is a Disease wherein violence is done to nature in some part or other of the Body. But this is a novelty to me, that you add, viz. that it is an inward deep-lurking, and for the most part invisible little swelling, and that that swelling is caused by a damp, etc. entreating you, that you would vouchsafe to express this more plain, and to render reasons thereof. And first, why you call it an internal and deep-lurking tumour?  
An. The better to distinguish it from other windy swellings, in respect of its seat: For, whereas those other lie between the flesh and skin, this lies deep, underneath the membrane that covers the bone; as hereafter shall be more largely proved.  
Qu. But why do you add, that it is a little and mostly invisible swelling?  
An. Because it is so indeed.  
Qu. But pray, Sir, take care that you run not against sense, out of a blind zeal of producing a novelty. For, is not the tumour which manifests itself in the Gout, big and conspicuous enough?  
An. You do not distinguish between the Disease itself and the Symtom, which is the stumbling stone of many even learned men. And the want of this very distinction seems to me to have been the main, if not the only obstacle, why they have not lighted upon the true cause of the Gout, and why they have taken quid pro quo?  
Qu. What then is to be done, not to mistake herein?  
An. You must ever make a difference between the swelling, which is caused by the morbific gouty matter, and that which is consequent to the Gout; and this is to be laid as a fundamental Truth, never to be removed, viz. That the humour, which makes the external palpable and visible swelling in the Gout, is not the Gout or dolorifique matter. Which are not so much my words, as the words of that famous Physician of Dort, called John Van Beverwyck, delivered by him in his Book of the Gout, and which he hath borrowed out of the description of that disease, which that learned and experienced Professor of Physic at Wittenberg, Daniel Sennertus, left behind him. Which also is the reason that I shall place that aqueous and serous tumour amongst the symptoms of the Gout; where also it is to be handled, and not here, where we speak of the Disease itself.  
Qu. What, is not the humour, that causes the outward and visible swelling, the Gout or dolorific matter?  
A. No, they differ very much from one another, and may be sufficiently distinguished by those that will attentively consider.  
Qu. Wherein consists this difference?  
Ans. In this, that the one is the cause of the Disease, the other a symptom; which will be made very clear, when we shall come to treat of this symptom. But in part to satisfy your curiosity, pray mark the ratiocination of the lately named Beverwyck, saying in the quoted Book: That the humour which makes the swelling, is not properly the peccant matter, is from hence evident; because that in the beginning, before the part swells, the greatest pain is felt, and the same grows less, when the swelling appears. 'Tis true, that that learned man adhereth still to the opinion of the saltish Serum, affirming that it is a serous humour, pervaded by a salin acrimony, that causes the Gout. But herein he, as well as the great Sennertus, hath mistaken. Mean time, 'tis certain, that the external tumour is not the morbid matter itself, for the reason given; and, which is more, some podagrical persons endure great pain, without the appearance of any visible swelling.   

CHAP. II.  
Of the inward Tumour of the Gout, and how it is mostly invisible.  
Qu. I Shall for the present rest contented with the proof alleged, until we come to the symptoms: But, when this symptomatical or accidental swelling of the Gout is present, do you then observe two sorts of swelling in this Disease, one inward, the other outward?  
An. I do so; of which two, the first is that which I say in the description to be a swelling that is little, and for the most part invisible?  
Qu. Why do you say so?  
An. Because it is indeed small, and for the most part cannot be seen by the sharpest eye of the body, though it be seen by the eye of reason. For, although you outwardly perceive no swelling, you may not thence infer, that there lurks none within, forasmuch as the contrary is true in these and other swellings. See the proof hereof in a couple of observations of the skilful Physician and Chirurgeon Hildanus in his second Part, the 37th. and 38th. concerning dangerous and desperate tumours in the muscles of the stomach, in which nothing preternatural of swelling, or other disorder could be seen outwardly.  
Qu. If this tumour cannot be perceived by the eye, whence do you then know that there is an inward one?  
An. From the violent, pungent, beating, distending, and continual pain, to be easily perceived by one's finger.  
Qu. But, it seems, by what you intimate in the description of the Gout, that sometimes this tumour may be seen?  
An. Yes, it may; for at times it appears plainly enough, though few Artists take it for a gouty swelling, misled by the external appearance of it, which is in the form of a small hard pimple on the place of the part affected; of which you have a manifest proof in Pareus, the French Chirurgeon, treating of a distemper in a young woman at Bourdeaux, that had such a tumour on her thigh; though Pareus doth not record it for such.  
Qu. When may this tumour be perceived by the eye?  
An. Then chiefly, when the gouty cause attacks the Patient, not about the joints of the limbs, but in or about the middle of those places, with a boiling pain, wherein nature labours as much as she can (though she be not strong enough) to expel the peccant matter. At which time, if you observe it carefully, some tumour appears, as was said above. This I have found not only in myself, but very notably in another, that was a young man, employed here in the Foundery of Batavia, called Martin Smith of Breslaw, who having the Gout in his right foot, without a considerable afflux of humours, the evil settled on the midst of his foot, in the form of a protuberant hard pimple or button: Which I also, by the help of God, did presently cure, so that he the same hour, without any pain, went out of the house to his Workhouse, which can be attested by the Physician Thomas Flory, and the chief Chirurgeon Warner Leuretius, as eye-witnesses, that saw it with great admiration.   

CHAP. III  
Of the next and always concomitant Cause of the Gout  
Qu. A After you have sufficiently made out, that the gouty matter causes a swelling, for the most part invisible; be pleased to explain to us what is the next and always accompanying cause of this tumour; which to know, I think to be of great importance.  
An. You judge aright; forasmuch as the Cure hath always a respect to the Cause of the disease; and since 'tis in vain to hope for a recovery, as long as there is an error or mistake about the peccant or gouty matter.  
Qu. Have Physicians been of one opinion herein?  
An. No: For some have assigned the cause to be a slimy and cold humour; some, a mixture of gall and slime; some, a crude, indigested and impure blood; others, a serous humidity, mixed with an acrimonious saltness; others, winds, with a mixture of the four known humours; others, ill-conditioned winds alone.  
Qu. Whence, I pray, ariseth this great diversity of opinions?  
An. From thence only, that (as hath been already intimated) they have not distinguished the Gout from its symptoms; which hath so abused them with the notion of the humours, that they have put those out of the list of gouty persons, who in their Gout perceived no afflux of humours, absolutely requiring the same in this disease; notwithstanding that such as find no serous swelling in their gouty distemper, do feel full as much pain as others that are wont to find that afflux, whose grievous pains also are considerably abated upon the swelling.  
Qu. Which then is, in your judgement, the next and immediate Cause?  
An. We have expressed it in our above-recited description of the Gout, to wit, that it is a Vapour or Damp, dry and cold, and mixed with malignity.  
Qu. But many will look upon this as an airy and windy fancy, and no solid truth.  
An. If men shall divest themselves of prejudice, and maturely consider all what hath been said, and is yet to follow; I shall then expect a more favourable judgement, and an unanimous consent to my doctrine.  
Qu. According to your theory, the Gout is to be reckoned among Windy swellings?  
An. So it must be, because grounded upon experience, the Mistress of Fools.  
Qu. But is not this a quite new opinion; or hath there ever been any learned man that hath delivered the same?  
An. When I lately enumerated unto you the various opinions concerning the cause of the Gout, you may remember, that the last of them was that which placeth it in mere winds, Now, among those Doctors, Sennertus reckons Guainerius and Matthaeus de Gradibus, two eminent Physicians; and, as far as I can find, the Chinese Doctors are all of that mind. Besides, that ancient Physician, Guido de Culiaca (though in the Gout he follows the Humorists) relates, that he had read in some prescriptions of health given to the Popes of Rome, that this disease did arise from winds; and the Royal Chirurgeon Pareus, p. 534. assigns, for the certain cause of the running Gout, a very thin fuliginous matter, which is nothing else but a subtle smoky damp, or spirituous substance.  
Qu. But Pareus doth not speak so of the other kind of Gout.  
Ans. 'Tis true, that he affirms it of the running Gout; but then I must say, that that kind doth not at all in its essence, or next cause, differ from the other Gout, but only in some qualities, relating to the thinness and thickness of damps; those, from whence proceeds the running Gout, thinner and subtler; and those which cause the other Gout, courser and thicker. And 'tis notorious, that almost all intelligent Physicians assign damps for the next cause of Tooth-aches, headaches, Pleurisies (at least bastard Pleurisies), Colicks, and Epilepsies: Diseases which in name indeed, place, and some symptoms, differ from the Gout, but not in their true essence; they being so near akin to one another, that they acknowledge but one and same cause.  
Qu. 'Tis true, that some learned men have affirmed, winds or damps to be the next cause of the Gout; but others have rejected that opinion, and for their ground of doing so, I shall produce but one argument for all, which M. Beverwyck allegeth out of Sennertus in his Treatise of the Gout, saying, All sicknesses which arise from winds, do not last so long as the Gout; and making use of this reason for his denying the flatus or winds to be the true Cause of the Gout. And further in his Medicina, p. 62. treating of Tumours in general, he declares, That the windy swellings do vanish easiest of all. What you can say to this objection, I long to hear.  
Ans. Those great men speak here only in general of windy tumours; and what they say is only true of such windy swellings as lurk under the skin, or in fleshy parts; not in those that lie in deep parts, and under firm and thick membranes, as in the Gout, and other hidden or manifest swellings, raised from latent winds: See the proof hereof in Hildanus, p. 6. obs. 40. in a Tympanites that was refractory to all remedies.  
Qu. What then is the true cause why the Gout is so long a curing? Is the gouty cause (the damp) so difficult to be with speed removed and evaporated?  
Ans. The gouty damp is easy enough to be evacuated, and 'tis even forward to be exhaled; but there is a notable obstacle which hinders the speedy performance of it. And that is this; The impacted and enclosed damp, which causeth the windy tumour in the Gout, seeks a passage to issue out at, but finds none; partly because of the grossness of the damp; partly and chiefly by reason of the close and firm membrane of the bone, under which it lurks; especially since the place, in which this cold damp lodgeth, enjoys but little warmth, for the attenuating of this gross damp, and expelling it through the small pores of that membrane.  
Qu. But, I pray, Sir, let me know what is the chief motive that hath induced you to make Damps the only next cause of the Gout?  
Ans. First, This remedy which I here offer, as that which suddenly cures this disease: For, if it be true, that the Medicine declares the Disease, as Physicians afirm with their Master Hypocrates; I must then conclude, that no humours, but only a Spirituous thing, is the cause of this Disease. Secondly, observing the sudden motion of the gouty matter, sometimes dislodging in a very short time from one limb to another, from the hand to the foot, from one foot to the other, etc. flying as 'twere with swift wings from above to beneath, and back again; I find myself obliged to judge, that these are not Humours, but some Spirituous matter able to do such things.   

