William Temple

An essay upon the cure of the gout

WRITTEN TO MONSIEUR DE ZULICHEM.

Nimeguen, June 18, 1677

I never thought it would have befallen me to be the first that should try a new experiment, any more than be the author of any new invention: being little inclined to practise upon others, and as little that others should practise upon me. The same warmth of head disposes men to both, though one be commonly esteemed an honour, and the other a reproach. I am sorry the first, and the worst of the two, is fallen to my share, by which all a man can hope is to avoid censure, and that is much harder than to gain applause; for this may be done by one great or wise action in an age; but to avoid censure, a man must pass his life without saying or doing one ill or foolish thing.

This might serve the turn, if all men were just; but as they are, I doubt nothing will, and that it is the idlest pretension in the world to live without it.; the meanest subjects censuring the actions of the greatest Prince; the silliest servants, of the wisest master; and young children, of the oldest parents. Therefore I have not troubled myself to give any account of an experiment I made by your persuasion, to satisfy those who imputed it to folly, rashness, or impatience; but to satisfy you who proposed the thing in kindness to me, and desired the relation of it in kindness to other men.

I confess your engaging me first in this adventure of the Moxa, and desiring the story of it from me, is like giving one the torture, and then asking his confession; which is hard usage to an innocent man and a friend. Besides, having suffered the first, I took myself to have a right of refusing the other. But I find your authority with me too great to be disputed in either; and the pretence of public good, is a cheat that will ever pass in the world, though so often abused by ill men, that I wonder the good do not grow ashamed to use it any longer. Let it be as it will, you have what you asked, and cannot but say that I have done, as well as suffered, what you had a mind to engage me in. I have told you the story with the more circumstance, because many questioned the disease, that they might not allow of the cure; though the certainty of one, and force of the other, has been enough evidenced by two returns since I left you at the Hague, which passed with the same success. The reasonings upon this method, which seem to confirm the experiment, and other remedies for the gout here reflected on, are aimed at the same end for which you seemed so much to desire this relation. The digressions I cannot excuse otherwise, than by the confidence that no man will read them, who has not at least as much leisure as I had when I writ them; and whosoever dislikes or grows weary of them, may throw them away. For those about temperance, age, or their effects and periods, in reference to public business, they could be better addressed to none than to you, who have passed the longest life with the most temperance, and the best health and humour of any man I know; and, having run through so much great and public business, have found out the secret so little known, that there is a time to give it over.

I will pretend but to one piece of merit in this relation, which is to have writ it for you in English, being the language I always observed to have most of your kindness among so many others of your acquaintance. If your partiality to that, and to me, and to your own request, will not excuse all the faults of this paper, I have nothing more to say for it, and so will leave you to judge of it as you please.

Among all the diseases to which the intemperance of this age disposes it (at least in these northern climates), I have observed none to increase so much, within the compass of my memory and conversation, as the gout, nor any I think of worse consequence to mankind; because it falls generally upon persons engaged in public affairs and great employments, upon whose thoughts and cares (if not their motions and their pains) the common good and service of their country so much depends. The general officers of armies, the governors of provinces, the public ministers in councils at home, and embassies abroad (that have fallen in my way), being generally subject to it in one degree or other. I suppose the reason of this may be, that men seldom come into those posts till after forty years old, about which time the natural heat beginning to decay, makes way for those distempers they are most inclined to by their native constitutions, or by their customs and habits of life. Besides, persons in those posts are usually born of families noble and rich, and so derive a weakness of constitution from the ease and luxury of their ancestors, and the delicacy of their own education: or if not, yet the plenty of their fortunes from those very employments, and the general custom of living in them at much expence, engages men in the constant use of great tables, and in frequent excesses of several kinds, which must end in diseases when the vigour of youth is past, and the force of exercise (that served before to spend the humour) is given over for a sedentary and unactive life.

These I take to be the reasons of such persons being so generally subject to such accidents more than other men; and they are so plain, that they must needs occur to any one that thinks. But the ill consequence of it is not so obvious, though perhaps as evident to men that observe; and may be equally confirmed by reasons and example. It is, that the vigour of the mind decays with that of the body, and not only humour and invention, but even judgment and resolution, change and languish with ill constitution of body and of health; and by this means public business comes to suffer by private infirmities, and kingdoms or states fall into weaknesses and distempers or decays of those persons that manage them.