CHAP. IU.  
Of the Qualities of the damps that cause the Gout.  
Qu. OF what quality, I pray, are these gouty Damps?  
Ans. The above-recited description saith, that they are dry, cold, and ill-conditioned.  
Qu. Why do you say they are dry?  
Ans. The better to distinguish these Damps from windy Humours.  
Qu. Why cold? Is there not a hot as well as a cold Gout?  
Ans. As there is but one next cause, which for quality is always cold; so is the distinction of a hot and cold Gout, vain: My opinion agreeing with that of Fernelius, that all Gout arises from a cold cause.  
Qu. But with what reasons can you maintain this opinion?  
Ans. Irrefragably by the remedy itself; as also by the pruriency and shivering which gouty persons, upon the motion of this cold damp, do commonly feel, especially in those parts through which it takes its course; as also happens in Epilepsies, Pleurisies, Colic, and the like, that come from cold damps.  
Qu. But soft and fair: Your last proof taken from shivering doth not hold, as Beverwyck objects; for than should the matter of hot Fevers be also cold, which passing through parts endowed with the sense of feeling, not only cause shivering, but also clashing of teeth.  
Ans. This is not said from well-grounded knowledge; since it hath never yet (that I know) been satisfactorily proved, that Hot Fevers (as they are called) must needs procced from an hot cause; and upon a thorough disquisition, it might perhaps be found, that they have been produced from some cold matter or other; which I think at least to be half proved, because sometimes an hot Fever ends in the Gout; as I have found; not to go far, in myself, when I was in the 50 th'. year of my age. It sometimes also comes to pass, that the Gout determines in an hot Fever; as appears from what Beverwyck saith in his Book of the Gout, p. 110. speaking of the ways through which the gouty matter takes its course. The damp, saith he, turns back into the veins, and ascends up again to the noble part (meaning the heart,) where it raises hot Fevers, Anguish, and the like evils; or shoots suddenly into some other limb, whereby the pain that is in the hand, is soon after felt in the foot.  
Qu. But is not that notable inflammation, which is often seen and felt in the Gout, sufficient proof that there is a sort of Gout which comes from heat?  
Ans. This is a Symptom or accident in the Gout, which is not caused by the next and always accompanying cause of it, but by the violent pain; as I shall more clearly make out, when I come to speak of this Symptom; But 'tis a Symptom, (not to pass that by in this place) which hath strangely misled those who have mistaken it for a mark of the Gout, as Sennertus and others do ackuowledg.  
Qu. Is this damp also ill-conditioned and malignant?  
Ans. So 'tis judged by considerable and experienced men, as well as by myself, and that from the intolerable pain and other accidents. So doth that old Master Guido de Culiaco; and Pareus in his 7th. Book, ch. 2. proves it by two Examples; and our new Medicine confirms the same. Besides, the foetid damps of the Gout do plainly speak this malignity, which is perceived both at the time of the act of burning, and after it; that being such, that sometimes both the Patient, and the Person that administers the Caustick, and dresses the part, are ready to fall away. And this is most of all found at the dressing of the little wounds, when they begin to omit good store of moisture. For as soon as you shall in a morning open the little Plasters, you will be so struck with a strange stinking smell, that it will almost cast you into a swound. 'Tis very probable, that this stuff is already malign before it be cast out from the heart into the limbs; yet remaining for a while wedged in the limbs, from the evaporation obstructed, its malignity is heightened. Hence it is not advisable, to serve this burning or dressing upon any one that is fasting; but 'tis best, that both the Patient and the Agent should first breakfast, and take a cordial.  
Qu. But, is it possible for Winds to occasion so much mischief?  
Ans. Very possible; and then especially, when they are more peccant by their quality than quantity: So Hypocrates in his golden Tract of Flatus' doth not without cause judge of winds, that most of all the grievous and dangerous Diseases owe their original to them.  
Qu. But can Winds breed such viclent pain?  
Ans. They can; chiefly when the membranes (the main instrument of the sense of Feeling) are by them attacked and distended.   

CHAP. V.  
Of the Part affected, and Seat of the Gouty matter.  
Qu. WHich then, in this painful Disease, is the part that is attacked and offended by these Winds?  
Ans. Principally, if not only, that sensible membrane called the periostium, that is, that membrane which immediately covers the bones.  
Qu. Do you not think, that the membranous ligaments do also suffer here, or rather the membranes of the ligaments?  
Ans. No; but I agree herein with Galen, that they have no feeling; the which is also confirmed by the learned Barbette in his Praxis, chap. 5. p. 30.  
Qu. What do you understand by the Periostium?  
Ans. That single membrane or film, whereby the Author of Nature hath outwardly invested and covered all the bones of our body, and which is a close and firm substance, extendible, and very sensible.  
Qu. Doth the gouty matter fall from without upon this sensible periostium, fretting and biting it by its acrimony?  
Ans. Not so; for than it could not cause so intolerable a pain, or the right Gout.  
Qu. Where then are we to look for the true seat of the gouty matter?  
Ans. Nowhere else but between the membrane and the bone.  
Qu. Wherein then consists the genuine essence of this Disease?  
Ans. In the violent distension or stretching of this sensible membrane by the Winds, whereby this membrane being forced out of its due and natural form and situation, excites so violent a pain.  
Qu. Whence do you infer that the gouty matter lies so deep, and particularly between the membrane and the bone itself?  
Ans. Not only from the distending pain, (which is to me proof sufficient) but also from the contumaciousness of the Gout, which made Hypocrates say in his 6th. Book, aph. 49. That the Gouty fit doth not cease before the fortieth day. And truly, whereas all other windy tumours, that are not lodged so deep, are in a short time made to evaporte; this windy swelling of the Gout lying so deep, and lurking under so firm and close a membrane, (and besides, in a place of little warmth, and itself coming from a cold cause) cannot be easily brought to a quick evaporation, but by such a kind of remedy as ours is.  
Qu. Have not the old and new Masters mistaken the Part affected, and the true Seat of the Gout?  
Ans. Certainly they have: For, (to speak of the part affected, and the seat together,) I must first allege the opinion of Galen, (as 'tis cited by Beverwyck;) he affirming, that the gouty moisture doth flow into the hollow of the joints, and there forces asunder the bones; whereby the ligaments and membranes, that fasten them together, are so violently expanded, that they cause that excessive pain.  
Qu. Hath this sentiment of the great Galen been generally judged and received to be conform to truth?  
Ans. It hath been rejected by many, as by Beverwyck and others; and by others maintained.  
Qu. Where do those that contradict Galen, find the Part affected, and the Seat?  
Ans. In the ligaments and membranes that tie the bones together, being penetrated and ouzed thorough by a sharp humour.  
Qu. What hath moved those that are of the later opinion, to reject Galen's Doctrine?  
Ans. See and read Beverwyck and others.  
Qu. But how doth Galen refute their opinion, who say, that the gouty matter ouzeth through the ligaments and membranes?  
Ans. Thus, that never a gouty person hath been perceived to have convulsions or drawings of the limbs: Which yet must needs happen, if the warm humour did pass through the ligaments and membranes.  
Qu. But these allege, to strengthen their opinion; First, that the pain, as soon as the limb is but touched, presently increaseth. Secondly, the debility and troublesome motion of the part. Lastly, the laxity of the ligaments, which being ouzed thorough by the humour, do stretch, and sometimes cause dislocation, Are not these solid reasons to persuade you and all others that they have hit right?  
Ans. Not at all; for their proof is lame in all its parts. And, not to repeat the irrefragable proof of Galen against their opinion, the pain doth not increase when the limb is but touched and moved, because, forsooth! the gouty matter hath ouzed through the ligaments and membranes: No; for, not these, but the periostium is the part affected in this evil, which being by the gouty damp already distended, is upon the touching, or least motion of the limb, irritated a new, and so causeth new pain. Where I establish this for a certain truth, that never the gouty matter, but only the accidental affluxed humour ouzeth through the ligaments, so as to occasion stretching and dislocation: Which we intent more fully to make out, when we come to speak of this accident of dislocation.  
Qu. But against Galen's proof, the defenders of this opinion allege, that 'tis no strange thing, that the acrimonious humour of the Gout ouzing through the ligaments of the joints, causeth no drawing in the limbs, because say they, the nerves themselves are not offended, but only the membranes and membranous ligaments, which do not cause the motion; and that therefore, although they are seized with great pain, they cause no convulsion; just as 'tis also found in the Toothache, Pleurisy, and Colic.  
Ans. This is an exception that concludes nothing, forasmuch as the Gouty matter provokes not the organs of Motion, but those of Sense.   

CHAP. VI  
That the Gout is a general Disease of the limbs, receiving its denomination from that limb which it seizes on; together with the place in which the Gouty matter is bred.  
Qu. IS the Gout a general Disease, (as Galen affirms) attacking all the joints of the limbs of the body?  
Ans. It is so general, that not one external part of any limb of the whole body is by its own nature exempt from it. The reason is, because that all parts and limbs are wrapped about with this sensible membrane, called Periostium, the head, neck, jawbones, breast, back, and the teeth themselves, forasmuch as they are enclosed in their groves or pits.  
Qu. Doth this Disease take different names, according to the limb which it infests?  
Ans. It doth so: Hence 'tis called Podagra, when it falls upon the feet; Gonagra, when upon the knees; Chiragra, when upon the hands; Ischiatica, when upon the hips: And so, the Toothache, when upon the teeth; the Pleurisy, when upon the skin that clothes the ribs, etc. All which I esteem to proceed from one and the same cause; though many will think this strange.  
Qu. What is the antecedent cause of the Gout?  
Ans. Whatsoever breeds these damps.  
Qu. In what place grows this damp, being the next cause of the Gout?  
Ans. The learned do as little agree in this, as they do in the next cause itself; and Fernelius complains, that no man had thoroughly searched into this point, and that through the want of the knowledge thereof, the Gout had been left for incurable.  
Qu. Is this peccant matter bred only in the head, excepting the skull, as Fernelius would have it; or without the brain, as others think; or most of all in the Viscera, as the stomach, spleen, liver, gall, and the rest?  
Ans. I give my voice for those that affirm the last, viz. that these Gouty damps are mostly generated in the inner parts, yet not excepting the head.  
Qu. But can you tell, Sir, in what manner they are there produced?  
Ans. Doubtless they are, through want of heat, gathered and laid up in some or other of the aforementioned parts from corrupted humours, and particularly from corrupted blood.   

CHAP. VII.  
How, and through which ways, the Gouty matter comes to the Limbs.  
Qu. SInce these morbid damps do cause such grievous pains in the external limbs, but are bred in the inner parts; by what means and passages do they come to those limbs?  
An. By means of the Circulation of the blood through the manifest ways of veins and arteries.  
Qu. Do not these damps ascend or descend directly into the limbs, without passing the heart?  
An. They must needs first pass into the heart.  
Qu. By what ways?  
An. Through the veins, which, gathering out of the inner parts the generated damps, carry them, together with the not yet sufficiently concocted blood, into the heart.  
Qu. But do not these malign damps offend that noble part, seeing they cause such grievous pains in the limbs?  
Ans. Certainly they do; and are the cause of Fevers, beating of the heart, and other distempers; and frequently cause death, when the heart wants strength and vigour to expel them.   

CHAP. VIII.  
Of the Expelling Part.  
Qu. IS the heart than the only strong expelling part, which drives those damps into the limbs?  
An. It is, as is evinced by the strong motion and beating of the arteries in the Gout; whereby the heart labours to deliver itself from such a pernicious damp, and to discharge and purify the nourishing blood of the same.  
Qu. Through what ways doth the heart drive out these damps into the limbs?  
An. Through the arteries.  
Qu. Whence is it, that the Gout for the most part manifests itself in the extremities of the limbs of the body, as (for example) in the great Toe of the left Foot?  
An. Because that the heart, undertaking the expulsion, drives this offensive matter as far as it can.  
Qu. May one from the Gout judge of the vigour and debility of the heart?  
An. You may probably do so from the suffering part: For, if that be far from the heart, than the heart is strong; if near it, then 'tis less vigorous, and unable to send that noxious matter far away.  
Qu. But when the heart through the arteries doth expel into the limbs, together with the nourishing blood, these damps; must those limbs receive them?  
An. They must receive them as well as the nutritive blood which accompanies it; the heart expelling them chiefly by the force of the arteries, not resting till they be thrust out.  
Qu. But why doth not the part aggrieved expel those damps, and send them further away?  
An. Sometimes it doth so; namely, when the expelling force of such a limb is strong and vigorous; for than it suffers not this bad guest to harbour there, but forces it by the veins to retreat back to the heart; whence it not seldom comes to pass, that by another expulsion from the heart it falls upon a weaker limb; as we see, that the pain which at first was felt in the hand, soon after is found in the foot, etc.  
Qu. When and how comes it to pass, that the limb is not able to drive or send away this peccant matter, but is constrained to lodge that unwelcome guest?  
An. When the expelling virtue and the natural heat of that limb is defective, and too weak.  
Qu. But, Sir, can you sully make it our, that these malign damps take their course to the limbs, only through the arteries?  
An. I can, my reasons being these: First, I prove it by the beating pain, which, amongst others, is in the Gout one of the sure marks; for, that beating pain sufficiently shows, that the Gouty matter comes out of the arteries. Secondly, 'tis plain from the swelling, distension, and quick pulsation of the arteries, as those through which this matter takes its course. Lastly, 'tis most evident from that remedy, which hath been used by the ancient famous Physicians, as likewise from our discharging medicine.  
Qu. What remedy of the Ancients do you mean?  
Ans. That of Arteriotomy, or the opening of Arteries; by means whereof, they declare to have found incomparable more help and ease for the gouty Patient, than from the opening of veins; for a proof, that the gouty matter is protruded from the heart through the arteries.  
Qu. But how doth it appear from your own Remedy?  
An. Forasmuch as the same being applied to the Arteries, (when they by their strong pulsation give sufficient assurance that the peccant matter is not yet quite expelled, but in part still harbours there,) fetches out that offensive stuff, and frees them therefrom; as we shall more plainly show in our manner of curing the Toothache: where it will manifestly appear, that this Burning of ours is not only a discharging, but also an excellent exhausting aid, forcing these damps in the arteries and veins to evaporate.  
Qu. Doth this painful matter cause no pain as long as it is included within the coats of the arteries?  
An. It causes no pain until it does violence to the periostium, because the tunicles of the veins and arteries are void of feeling.  
Qu. When the Arteries (in those that already feel great pain) do not cease to beat strongly, what conclude you thence?  
An. That the Gouty matter in part still rests in the arteries.  
Qu. May this matter be totally expelled out of the arteries?  
An. Not only it may; but the heart, as the source of the arteries, never rests till it hath effected it.  
Qu. Can this damp of itself, or by too strongly repercutient mean, be turned back again through the arteries to the heart?  
An. Some indeed are of opinion that it can; but I say that 'tis not possible: Nature, or rather the wise Author of it, having provided certain valves, which towards the heart are shut, and so hinder the return of blood and vapours thither through those vessels.  
Qu. Through what vessels then returns this damp to the heart, as it often doth?  
An. Through the veins, the Antagonists (as one calls them) of the Arteries; for this way is open and unobstructed, all the valves of them towards the heart being open.  
Qu. How comes it to pass that this damp returns to the heart?  
An. Either when the expelling virtue, and the natural heat of the part that receives the damp is great; or when strong repelling means are unwarily applied; by which latter way the Patient is exceedingly prejudiced, because thereby the pernicious damp is made to return to the heart, which with so much labour had discharged itself from it; and there it causes Fevers, Anguish, and the like distempers, and often Death itself.   

CHAP IX.  
Of the Diagnosticks, or Signs of the Gout.  
Qu. IS it necessary to know the proper Signs of the Gout?  
An. Certainly it is; forasmuch as those only are fit to cure the Gout, who know well the proper Signs thereof.  
Qu. Hath there been no mistake herein hitherto?  
An. There hath; for men have made those to be signs of the Gout that are none, as Inflammation, Heat, Fever, etc.  
Qu. Which then, in your opinion, are the proper signs whereby the Gout can be best distinguished from other distempers?  
An. Vitiated motion and Pain: which signs are present from the beginning of the Gout, and as 'twere born with it, and do grow up with the same to its height, and abate also and vanish with it.  
Qu. Are these the only and always concomitant signs, by which we may know this inward, and, for the most part, unseen windy tumour?  
An. They are so; though swollen veins, and strong beating arteries, may also be put for signs of the same.  
Qu. Those two first, are they Signs only, or also Symptoms?  
An. They are sure signs, but they are also symptoms.  
Qu. Inflammation, Heat, Fever, outward swelling from afflux of humours, etc. why may not they be esteemed to be proper signs here?  
An. Because they do not immediately follow the Disease, nor any proper effects of the Gouty matter, nor do they always appear in the Gout; and therefore are deceitful signs, not to be trusted to, and such as have misled some of the most sagacious men.  
Qu. Are they to be reckoned amongst the Symptoms?  
An. Not among the proper symptoms of the Gout, but only such as proceed from some proper symptom of the same.  
Qu. How is that pain conditioned, which you make to be a proper diagnostic or sign of the Gout, whereby the Gout, or the inward tumour in though periostium, is made manifest?  
An. 'Tis a pungent, distending and beating pain, which begins and ends with the Gout, and grows up, and declines with the same.  
Qu. What denotes the pungent pain?  
An. That the periostium suffers.  
Qu. What the distending pain?  
An. That the sensible membrane is raised and stretched by the Gouty matter.  
Qu. What the beating pain?  
An. That the gouty matter is already impacted and wedged in.  
Qu. What signifies the intolerable pain?  
An. Both the plenty and malignity of the damps, whereby the sensible periostium is forcibly severed from the bone, and stands by the force of the intruded winds bend, like a string upon a bent Bow.  
Qu. What doth the Pain indicate, which not only pervades all the parts of the body, upwards and downwards, but also passes to the most extreme part, in such a degree, that the poor Patient can rest neither day nor night?  
An. This plainly and palpably shows (besides what was just now said in the next foregoing answer,) that the membranes of the parts have a strict communication with one another, and a mutual sympathy.  
Qu. What doth the Vitiated motion indicate, which increases and decreases as the Disease doth?  
An. Not that the organs of motion are attacked, hurt or tormented, but only that the periostium is put out of its natural posture; which is manifest from hence, that as soon as this membrane is restored to its natural state, you cannot perceive the least defect in those organs.  
Qu. Why then doth the pain increase, and grow more violent upon touching or moving the part affected?  
An. This comes not to pass because that the organs of motion, or their membranes do suffer; but because that the membrane being already distended, by the touch or motion thereof it comes to suffer, and to stretch a new; whereupon new pain must follow.   

CHAP. X.  
Of the Symptoms of the Gout.  
Qu. FOrasmuch as there are found many and different Symptoms in the Gout, will it not be proper to make a distinction between them, thereby to come to the true knowledge of them?  
An. You will do very well to distinguish first the Symptoms in general from the Disease itself; and then to make a distinction between the Symptoms themselves.  
Qu. What distinction is there to be made between the Symptoms of the Gout?  
An. This; that the symptoms that arise and vanish with the Disease, are to be distinguished from those that are bred not from the Gout, but from the symptoms of the Gout.  
Qu. Which are the Symptoms that do immediately accompany the Gout, and are born and die with it?  
An. Of these there are but two, already spoken of, viz. the Vitiated motion, and the Violent pain: These come and go away with the Disease, following the Gout as a shadow doth a body.  
Qu. Which of these two Symptoms is the chiefest and most grievous?  
An. The Pain; which is not the Disease itself, or the cause of the Gout, as hath been already said; nor yet is it a simple Symptom, in regard it is a cause of other symptoms, especially when it is violent.  
Qu. What Symptoms are occasioned, or rather caused thereby?  
An. Inflammations, Fevers, Faintings, Sleepiness, Loss of strength, Afflux of humours.  
Qu. Is it certain, that all these six Accidents are caused by the raging Pain of the Gout?  
An. Dr. Paul Barbette reckons them all amongst the effects of the Gouty pain, when he treats of the Symptoms of Wounds in his Chirurgery, p. 165. of his Dutch Edition. Besides that 'tis manifest, that most of these do then first appear when the pain grows violent, and disappear with the diminution and ceasing of the pain.  
Qu. Whence comes it, that these Symptoms that are caused by the Gout, not only in divers Patients, but also in the same, show themselves at one time more than another, and differ so much from one another?  
An. It comes from the greater or lesser intenseness of the efficient cause, the Pain; which receives its degrees from the quality and quantity of the gouty matter. For the more malign and abounding the damps are, the more grievous also are not only the proper Symptoms, but also these Accidents of the Gout.  
Qu. Doth the raging pain excite in all Gouty persons these Symptoms all together, and at once?  
An. Not so; for in bodies that have but little serosity in the blood, the first five Symptoms do appear; but not at all, or very seldom, the sixth and last, which is the afflux of humours: In others, who abound in that serosity, the afflux of moisture will be perceived first of all, and often without inflammation. Again, when the gouty matter lurks deep, as in the Sciatica, and in the Gout of the shoulders, you are not then to reckon upon the change of colour, and the afflux.  
Qu. That raging pains do cause inflammations, is easily understood; but how do they produce Fevers, Faintings, Sleepiness, and loss of strength?  
An. The intolerable pain drawing to the heart, causeth there a Fever and Fainting; and passing to the brain, produces there Waking: whence must necessarily follow Loss of strength.   