Within these fifteen years past, I have known a great fleet disabled for two months, and thereby lose great occasions, by an indisposition of the Admiral, while he was neither well enough to exercise, nor ill enough to leave the command. I have known two towns, of the greatest consequence, lost, contrary to all forms, by the governor’s falling ill in the time of the sieges.

I have observed the fate of a campania determine contrary to all appearances, by the caution and conduct of a general, which were attributed, by those that knew him, to his age and infirmities, rather than his own true qualities, acknowledged otherwise to have been as great as most men of the age. I have seen the counsels of a noble country grow bold or timorous, according to the fits of his good or ill health that managed them, and the pulse of the government beat high or low with that of the Governor: and this unequal conduct makes way for great accidents in the world: nay, I have often reflected upon the counsels and fortunes of the greatest Monarchies, rising and decaying sensibly with the ages and healths of the Princes and chief officers that governed them. And I remember one great Minister that confessed to me, when he fell into one of his usual fits of the gout, he was no longer able to bend his mind or thoughts to any public business, nor give audiences beyond two or three of his own domestics, though it were to save a kingdom; and that this proceeded, not from any violence of pain, but from a general languishing and faintness of spirits, which made him, in those fits, think nothing worth the trouble of one careful or solicitous thought. For the approaches or lurkings of the gout, the spleen, or the scurvy, nay, the very fumes of indigestion, may indispose men to thought and to care, as well as diseases of danger and pain.

Thus, accidents of health grow to be accidents of State, and public constitutions come to depend, in a great measure, upon those of particular men; which makes it perhaps seem necessary, in the choice of persons for great employments (at least such as require constant application and pains), to consider their bodies as well as their minds; and ages and health, as well as their abilities.

When I was younger than I am, and thereby a worse judge of age, I have often said, that what great thing soever man proposed to do in his life, he should think of achieving it by fifty years old. Now I am approaching that age, I think it much more than I did before; and that no man rides to an end of that stage without feeling his journey in all parts, whatever distinctions are made between the mind and the body, or between judgment and memory. And though I have known some few, who might perhaps be of use in council, upon great occasions, till after threescore and ten; and have heard that the two late Ministers in Spain, Counts of Castriglio and Pignoranda, were so till fourscore; yet I will not answer, that the very conduct of public affairs, under their Ministry, has not always tasted of the lees of their age.

I observe in this assembly at Nimeguen, from so many several parts of Christendom, that, of one and twenty Ambassadors, there are but three above fifty years old; which seems an argument of my opinion being in a manner general: nor can I think the period ill calculated, at least for a great General of armies, or Minister of State, in times or scenes of great action, when the care of a State or an army ought to be as constant as the Chemic’s fire, to make any great production; and, if it goes out for an hour, perhaps the whole operation fails. Now, I doubt whether any man, after fifty, be capable of such constant application of thought, any more than of long and violent labour or exercise, which that certainly is, and of the finest parts. Besides, none that feel sensibly the decays of age, and his life wearing off, can figure to himself those imaginary charms in riches and praise, that men are apt to do in the warmth of their blood; and those are the usual incentives towards the attempt of great dangers, and support of great trouble and pains.

To confirm this by examples, I have heard that Cardinal Mazarine, about five-and-fifty, found it was time to give over: that the present Grand Visier, who passes for one of the greatest men of that empire, or this age, began his Ministry about twenty-eight: and the greatest I have observed, which was that of Monsieur De Witt, began at three-and-thirty, and lasted to forty-eight; and could not, I believe, have gone on many years longer at that height, even without that fatal end. Among other qualities which entered into the composition of this Minister, the great care he had of his health, and the little of his life, were not, I think, the least considerable; since, from the first he derived his great temperance, as well as his great boldness and constancy from the other. And if intemperance be allowed to be the common mother of gout, or dropsy, and of scurvy, and most other lingering diseases, which are those that infest the State, I think temperance deserves the first rank among public virtues, as well as those of private men; and doubt whether any can pretend to the constant steady exercise of prudence, justice, or fortitude, without it.