CHAP. XI.  
Of the external Serous Tumour, which often manifests itself in the Gout.  
Qu. IS it worth while, to treat somewhat more largely of this Tumour, than of the other Symptoms caused by the Pain?  
An. 'Tis very necessary, because by this Symptom many Learned men have been so misled, as to take it for the Gout-breeding matter itself, or at least not to distinguish it from the Sickness itself: Whence, as from a fruitful soil, have sprung so many errors about the Gout, and especially about the proxime Cause thereof. Yea this is the only cause, that so many Physicians and Chirurgeons are so much wedded to the Notion of Humours, that they dare almost take it for granted, that the Gout cannot be without this Swelling and Afflux of Humours; insomuch, that if they meet with any Gouty person, in whom they cannot find this Swelling or change of Colour (although they find great pain,) they will rather discard them out of the number of the Gouty, than acknowledge, that sometimes there are no humours at all accompanying the Gout.  
Qu. But since the Affluxed humour, which breeds the external swelling, is neither in whole nor in part the Cause of the Gout, what shall we make of that tumour and its matter?  
An. It is a Symptom, which is no inseparable companion of the Gout; yea never begins, and seldom ends with that disease: Which I think I can so plainly make out, as that the most ordinary capacity shall understand it to be so.  
Qu. Does then this serous Swelling not always accompany the Gout as an inseparable Symptom?  
An. No; for, besides that some Gouty persons seldom or never perceive this Tumour (caused by affluxed humours,) as I have experienced, and many Writers must witness; commonly there is no affluxed Humour found in the Sciatica.  
Qu. But does this Swelling never begin with the Gout?  
An. 'Tis never perceived in the beginning of the Gout; for, though in many Patients this Tumour very soon follows upon the Gout; yet, if it be well observed, it is never of the same age with the Gouty tumour, which in order of time always precedes it: Yea, if care be had, its birth may sometimes be altogether prevented, by being timely ready to evaporate this dolorifick damp by a speedy application of my matchless discharging Remedy; as I have often experimented on myself, and shall further teach in the second part, treating of the Cure of the Gout.  
Qu. But as this Symptom never begins with the disease, does it neither end always with it, as other Symptoms do?  
An. No: This Symptom alone survives the Gout; yea the cause whence it rises ends not with it. For, as for the most part it first appears when the sickness is at its height, and the pain rageth; so it is often seen a good while after the Gouty pain, and then by good means and some patience dispelled.  
Qu. It seems then, that the pain, which is the cause of this Symptom, ceasing, the outward tumour doth not vanish at the same time?  
An. No; for very often the limbs remain swelled as before, and it requires some days, and some trouble, before this Swelling can be removed; yea, if you do not take care, it not only lames the Patient, but also deforms him by Nodes and Schirres, whereby the Motion of the limbs is for ever destroyed.  
Qu. What then is to be done, to judge aright of this Symptom?  
An. You must hold it for a certain truth, that the Humours which in the Gout breed the Swelling, are not the peccant or Gout-breeding matter.  
Qu. To make me the better comprehend this, pray give me a clear description of this Swelling, which hath been the occasion of so many Errors, and hath deceived so many Learned men?  
An. It is a Preternatural swelling in the Fleshy parts, consisting of a serous humour pervaded with saltishness, by the sharp pain penetrated into the Limbs, and 'tis soft, pale, and cold.  
Qu. But how may we best distinguish this Swelling from the Gout?  
An. If it be viewed at the time when its Efficient cause is gone; for than it may be seen in its true essence and qualities, and looks no otherwise than a Serous humour is wont to do.  
Qu. I see, you make two sorts of Swellings in the Gout?  
An. I do so; the one is Windy, which is the Gout itself; the other Serous, which is a Symptom: And they differ exceedingly from one another.  
Qu. Wherein consists that difference?  
An. Chiefly in these particulars: 1. In respect of the Name, which they receive from their several Causes; for the Gouty tumour coming from Winds, takes the name of Windy tumour; the other, coming from a serous humour, is called the Serous tumour. 2. In respect of the Part or Place affected; for, whereas the Windy tumour distends the Membranes of the bones, the Serous fill the Carncous parts, as water a sponge, and render the Flesh very spongy. 3. In regard of the Signs; for, whereas the Inward swelling excites grievous and intolerable pain, the Serous none or little. 4. The Internal swelling is a proper disease; the other is raised by the pain, and is a Symptom bred by Consent of parts.  
Qu. But since that the Serous tumour in the Gout is not produced by any External cause, but by an Internal, what is this Cause?  
An. The violent pain, as hath been often said, which is here the cause of the Afflux of humours, it being known by Artists, that Pain draws humours after it; which therefore is by them assigned to be one of the principal causes of the Afflux of humours.  
Qu. But are these humours, of which this kind of Swelling consists, drawn into the suffering parts by the Pain alone?  
An. Artists are wont to add, that sympathising Nature, as a kind Mother, succours the suffering part by sending moisture to it; and accordingly this Swelling should be generated by Sympathy of Consent of the parts.  
Qu. What benefit or ease doth the part affected receive from sympathising nature by her sending those humours thither?  
An. That the raging pain is thereby mitigated, and rendered more tolerable.  
Qu. In what manner is that done, or how doth the conveyed humour assuage the enraged pain?  
An. Though this be difficult to explain; yet I cannot agree to the common opinion, importing, that the Pain-breeding matter by means of the conveyed humours is driven outward, and dispersed through the neighbouring flesh, and so the suffering member for a great part freed of the pain-causing matter: For, the conveyed humours can by no means approach or come to the dolorifick matter, much less fotch it out of its deep seat, and dislodge it, because 'tis so fast impacted and included under so firm and close a Bone-membrane.  
Qu. What is then, in your opinion, the reason why the sharp pain is often diminished upon the afflux of moisture, not only in the Gout, but also in the Toothache? etc.  
An. Methinks 'tis probable, that 'tis done after this manner: The musculous fleshy parts being by the conveyed humours rendered softer, plumper, and more spongious, and consequently gentler, do not, in the first place, press against, or rather resist so much the sensible and distended periostium, as before, when the carneous parts had but their own native and proper moisture. Secondly, the periostium being by the conveyed moisture from without made gentler, may with less pain be stretched; and it may also come to pass, that by that little warmth, which this serous matter hath in it at first, it being now come near the periostium doth somewhat attenuate the included gross damp, and so the better dispose it to evaporate.  
Qu. But doth the affluxed humour occasion no mischief?  
An. Very much, and sometimes more than the Gout itself; for without care it causeth Dislocation of the suffering members, and the Nodes.   

CHAP. XII.  
Of the Dislocation.  
Qu. HOw is it possible, that the Gout-breeding matter should cause a Dislocation?  
An. By the plenteous stock of humours conveyed and drawn in.  
Qu. But how; doth this abundant moisture, falling into the cavity of the joints, forcibly thrust the bones out of their cavity?  
An. Not so; but 'tis done in manner following: Pain and Nature cooperating, the one by drawing in, the other by conveying, bring such a quantity of humours to the suffering part (for example, the Hipp,) that thereby, in time, the strong ligaments, which tie the bones together, are so ouzed thorough, that being debilitated they stretch and grow so lax, that the bone falls out of its cavity, and so causeth dislocation: Of which we have many sad Examples.  
Qu. Doth not this mischief fall often out in other Cases?  
An. It may happen in all the members of the body; and then especially, when an unskilful or imprudent Master by the use of wrong means occasioneth yet a greater afflux of humours than hath been already drawn in by the pain, and furnished by nature: Of which, Pareus records a memorable Example in the Dislocation of the knees, caused by a Parisian Master, called Greaulm, fol. 256.  
Qu. May this Dislocation be prevented by Art?  
An. Very well; as shall be shown in that part of our Book, which is to treat of the Cure of the Gout, and its Symptoms.   

CHAP. XIII.  
Of the Nodes.  
Qu. IS there yet more danger to be apprehended from this Symptom, or its matter?  
An. There is; for if you take not great care, it will change into an incurable Scirrbus or hard tumour, which in the Gout are called Nodes, according to that of Ovid;  — Tollere nodosam nescit medicina pedagram. 
Qu. When comes this swelling to change to such an hardness?  
An. To borrow the words of Beverovicius; when the thin humour is insensibly exhaled, and the sediment rests behind, then will that turn into hard knobs, which bursting of themselves, or being opened, render a chalky or such like matter, whereby our limbs are not only deprived of motion, but also disposed to crookedness.  
Qu. How many ways are these stony swellings generated?  
An. Two; either of themselves, or by the unskilfulness of the pretended Artist.  
Qu. When of themselves?  
An. The Evaporation of the subtler or thinner parts of these humours may be caused by the natural and innate warmth of the suffering part, assisted by the adjacent parts, as also by the preternatural heat of the inflammation of the same, without any other external cause: Whereupon the gross, thick, saltish, and carthy parts, as the sediment and relics remaining in the limb, are coagulated and concreted.  
Qu. I. understand you very well; but, I pray, tell me also, how may this come to pass by the Unskilfulness of Practitioners?  
An. When they apply too strongly repelling, or drying, or too much cooling remedies, which drive the thinner parts inward, or dispel them, and so harden and render incurable the thicker stuff; whereas they should use moderately warm mollifying remedies, thereby to expel and consume the whole matter.  
Qu. Do these Nodes, when they are caused without the application of perverse remedies, grow on leisurely?  
An. They do so, when they are bred of themselves: For, the foundation of this chalky matter being once laid, 'tis raised and increased more and more upon every new afflux, and from time to time scaled over, until it comes to that bigness, that it only hinders the motion of the limb, and renders it crooked, but can also stay or have room no longer under the skin, but making it first protuberant, bursts it at length in pieces.  
Qu. Surely an ignorant Practitioner can bring this to pass much sooner?  
An. So he can, and to such a degree, that the poor Patient in the very first fit of the Gout is for ever deprived of the motion of the suffering limb; of which we have in Banda an Example of a Lieutenant of ours, now lying here in Garrison, called Jan van Haerlem.  
Qu. But may not this growing of Tophes or Nodes be prevented and hindered?  
An. Very well; as shall be taught in the Cure of the Symptoms of the Gout.  
Qu. Will you proceed now to the second principal you intended, viz, the Cure of the Gout?  
An. I will, after you have heard what I had to say of the Nature and Cause of the Gout, its Seat and Part affected, its Diagnosticks, Symptoms, and the necessity of distinguishing these latter not only from the disease itself, but also from one another: All which have made way to judge the better of a fit Remedy to cure the same; seeing we cannot hope for Cure, before the Malady be throughly understood.    

THE SECOND PART: Of the CURE of the GOUT.  

CHAP. I.  
Treating of the Cure of the Gout, in general.  
Qu. HAve there not been at all times men that have pretended to the skill of Curing the Gout?  
Ans. Yes indeed; but Experience hath put them to shame: For whereas they have promised cheap and sure remedies against this painful disease, their promise hath notoriously failed, and their Patients have been at last abandoned remediless. See hereof, amongst others, Fabritius Hildanus his second Part, p. 174. where he speaks of one, whom he calls a Monster, that highly bragged, he could conquer that great Enemy of Mankind, the Arthritis or Gout, but was confuted by very sad Experience.  
Qu. Why doth he call him a Monster?  
Ans. Because of that monstrous and mischievous means by him used, whereby he killed his Gouty Patients. See in the same Hildanus his second part, p. 87, that unhappy preparation of Quicksilver for the Gout.  
Qu. But have none of the best Physicians of Europe in so many Ages found any sure Remedy against this Disease?  
Ans▪ None that I know of; they rather call the Gout Ludibrium Medicorum, and the Disease of Rich-men; though it seizes also on the Poor, who, if they could be helped, would soon lose that name. Hence 'tis become a Proverbial saying, viz. that he who undertakes to perform something extraordinary, is like him that pretends to Cure the Gout: Which pretenders are usually sent to the Courts of Kings and Princes, to practise their skill on them, who will not sail to make such men rich, as shall perform such undertake.  
Qu. What's the matter then, that the true Remedy hath not been found hitherto? is the fault in the Physicians, or in the Gouty Patients?  
Ans. In both, but most in the former, as not knowing the true nature of this Disease, notwithstanding all their Disputes and Discourses about it.  
Qu. What do you think of Cardanus his saying in the praise of the Gout, viz. That whosoever will stop the source of the Gout, stops withal the source of life: Doth not this imply, that the Gout is incurable?  
Ans. He will say, that the Root of the Gout cannot be totally pulled out, though you may strip off the Leaves, that is, remove the outward Accidents thereof.   

CHAP. II.  
That the Gout is curable by Burning with Moxa.  
Q. BUT pray, let me know your opinion in this matter: Is the Gout an incurable Evil, and Cardanus his saying true?  
A. I or the comfort of all the Gouty, I here openly and joyfully declare, that 'tis Curable:  
Q. But is not this a presumptuous Arrogance?  
A. No; for the good God, in compassion to mankind, hath been pleased not only to bring me to the true knowledge of the nature and condition of this Disease, but also to direct me to a specific and proper remedy thereof, which removes this sore Evil, it being now, through the divine goodness, in our power to quell and tame this Giant, without making ourselves guilty of any vanity.  
Q. What means is this, I pray?  
A. 'Tis the harmless Burning with Moxa, which being three or four or more times repeated, according to the condition of the place which the Gout hath seized on, pulls the Enemy out of his fastnesses. Mark it, the raging Gout in the height of its rage, is first stopped in its carrier, and soon after forced to pack away.  
Q. Is this possible?  
A. It is; for I have successfully experienced it on myself, and many others.   

CHAP. III.  
How, and for what this Remedy is used.  
Q. BUT to speak with order of the Cure of the Gout, what is above all to be considered in this Disease?  
A. The suffering part and labouring nature is to be succoured without delay, and the part affected to be delivered of the enclosed damp; the Cure principally consisting herein, viz. in giving an outlet to the Gout-breeding or peccant matter, and even in forcing it to evaporate.  
Q. Which then is the remedy, that performs so great an effect? Is it not known in Europe? Where hath it been found out?  
A. 'Tis Moxa, best known amongst those of China and Japan: so celebrated, valued, and commended there, that no other remedies are to be compared therewith upon the account of its excellent performances; considering that there are few pains in the body, for which they do not use it with great benefit.   

CHAP. IU.  
What Moxa is, and where to be had.  
Q. BUT what is this Moxa?  
Ans. 'Tis a very soft and woolly substance, made by a very skilful preparation out of a certain dried Herb.  
Q. What name hath that Herb, out of which this woolly matter is prepared? Is it not known amongst us?  
A. The name is unknown to me; but I am well assured, that 'tis one of the best Herbs under the Sun, and may very justly bear the name of Mater Herbarum.  
Q. Is there requisite a particular skill to prepare it?  
A. Yes verily; and there is none of all the Droguists of Europe that have that skill.  
Q. Is the preparation of it much valued by the Chinese and Japanese?  
A. This Art is by those Nations so highly valued, that they will not for any money communicate it to other Nations, but do keep it for a great secret.  
Q. Do they in China and Japan publicly vend it?  
A. They drive a good trade with it, and carry it in whole bales through those vast Empires for sale.  
Q. Which of those Nations hath the reputation to prepare it best?  
A. The Chineses do herein sar excel the Japonese; as they also do in preparing and conserving all other sorts of Medicines.  
Q. Is this prepared Herb in great esteem with those people?  
A. In so great an one, that they are seldom found to be without it.  
Q. For what use do they employ this woolly substance?  
A. For an actual Caustick, and an efficacious discharging remedy.  
Q. Against what Diseases, and in what places of the Body?  
A. Against all indispositions arising from cold Damps and Humours, and in all places of the Body, none (that I know) but the eyes excepted.  
Q. Do they find good from this Caustick.  
A. Exceeding great, and that with great safety; by virtue thereof freeing the Body from all lurking winds and cold humours.   

CHAP. V.  
Directing how this Remedy is to be used.  
Q. IN what manner do they use this matter for a Caustick, and in what quantity?  
A. They make between their fingers a little pellet of this woolly substance, which is scarce of the bigness of a small white pea, at one end somewhat sharp, and at the other end flat; and this they put with the flat end on the place where the Burning is to be made, setting fire to the upper sharp end by some small Aromatic sticks, expressly prepared for it, which yield a very grateful scent.  
Q. Doth this woolly matter catch fire quickly?  
A. When 'tis competently dry, it catches fire sooner than any tinder: whence the Chineses employ it also in their Tinderboxes.  
Q. Doth this pellet, when kindled, turn all to ashes?  
A. Never wholly, but there always remains a little bottom that is not incinerated.  
Q. What may be the cause that 'tis not wholly turned to ashes?  
A. The moisture which by this burning matter is drawn out of the suffering place; of which moisture indeed the greatest part flies away in fume, but yet some of it draws into the burning pellet, and so moistens it that it cannot all be converted into ashes.  
Q. Can the humours under the skin be seen with the naked eye to run towards the burning pellet?  
A. Very well, it being done with more speed than men are wont to run to an house that is on fire.  
Q. Doth this Burning raise no blisters in the skin?  
A. None at all; it only causes a little grey speck, though the pellet be divers times successively kindled upon the same place.  
Q. What reason is there for it, that the fire here raiseth no blisters?  
A. None other, but that the pellet burns not quite thorough to the skin.  
Q. Doth not this Burning cause intolerable pain?  
A. The pain is very tolerable, because the matter is woolly and soft, not close nor thick; and the pellet is small, and burns not unto the very skin.  
Q. How long lasts the Burning of one pellet?  
A. About the time of telling fifty.  
Q. How often is the Burning repeated upon one place?  
A. Ordinarily thrice upon weak and tender limbs; but upon other places, if need be, so often till the pain be removed, although you should (for example in the Sciatica) on one and the same place kindle 25, yea 50 pellets; of which you need not fear the least inconvenience, but may expect the better discharge.  
Q. But doth not this Burning occasion great after-pain?  
A. None at all; but as the fire is out, you may handle the place burnt without causing any pain; and, which is more, you may crush and press it as hard as you please.  
Q. Doth this Burning take away the pain that is in the place or part, or only mitigate it?  
A. It doth both, to admiration.   

CHAP. VI  
What is to be done after the Burning upon the places where it hath been made?  
Q. SO then, there is nothing to be done after the Burning upon the part burned to ease the after-pain?  
A. I told you just now, there is no such thing as after pain: But yet you must not leave weak nature to herself alone, but you ought to aid her, and to use means to separate the little Escar as soon as is possible.  
Q. What is to be done herein?  
A. Lay a little beaten Leek upon the said Escar, and over that, one of the outermost coats of the same Leek, a little moistened in the mouth; the which, like a plaster, keeps the beaten Leek fast upon the Escar. This being taken off together, some 24 hours after, more or less, you'll see the little Escar disposed to separation, appearing to have round about it a circle of clear skin, which sometimes also rises to a wound or blister, which may with scissors be opened to give it vent.  
Q. Is not this little Escar to be treated with incision, and to be taken away with little pincers or lancets, that so the ill which may lurk there may evaporate? Or is it better to leave it for nature further to open the Escar, and to throw it off?  
A. Beware to use any severe means (from ill-grounded considerations) or any force; for great pain may thereby be occasioned: And therefore use only warm Plantin-leaves to make the Escars fall off, patiently staying till they fall off by that means, and the part heal up; the which is effected by provident Nature herself, if it be good for the part affected.  
Q. But when the Escar seems to be already loose, and even to hang doubled in the little wound, is it not then to be taken away?  
A. No.  
Q. If the Escar is severed, and taken away by Nature herself, and the pus or matter looks like lard, is not this ro be removed one way or another?  
A. You are not so much as to touch it, burr leave it to Nature to dispose thereof,  
Q. Must you not do your best with the greatest speed to heal up the burnt places?  
A. No; but rather you are to keep them open as long as you can, yet without changing them into Issues by putting peas or pellets into them.  
Q. How is that to be done?  
A. By laying upon them warm Plantin-leaves, with the rough side to the skin. I say, they must be laid on warm, not cold: And this is to be done not by holding the leaves in warm water, but by laying them on glowing wood-coals; where they must lie until you see them begin to fall-in; and then they are to be taken off and rolled stiff together betwixt the palms of the hands, and then to be unrolled and displayed again, being yet warm and moist, and so laid on the Escar: Continuing this until it be time to heal up the wound; when the leaf, being prepared again after the former manner, is to be laid on with the smooth side to the skin; by which means it will heal up without leaving a mark upon the part, and much better than if you had employed the best plasters.  
Q. Why must these Leaf-plaisters lie a great while upon the part with the rough side, and at last only with the smooth side?  
A. Because the rough side draws out, and the smooth side heals?  
Q. Is there n●thing else to be observed touching these vegetable plasters?  
A. They are to be kept from falling off by some▪ compress of linen rags; and to be refreshed or renewed twice in 24 hours.  
Q. But in case the burnt places could not well endure the use of linen compress, how then may these Leaf-plaisters be secured from falling off?  
A. You may lay over them a Diapalma or Basilicum-plaister, only to keep the Leaf upon the Escar.  
Q. But if Plantin-leaves be not to be had, may not other leaves serve?  
A. In that case you may use red Cabbage or Colts-foot-leaves; and, if these cannot be had, employ the said Diapalma or Basilicum-plaisters: Which may chiefly stand you in good stead, when you are travelling by water or land.   

CHAP. VII.  
Of the admirable Effects of this Caustick.  
Q. MAY a man rest in this application, and expect the desired cure?  
A. You may, by God's blessing; and the Physician may look for honour, considering that in so doing he cureth surely, without inconvenience, and even with pleasure.  
Q. Then, it seems, there is no danger in the right use of this remedy?  
A. None at all; yea it is such an one, than which there will hardly be devised a better, and of which you will really see a wonderful effect for the good of the Patient.  
Q. Will it succour nature with most speed, and free her of the evil that encumbers and torments her?  
A. It will; whereas Hypocrates l. 6. Aph. 49. saith, that the Gout requires 40 days to cure it; which Galen seconds, with the adding this condition, viz. if the Physician understand his work, and the Patient do his part in observing carefully what is prescribed. But this our Moxa, by means of the Burning described, draws this Wolf with speed out of his den, and delivers the Patient instantly from his pains and anguish.  
Q. But is this way of curing sure?  
A. So sure that it fails not, but is always beneficial; and the success of it is so manifest, that it cannot be doubted.  
Q. But you did add, that it would cure with pleasure; which I understand not, since you have above acknowledged, that this Burning is not without some pain.  
A. I mean thus, that the Cure is pleasant, in regard that upon a little sharp pain, which lasts but a short time, there follows a great pleasure and joy; the fruits of this short pain being great and every way delightful, forasmuch as the poor Patient, discharged from the intolerable pain of the Gout, instead of his doleful lamentations and outcries hath now cause to rejoice, and to break out into thanks.  
Q. But is this all, which the Burning with Moxa produceth?  
A. No; for the same, being timely used, hinders the afflux of humours, though not always totally, yet at least in great part.  
Q. What benefit ariseth from thence?  
A. Thereby is prevented all the mischief, which otherwise may be occasioned by the afflux of humours; such as is Dislocation and Nodes: Whereas 'tis certain, that those who use this way of Burning duly and maturely, shall never have cause to complain of those grievous effects.  
Q. If all this be true, this remedy may be extrolled to the sky?  
A. Not only that; but it enables the Patient to be upon his legs, and to follow his vocation, if it be not too toilsome; and even to travel without any considerable trouble: By the same also he is exempt from all other tedious and costly stuff, salves, ointments, plasters, etc.   

CHAP. VIII.  
Showing, that this Burning with Moxa goes beyond all other Remedies of Europe hitherto used against the Gout.  
Q. BUT when the Physicians of Europe and other parts from hence have better understood the nature of the Gout, will they not be able to find out a better Remedy against it?  
A. 'Tis probable, that upon the acquisition of the true knowledge of this disease, they will not deviate so far as before from the way of curing it, and that in all probability they will eschew many errors and mistakes; but they will never find out any better remedy than this Burning with Moxa, it being the best, because the speediest, cleanliest and safest, yea the most genuine, most secure, and most accommodate means, that can be excogitated by men.  
Q. May not the enclosed wind, which you say causeth all the trouble, be drawn out by Sudorificks, Cupping-glasses, Issues, Leeches, or common Caustics?  
A. By Sudorificks possibly there might be effected the greatest ease, but the evil would not be fully removed, seeing that thereby only the subtlest of the gourty damps would be exhaled. And for Cupping-glasses, Issues, Leeches, and Caustics, none of them is able to fetch out this evil from its deep-lurking hole, which is under the close and firm membrane which invests the bones.  
Q. Is it not advisable to employ anodynes?  
A. By no means, because the pain is thereby not removed, but only palliated and dulled; but is afterwards raised up into greater rage.  
Q. Is not Letting of Blood beneficial, as many would maintain?  
A. Letting of blood is better omitted, for these reasons: First, because, according to the opinion of the best, 'tis not advisable, when the pain is raging, to open a vein. Secondly, 'tis not the Blood that's peccant or faulty, but the ill-conditioned Damps, which indeed run together with the blood and spirits in the vessels, but do never so mix with the blood, as to make one body, but may easily be severed: Whereas 'tis otherwise with the Blood and Spirits, they two making up one body; as the heat and water constitute hot water, or as wine and the spirits thereof make one body of wine. Thirdly, by Blood-letting the noxious Damps are drawn inwards to the Heart, and there occasion much mischief, and the benefit you look for from it will not countervail the harm. Fourthly, the forces of the Patient are thereby diminished, and Nature is enervated in her conslict with the disease; whereas a good Artist ought always to befriend Nature by strengthening her against her enemy; and a wise Physician will not be forward to shed blood, but preserve it as the treasure of life: And as a Seaman in a tempest will not throw his Bread over board, but rather such commodities as he can be without; so a good Physician will keep the blood of his Patient, and drive out ill Damps.  
Q. What do you think of salves, oils, or other unctuous medicaments in this case?  
A. They close the pores, and obstruct evaporation.  
Q. What opinion have you of hot Pickle, humane Urine, warm Cowdung, etc.  
A. They are means which are apt to mitigate, yea sometimes to remove the pain; but not always, or very slowly, nor radically.  
Q. Would not an Hot iron be convenient to make this damp exhale, as was practised in the Sciatica upon Jacobus Vincus, Ambassador of the Prince of Lansbergen; witness Dr. Nicolaus Tulpius, Burgemaster of Amsterdam, in his Observations, ch. 26. p. 228; by which means that Gentleman was freed from his trouble?  
A. 'Tis too sierce, and withal too dangerous a remedy; practicable indeed, (notwithstanding the contrary judgement of Fabrit. Hildanus in his 6th part, p. 501;) but 'tis better to use our gentle way of Burning, which, by far, causes no such pain, and is more beneficial without putting nature so hard to it. To confirm this, I shall now only add, what Herls saith in his Examen of Chirurgery, p. 364. viz. The burning with a red-hot Iron is too violent a way for Surgeons, and too painful for Patients, and can seldom be used without hurting the flesh and muscles. And doubtless all Physicians and Surgeons will be of the same mind, as soon as this way of Burning with Moxa shall come to their knowledge; my opinion being, that they will never make use more of an hot Iron but in such cases, wherein the said Burning is not powerful enough, as, for example, in the Rottenness of bones, and the like.  
Q. What think you of Spanish Flies, now of so frequent use; of which Jobus van Mekeren writes in his Observations, that he hath used them with much benefit against the Gout, following the advice of Dr. Vopisus Fortunatus P. lempius?  
A. I esteem, that all intelligent Physicians and Surgeons will much rather make use of our Moxa for the good of their Patients, they knowing sufficiently the venemousness of those Spanish Flies, and how hurtful they are to the Bladder and other viscera; and having used them long enough of necessity, because they knew no better means. And 'tis remarkable what Aquapendente warns of the qualities of Spanish Flies in his Art of Chirurgery, ch. 3. p. 246. concluding with these words, That 'tis madness to use this deadly remedy.  
Q. Is the Burning with Moxa less painful than that with an Iron?  
A. Incomparably less; nor is it so Dangerous, according to the golden rule of Hypocrates, lib. 2. Aph. 12. That to heat much, and suddenly, is dangerous; but to do it by little and little, and slowly, is without danger. And this is it, what the expert Physician Guilandin confesseth in Prosper Alpinus de Medic. Aegyptiorum, ch. 12. in that remarkable practice of the Burning in Cairo, and thereabout: Which Chapter highly deserves to be considered.  
Q. But, Sir, do you not apprehend, that the Egyptian manner of Burning will go beyond that with your Moxa?  
A. Not at all, being well assured, that the Egyptians will be very glad to exchange their Cotton and Stramineous linen with our Moxa, as soon as they shall know the admirable virtue and effect thereof. Nor is the Burning with Moxa by far so painful, as all the world will judge, when they shall see and compare both.  
Q. Then, I pray, Sir, be pleased to repeat in short, what remedy it must be, that shall free a man from this disease?  
A. The genuine Cure of this Evil, which attacks suddenly, and will not bear delay without great injury to the Patient, consists in the removal of the Cause, and requires a remedy, having these following proprieties. First, it must powerfully open not only the Pores of the Skin, but those also of the Membranes of Bones. Secondly, it must attenuate the cold thick damps, and resist their malignity. Thirdly, it must strengthen the innate heat, and the expulsive force of the part affected, thereby the better to master and remove the Evil. Now the Burning with Moxa performs all this: It strongly draws out from the deep, and resists all malignity; it attenuates the cold and crass vapours lurking under the membranes, consuming or extracting them, and so disburthening nature of her enemy; lastly, it so corroborates the weak suffering par●▪ that it will not so easily receive and lodge again Damps of that nature.   

CHAP. IX.  
Showing, that this Burning is very tolerable.  
Qu. BUT do you think, you can easily induce your Patients to undergo this Burning?  
A. Certainly being well instructed they will quickly submit to it; though that kind of Burning which hitherto hath been used in Europe, hath made men very averse from that way.  
Q. How may they be best persuaded to it?  
A. I would rather have them persuaded by other prudent and understanding persons, than by the Physician himself. For as to him, it will be more advisable, he should seem himself cool in this business, and stay to be entreated.  
Q. But in case they will not be induced to it out of that perverse apprehension, what then?  
A. If they be so delicate as not to submit to so slight a pain, they deserve not to be cured, and so must keep their Disease: But, I presume▪ it will be with you as 'twas at first with me, who having from an idle fear refused this Burning, was afterward constrained by the grievous and raging pain to desire the use thereof. And since that Gouty persons must day and night combat against the intolerable pain of the Gout, certainly they will not easily be afraid of this innocent way of Burning. I have seen weak and timorous women, and young maids, which made nothing of it, in respect of the pain they had endured in their teeth and head: Not now to speak of Children, who without much cry and tears have endured this Burning, to be cured of that kind of Dropsy called the Tympanites, and of other infirmities, and particularly of Convulsions.  
Q. But many Doctors and Surgeons are like to condemn this remedy as new and unknown, and so render it suspected among their Patients?  
A. The Effect will soon silence you, and convince you of envy and ignorance.  
Q. But may not this Disease be cured by gentler remedies?  
A. No: You may indeed mitigate the pain by gentler means, but not remove the cause, nor root the Evil out of the part affected; which may best be done by this our Burning.   

CHAP. X.  
Of the Qualification required in the person that is to perform this Burning.  
Q. IS every one fit to perform this Burning?  
A. No certainly; but it must be one that hath a perfect knowledge of what is requisite to it, both before and after, and that is experienced in it; because considerable mistakes may be committed therein.  
Q. What are the particulars, of which this Artist must be well instructed?  
A. First, of the Disease, to the cure of which this Burning is to be used. Secondly, of the Remedy or Moxa, and its virtue, as also of the Herb, and the way of preparing it. Thirdly, he must know in what manner this Burning is to be made, and what is to be done both before, in, and after the same.  
Q. What else is required thereto?  
A. The Practitioner must be a person of a good sight, not unwieldy of body, having sleady and dry, no trembling nor sweaty hands; for else he will not be able to give to the pellets their due form or shape, to put them fast upon the right place, and to make them catch fire: All which is to be done with a particular dexterity and expedition, that so the patient may not be held any time in fear.  
Q. Pray, will you teach me, how the good Moxa is to be distinguished from that which is naught?  
A. By your sight, smell, and touch.  
Q. How by the sight?  
A. That which is good hath a fine grey colour?  
Q. How by the smell?  
A. It hath a grateful seent?  
Q. How by the touch?  
A. It must be soft like fine wool; if it be hard or stubborn, 'tis then unfit for this Burning. And if it have this last quality relating to the touch, though the colour and scent were somewhat decayed, it would not be unfit for this purpose.   

CHAP. XI.  
Of the little Aromatic sticks, and their Use.  
Q. BUT where is this Moxa to be had?  
A. It must by the Commissioners of the East-India Company be sent for out of China: Which will be very well worth the while, since it will prove a gainful commodity in Europe, and be no bruthen to ships.  
Q. What use is there of those Aromatic sticks you have mentioned?  
A. They are necessary to kindle the Moxa with; and these must likewise be had every year out of China or Japan: They also by their pleasing scent when kindled, keep the Patient and Bystanders, and the Operator, from the ungrateful and offensive smell, which the gouty damps emit▪ when by the burning Moxa they are forced to evaporate; especially if it be considered, what ill the smell of such stinking vapours may cause in our Bodies.  
Q. Are these sticks prepared by Art?  
A. They are so, and that of several sorts of well-scented wood, of which Santal is the chiefest. And they must be very tenderly handled, being very sragile.  
Q. I or what use do the Chineses and Japonese employ these sticks?  
A. For burning; but most for perfuming before their Idols.  
Q. May they be kept good for a long time?  
A. For some years, if they be kept shut up in a dry box.  
Q. May they not be had at Batavia from China, together with the Moxa?  
A. They may; but in case a great quantity were required to serve all Europe, it must be sent for from China or Japan.   

CHAP. XII.  
Of the Place where the Burning is to be made.  
Q. IN what place is this Burning to be made?  
A. In all places where the Gout-breeding matter is seated, and causeth great pain. And here the rule of Hypocrates may be applied: Burn where pain is. Wherefore the Physician or Chirurgeon must needs exactly know the very seat of the gouty pain, without which the operation is for the most part fruitless. And if the application be made but an inch wide from the very part that is in pain, it would not have the desired effect.  
Q. Since it is of that importance▪ to know well the true seat of the pain▪ how may it best be found?  
A. By the Eye and Touch.  
Q. How by the Eye?  
A. The Master ought to have Eagles eyes, and then by looking attentively he will soon spy the place▪ especially if the pain be very great and violent, and the gouty limb by the affluxed humour not much swelled: For then the Inflammation directs manifestly to the very seat of the pain and shows the hole of this raging wolf. And in this case one may easily see the genuine Gout-or Wind-tumor by taking notice of a little distension and standing out of the skin, appearing like a small pustule; on the extant head of which, if the burning be applied, the Patient will be freed of all pain, so as that the Bystanders will admire, and all Gainsayers be convinced of the virtue and power of this remedy.  
Q. But in case the Seat of the Gout should not be visible, how is it then to be found out?  
A. Considering that this mostly happens in persons that are the first time attacked by the Gout, and often also in those that are subject to a great afflux of humours from the Gout; it will be incumbent on the Master to be very coutious in finding out the true seat of the pain, that so he may not put the Patient to unnecessary torment. And therefore he must with his forefinger feel so long upon or about the place, where the Patient complains of most pain, until by the Patient's greatest sense he do find out the true place; which, to avoid all mistake, he must touch again and again, and then perform the operation of Burning accordingly.  
Q. Pray, Sir, inform me, Whether the people in China and Japan ar● subject to the Gout?  
A. This evil reigns as well in those parts of the World, as in Europe, and even among the Hottentots on the Cape of Good Hope.  
Q. Do these Nations cure themselves and others of the Gout, surely and speedily?  
A. No, they do not, except it be casually: which may be wondered at.  
Q. What's the matter, seeing they have possessed this excellent means ● Burning from immemorial times?  
A. 'Tis not the want of a good remedy, but their stubborness, superstition and perverse custom, th●● they do not cure the Gout but by chance or good fortune. For they have been taught indeed to burn in very many, but yet in certain determined and prescribed places of the body; not being to be induced to transgress those prescriptions, though the pain should require it. If then it chanceth, that the Gout sits just in the place, where they are accustomed to burn, it is cured; but if it happen to be seated one inch more or less from the place prefixed, and call for the operation of Burning, they let the Patient complain and cry out, and will not succour Nature where she needs it. And this is the true cause, why they enjoy not that benefit against the Gout by this way of Burning, as they might do.  
Q. Is it then allowed and advisable to burn upon all places where the gouty pain is seated, though there be Veins, Arteries and Nerves underneath?  
A. Yes, without exception; forasmuch as this kind of Burning, being performed after my prescription, cannot hurt these parts or vessels; yea 'tis beneficial, by this burning to discharge the swollen veins and arteries of their damps: And therefore the prescribed pellets may and must be burnt out just upon them; as shall be more particularly directed hereafter in the Toothache.  
Q. But now, the place being found out, is there nothing that may hinder the Burning?  
A▪ If there be any hair upon the place affected, that must be shaved off with a razor; in regard that the least hair impedes the Burning, because it keeps the ●ine pellet from perfectly touching the skin.  
Q. Is there nothing else in the way?  
A. If the place, where the Burning is to be made, be fatty or moist, that satness and moistness must be taken away, and the place duly cleansed and dried: That done, put the little pellet upon the right place, and there burn it, repeating it so often till the gouty pain be gone.  
Q. But how may it best be known, what effect this Burning hath produced?  
A. The Patient will soon find that by the diminution of the pain and of the inflammation, and the Master, that administers, must, (if the Burning have been made upon an ordinary place of any tender limb, to three, four or five times successively,) press with his forefinger hard upon the Escar, to learn whether the dolorifick gouty matter be wholly drawn out or not, which the Patient is with freedom to declare, if he means to be fully cured, and not in part: For, if he deceives the Master, he most deceives and wrongs himself.  
Q. If the pain with three pellets be quite removed, as commonly it is, will it be necessary to trouble him with any more?  
A. By no means.  
Q. But in case the Patient, contrary to expectation, should out of tenderness and effeminacy, in the burning of the first pellet, which causeth most pain, cry out and grow impatient, what then?  
A. The Master in that case is not to mock or laugh at him, but only show a cheerful countenance, and entertain the Patient with a discourse of the excellency of the remedy, of the shortness of the time that the operation will last, and of the number of persons that have been cured thereby.  
Q. But pray tell me, Sir, what's the reason, that this Burning hath been so many years hid from us Europeans, whereas it hath been experienced for so vast a time in those Indian Kingdoms, where it is so common, and is used for the most part with great benefit?  
A. This is to be imputed to the carelessness and conceitedness of the Europeans, because having so good an opinion of themselves, they are ashamed to learn any good thing from those Pagans; as if they alone were possessed of all knowledge, and those Nations had no share at all in it: Without which conceit and negligence, this excellent remedy might have been long before communicated to these parts of the World.   

CHAP. XIII.  
Treating of the mischiefs, inconveniences, and dangers of the Burning misused.  
Q. BUT, may any ill be occasioned by this Burning?  
A. There may; and even in Japan, China, and other places, considerable mistakes are committed in the Use of this Burning, whereby some, using it without fear or wit, do cause not only grievous and fistulous wounds, but also lameness of limbs.  
Q. Pray, explain to us more particularly, how these evils proceed from this Burning misused?  
A. To be short, when, after the manner of some Japonese, the Burning is made too much and too deep, without due regard had to the places to which the Burning is to be applied: Whence it comes to pass, that Nature being unable without help to cast off the Escar (which is great and thick) the purulent matter remains within, and eating in from time to time, causeth a deep ulceration downwards.  
Q. What danger is there of lameness, in case of imprudent Burning?  
A. When he that performs the operation, burns the Nerves and Ligaments too hard, that may easily occasion convulsions of limbs and lameness: Which evil yet needs not to be feared (no more than that abovementioned,) if you employ a good Master, or follow my prescription.   

CHAP. XIV.  
Of the Serous swellings of the Gout, bred by accident, and the Cure of them.  
Q. OF what matter do these Swellings consist?  
A. Of a Serous matter, pervaded with saltness, mostly caused by accident through pain; being of little danger, and not troublesome to cure; especially in or about the Joints of the limbs, in which these aqueous tumours are very easily bred by pain.  
Q. It seems, you make no great matter of the cure of these swellings, which yet Physicians count very troublesome to cure, knowing that they are not to use any repercussive means in this case?  
A. ' This serous humour cannot be better discharged than by our way of Burning; and that is so sure and safe, that no body ever needs to apprehend from these swellings any ill, much less incurable nodes or knots, forasmuch as by our Burning the humour and other feculent matter evaporates, whereby also the part affected is strengthened, and preserved from all putridness.   

CHAP. XV.  
Of the Nodes and Stony Tumours, and their Cure.  
Q. WHence arises that Stony or Chalky hard swelling in the external parts?  
A. From the faeces or sediment of the serous swelling; as hath been taught in the Symptoms of the Gout.  
Q. Is there a difference to be made between these hard Tumours?  
A. There is; for there is a great difference between a Schirrus that is hardened, unmovable and indolent, and such an one as is but coming on, and not yet hardened.  
Q. Are both these kinds curable?  
A. The first yields to no remedies; the other is best and soon cured by our Burning, whereby it is fully discharged, without any relics remaining behind.  
Q. Have you experience hereof.  
A. I had a notable one in our chief Chirurgeon, Francis de Ray, a very skilful Master, who in his Art had served our East-India Company near 30 years. He was exceedingly tormented by the Gout, and got a Schirrhus upon the forepart on his right hand, which though it took not quite away the Use of the hand, yet did very much disable and weaken it by a notable intumescence; which being by my advice burnt and so opened, was in a little time perfectly cured; the matter of the Schirrus, thence discharged, white like mixed chalk, which the Patient himself took up with a Spatula, and having laid it on a paper, showed it me, being dried; whereupon his hand was so strengthened, that he could use it at pleasure. In like manner the same person freed himself from such another imperfect Schirrus, seated upon the great Joint of the great Toe on his left foot.  
Q. When, I pray, is the best time to perform this Burning on the head of the imperfect Schirrus?  
A. Then when the Gout returns again to the schirrous part; which very easily comes to pass in those that are much subject to the Gout; for, in following this Prescript, you kill two Birds with one stone, and cure at the same time the Gout and the Schirrus.  
Q. Will not this Burning mollify and cure a perfect Schirrus?  
A. I have not tried this hitherto; mean time I trust, there are means to be found, if not totally, yet in part to remove this evil.  
Q. What then think you to be most advisable in this case?  
A. To open, (as often is done and must be done) the skin, and to take out the matter of the Schirrus as far as is possible, and that done, to heal up with my Coridon's or Leaf-plaisters the skin as well as you can.  
Q. But then, if this should succeed well, can you preserve the place thus weakened from a new afflux of humours?  
A. I think, I can and that after this manner: If the Schirrus were, for example, upon the knuckle of the forefinger, I would then duly burn the limb under it on the hand, and thereby intercept all ill humours, and so keep them from flowing to the weak part.  
Q. But what, if that should fail you, and the Gout surprise the limb with a new afflux of humours?  
A. Then should I resolve to hinder those humours from coagulation and induration by the advantage of our Bruning remedy; by which means you may at least take away the disfigurements, which these nodes cause in the limbs, if you cannot restore the use of the limbs.  
Q. It seems, you have some hopes even of the last?  
A. I have, because I know, that the nodes do lodge not in the very Joints, but about them; and being discharged one way or another, 'tis found that the Joints are free, provided only that the veins and arteries, yea the nerves too, be not so obstructed by the bigness, hardness and diuturnity of this stony tumour, that the pervasion of the Blood and Animal spirits cannot by fit means be restored; in which case the limb must needs remain stiff.   

CHAP. XVI.  
Whether there be different sorts of the Gout, and an Essential difference betwixt them?  
Q. ARE not almost all Physicians of opinion, that there are different kinds of the Gout, essentially dissering from one another; or at least, that there is the Cold and the Hot Gout?  
A. They are; but they mistake, being misled by the external Symptoms: For, all Gout ariseth from cold, dry, and malign damps.  
Q. But yet the Gout may be distinguished?  
A. It may, in divers respects, and principally, First, in respect of the Limb it seizes on; whence are the names of Chiragra, Sciatica, Podagra, etc. Secondly, in respect of the quantity, and quality, grossness or subtlety of the Gouty matter, more or less malignity; whence proceed the denominations of the Running and Fixed, Young and Old, Adventitious and Hereditary Gout. Thirdly, in respect of the greater or less afflux of humours. Fourthly, the Gout is either with nodes, or without nodes. Fifthly, there is a Gout which is seated in or about the Joints, and another (though that be rarely perceived) which lodges itself in the midst of the limbs: And this is to be noted against all those, who will not acknowledge such a Gout for any Gout; which is a great mistake, and no longer tolerable, because Experience teacheth us otherwise.   

CHAP. XVII.  
Means useful to prevent the Gout.  
Q. WHat general means do you think to be good to prevent the Gout?  
A. These following: First, you must beware of windy meat and drink. Secondly, you must avoid great and violent commotions of the mind, especially the passion of anger. Thirdly, neither must you put your body into too violent motions and exercises, nor afflict it with night-wakes. Fourthly, you must take continual care to keep your body soluble, and to prevent costiveness, nor to remove the same too suddenly. Fifthly, 'tis beneficial, to take a gentle Vomitive after your meal, once a week. Sixthly, as soon as you perceive any signs of a Fever (the mother of the Gout,) then is it proper to take a sudorific, by the advice of some experienced Physician, to open the pores, and to promote evaporation. Eighthly, since that many of the chief Physicians forbid wine to Gouty persons, as if it were poison to them; (though Sennertus is not so peremptory therein, but that he allows even to those that actually are in a gouty fit, a cup of good and sincere Rhinish wine, especially if the Patient cannot forbear it:) I see no reason in the World, why these Patients should be so quite debarred this strengthening and cordial liquor, (wine,) as in and after the fit; especially if it be a good conditioned wine. And my opinion is, that such a wine is so far from being noxious, that it is beneficial to them, for many reasons, which Van Helmont allegeth at large in his Book of Fevers; whose judgement I cannot but subscribe to in this matter.   

CHAP. XVIII.  
Of the Toothache or the Gout of the Teeth, and the Cure thereof  
Q. IS there also a Gout of the teeth; for I have been informed by Dr. Wilhelmus de Ryne, who lately is arrived here, that there is published a treatise in Europe, entitled, of the Gout of the Teeth?  
A. Thus is very properly expressed that kind of toothache, which hath the same proximate Cause with the Gout, and ariseth from cold Damps, as the Gout doth, which otherwise, according to the common opinion is bred from Desluxions.  
Q. But seriously, do you think, that the Gout and Toothache come from the same Cause?  
A. ti's certain to me (whatever some may allege to the contrary,) that the next cause, the part afflected, the seat, the ways, the signs and symptoms are the same in these distempers, and do agree together.  
Q. Is then the Cure of the Toothache to be performed after the same manner as of the Gout?  
A. By no means, the Toothache is to be cured in another place, because that the place, where the pain hath its seat here, is within the mouth and the teeth, where you cannot come to burn with our Moxa?  
Q. Would you then have the Temporal Artery opened with a lancet, (this seeming to be the way by which the evil damp may be expelled out of the teeth;) as some hath ventured to do, to the great ease of the pain?  
A. This means is too dangerous, because it is very subject to occasion an Aneurisma, and spends too much of the vital spirits.  
Q. What do you say then of scarification in the neck or upon the shoulders; or of purging, or of blood-letting?  
A. These and the like remedies seldom give ease.  
Q. Would you have then the aching Tooth pulled out?  
A. Not at all; that way being a desperate one, and not only accompanied with great pain & mischief to the poor Patient, but also occasioning many evils, and even death itself. But take me right, I pray; for I here only speak of that kind of Toothache, which is above described, not of that which comes from the Rottenness of teeth.  
Q. What then, may we follow Spigelius, whole manual operation Scultetus mentions in the 18th of his Chirurgical Observations; who with his knife, heated red-hot, did cut off that little branch of the temporal artery which runs through the Ear to the teeth; by which means the pain presently vanished and never returned.  
A. 'tis true, that Scultetus speaks with great commendation of this device, calling it a Chirurgical remedy of wonderful virtue; which the Author hath first practised upon himself, and afterwards, in Scultetus his presence, upon others (always with good success:) And this hath been further improved by others: For whereas Spigelius made use of a red-hot knife, to cut off the said little branch on the outside of the Ear; others have used a little flat cauterising Iron, in a silver case, that they might go safely, and not burn deeper than was fit; and therewith they have burnt off and seared within the Ear, the same ramification of the Carotid Artery, with the like happy success: As I myself have experienced 26. or 28. years ago at Arnheim, where Dr. N. Coets did, by this means, immediately free me from an intolerable toothache. I have also understood here in India from very credible Persons, that D. Godefridus Dellius, Minister at Kooten near Wyck of Durstede, hath cured many of that pain by this very means.  
Q. Since this is so excellent and effectual a remedy, shall we then stand by it, or is there something to be said against it?  
A. So there is; and to deal plainly with you, it ought to yield to a better remedy, viz. to our burning with Moxa, the which in the Gout of the Teeth serves not only for a discharging but also for a revulsive intercepting remedy, which always produces good (if used according to my prescript) and never the least evil. For, whereas by the former way, of using the red-hot knife and the cautery, the body loses one of the necessary and the nobler kind of blood-vessels, to the detriment and spoiling of the teeth; by our way those vesels are preserved entire and unhurt. 'tis true indeed, that the pain of the teeth by the former art is so removed as that it never returns (in case that whole branch be burnt off;) but this is also true, that by such a cauterising operation there is for ever cut off that afflux of the blood and vital spirits, through this seared artery, to the teeth; whereupon at last must follow an exiccation and mortification of the teeth.  
Q. Since then you prefer your burning with Moxa before all other remedies in the toothache also, pray, teach me, where it is to be applied?  
A. Just upon the temporal artery, where the same in the Temples, not far from the Ear, beats strongest in a violent toothache; which is that place where Chirurgeons are wont to apply their Mastick-plaisters, etc.  
Q. But is the burning with Moxa upon the temporal arteries not too dangerous?  
A▪ Not at all, if your work be done carefully; yea it is a means very beneficial, and hath been practised by the father Physicians, of Hypocrates himself.  
Q. After what manner then is this Burning to be performed; must it be done as in the case of the Gout?  
A. Just so; only you must in this case Kindle lesser pellets, and these to the number of three upon one place, and no more; though it be not forbidden, at some little distance from the burned place to perform anew the like burnning; which may be done not only without fearing the least mischief from it, but also with an expectation of more ease.  
Q. Is this Burning followed by a Mitigation or by a Removal of the pain?  
A. It performs both, in an admirable manner, and that instantly, or presently after, without fail; unless, unknown to the Patient and Operator, the Toothache should proceed from a hidden rottenness of the Teeth.  
Q. But, Sir, how will you make it out, that this is a revulsive and intercepting remedy, and withal discharging the part affected from the evil which afflicts it?  
A. This is as clear as the Sun at noonday, and that from the effects: For the Damps, which were already by the expelling power of the Heart driven out into the place that is between the membrane and the teeth, and there produced so great pain by the expanding of the sensible membrane, are by this our Burning drawn back to the place where the Burning is made, and other Damps intercepted that were on the way, and so the body, according to wish, disburdened from both, and the blood purified.  
Q. Mean time the learned Sennertus saith, that the true means duly to purge the blood hath not yet been found out: Is that true?  
A. It is; for the ways hitherto found out to purify the blood do not deserve that name. For, the matter being well considered, they do something else than discharge the blood of its impurities: And I am of opinion, that unto this very time there hath been found out no better means for that purpose than what we here propose; forasmuch as thereby the Blood is suddenly and most safely purged of all noxious damps.  
Q. What is to be done after the Burning for the Toothache?  
A. After this slight Burning there remains only a little grey speck, which needs not to be looked after, because it dries and heals up of itself, and serves till than for a vent to the evaporating damps.    

AN APPENDIX Concerning Three Remarkable OBSERVATIONS.  

OBSERVE. I.  
About the Removal of the Falling-Sickness by our way of Burning with Moxa.  
IAcobus Ionas, about 13 years of age, Son of Ionas Aertz, who was chief Chirurgeon in the Hospital of the Noble Company in Batavia, having taken a fancy (against his Father's command) to see the sad and dismal agonies of dying persons in a place where desperate and incurable persons were lodged, did upon a Sunday morning see one of those give up the ghost in so affrightful a manner under such terrible convulsions, that being more than usually terrified therewith, he could not forbear to speak of it at Table with amazement: At which relation his Father being much troubled, did severely rebuke him for so dangerous a curiosity, strictly commanding him, never to repair to that place again, from an apprehension, lest one time or other he should rue such a curiosity. But behold! The boy laying himself down upon a bench after dinner, to take (as 'tis common in that place) a nap in the afternoon, there appeared to him (as he related afterwards) in a dream that fearful departure of the dead, so lively to his fancy, that in a fright he awakened, crying out a loud, and, seized on with a terrible fit of the Epilepsy. To which distemper he remained a great while subject, and in such a manner, that upon the least disturbance he fell into new fits, of which his Father was not able by any of the means by him employed to free him. This did so grieve the good old man, that in all likelihood it contributed not a little to his hasty death.  
It happened, that upon occasion I visited the widow of this Chirurgeon, where seeing this Youth halting, I asked what the cause of it was. He showing me a swelling above his left knee, accompanied with grievous pains; I was apt to conclude that it was a Gouty distemper, and resolved, thereupon, with the consent of the parties concerned, to treat it as such; employing my way of burning, which I did with three pellets consumed on one place: whereupon all pain being vanished, the youth instantly walked without any inconvenience. I put upon it a Coridon's plaster, and ordered him to renew it twice in 24 hours. And since that time he never had any fit of the Falling-sickness; doubtless because that the venomous Damps, which caused this grievous distemper, had been evaporated our of the body, or rather had been thence drawn out by the Moxa. And 'tis observable, that (according to the relation made me by the Lad's Mother,) this Damp never caused in him a fit of the Falling Sickness, till it had first for a while tormented the place abovementioned, no otherwise as if it had been the Gout. Now, when this peccant matter did ascend from the knee to the Head (which usually fell out every sixth or eighth day,) it was attended with a sensible Cold in the passage of this Damp, yet acting so slowly, that the Youth had time enough to give warning to his Mother of a new sit, that so she might take the better care of him.   

OBSERVE. II.  
Concerning the Cure of a Mad Female-Slave, by the Burning with Moxa.  
URsula, one of our Female-slaves▪ being sent out to buy some fish for our family, and come to the place where the Fishermen use to be with their boats, and having seen one of them arrived with fish, she stepped over several of those boats to get into that, where she might buy. Which having done, and stepping back again over those boats to shore, she was frighted at the sudden and unexpected sight of a drowned Humane body, she had stepped over, that had been brought up to be viewed by the appointed Officer. Which fright did so seize her, that she fell down and quite fainted away. But being somewhat recovered, she was brought home with the fish in her hand, but out of her wits; which the same night was followed by such a fit of Madness, that at first we knew not what to do. But having recollected ourselves, we resolved to send for the Guinam-Doctress, to hear her advice, since she had so successfully cured me of the Gout. She came the next morning, and being well informed of the circumstances of this ease, and demanded whether she knew any remedy for it, she answered, That she would use her Art, and hoped God would bless her operation. What doth she? She bids the other slaves that were present to hold this poor she-slave fast, and binds the hair of her head close together, into a knot; which done, she makes one of the most robust slaves to hold that hair-knot with his hand, and to turn the Patient's head which way she, (the Doctress) would have it. Whereupon she began to burn with her Moxa close under the hair, from the forepart of the head unto the neck▪ and from the neck again to the forepart, round about; performing this so artificially and gently, that hardly any mark could be perceived: Whereupon this poor mad creature, to the admiration of us all, fell into a sweet sleep, of which she awakened towards evening in very good health and in her right wits, without ever after relapsing into that grievous fit of madness again; it being now about Ten years since her recovery.   

OBSERVE. III.  
Touching a Strange Catalepsis or Stiffness cured by the Moxa.  
ONe of our she-slaves, which my Wife had lent to our chief Chirurgeon William Perceant (who a little while▪ before had married one of my daughters,) was about evening, as she was at work without doors upon the wall, suddenly surprised with this distemper, so that in a trice she became as stiff as a statue, without any hearing, seeing, speaking, or moving any limb. The said Chirurgeon having tried upon her the utmost of his skill to no purpose, and I being made acquainted with the condition of this wretched slave, my Wife and Son, upon my desire, went immediately to her, and according to my direction burned her upon the Arteries of her temples: Which was no sooner done, but she recovered the use of her senses and the Motion of all her limbs, and she enjoys to this very day a good state of health.  
I conclude with the advice of the never too much celebrated Nicolaus Tulpius, in the first Book of his Medical Observations, chap. 8. where he saith, You Surgeons, take good notice of the wholesome Use of Caustics; it shall turn to your Credit, and to the Benefit of your Patients.  
FINIS.