Upon these grounds, whoever can propose a way of curing, or preventing the gout, (which entered chiefly into those examples I have mentioned of public affairs suffering by private indispositions,) would perhaps do a service to Princes and States, as well as to particular men; which makes me the more willing to tell my story, and talk out of my trade, being strongly possessed with a belief, that what I have tried or thought, or heard upon this subject, may go a great way in preventing the growth of this disease where it is but new, though perhaps longer methods are necessary to deal with it when it is old.

From my grandfather’s death I had reason to apprehend the stone; and from my father’s life the gout, who has been for this many years, and still continues, much afflicted with it. The first apprehension has been, I confess, with me ever the strongest, and the other hardly in my thoughts, having never deserved it by the usual forms; nor had I ever, I thank God, the least threat from either of them till the last year at the Hague, being then in the seven-and-fortieth year of my age, when, about the end of February, one night at supper, I felt a sudden pain in my right foot, which, from the first moment it began, increased sensibly, and in an hour’s time to that degree, that though I said nothing, yet others took notice of it in my face, and said, they were sure I was not well, and would have had me go to bed. I confessed I was in pain, and thought it was with some sprain at tennis: I pulled off my shoe, and with some ease that gave me stirred not till the company broke up, which was about three hours after my pain began. I went away to bed; but it raged so much all night, that I could not sleep a wink. I endured it till about eight next morning, in hopes still of stealing some rest; but then making my complaints, and shewing my foot, they found it very red and angry; and, to relieve my extremity of pain, began to apply common poultices to it; and, by the frequent change of them, I found some ease, and continued this exercise all that day, and a great part of the following night, which I passed with very little rest. The morning after, my foot began to swell, and the violence of my pain to assuage; though it left such a soreness, that I could hardly suffer the cloaths of my bed, nor stir my foot but as it was lifted.

By this time my illness, being enquired after about the town, was concluded to be the gout; and being no longer feverish, or in any extremity of pain, I was content to see company. Every body that came to visit me found something to say upon the occasion; some made a jest of it, or a little reproach; others were serious in their mirth, and made me compliments, as upon a happy accident and sign of long life. The Spaniards asked me albricias for telling me the news, that I might be sure it was the gout; and, in short, none of the company was in ill humour but I, who had rather by half have had a fever, or a worse disease, at that time, where the danger might have been greater, but the trouble and the melancholy would, I am sure, have been less.

Though I had never feared the gout, yet I had always scorned it as an effect commonly of intemperance; and hated it, as what I thought made men unfit for any thing after they were once deep engaged in it: besides, I was pressed in my journey at that time to Nimeguen by his Majesty’s commands, to assist at the treaty there. Most of the Ambassadors from the several parts of Christendom were upon their way: one of my colleagues was already upon the place, and I had promised immediately to follow; for, by our commission, we were to be two to act in that mediation; and, to help at this pinch, I had always heard that a fit of the gout used to have six weeks at the least for its ordinary period. With these comforts about me, and sullenness enough to use no remedy of a hundred that were told me, Monsieur Zulichem came to see me (among the rest of my friends) who, I think, never came into company without saying something that was new, and so he did upon my occasion. For, talking of my illness, and approving of my obstinacy against all the common prescriptions; he asked me, whether I had never heard the Indian way of curing the gout by Moxa? I told him no; and asked him what it was? He said it was a certain kind of moss that grew in the East-Indies; that their way was, whenever any body fell into a fit of the gout, to take a small quantity of it, and form it into a figure broad at bottom as a two-pence, and pointed at top; to set the bottom exactly upon the place where the violence of the pain was fixed; then with a small round perfumed match (made likewise in the Indies) to give fire to the top of the moss; which burning down by degrees, came at length to the skin, and burnt it till the moss was consumed to ashes: that many times the first burning would remove the pain; if not, it was to be renewed a second, third, and fourth time, till it went away, and till the person found he could set his foot boldly to the ground and walk.

I desired him to tell me how he had come acquainted with this new operation. He said, by the relation of several who had seen and tried it in the Indies, but particularly by an ingenious little book, written of it by a Dutch Minister at Batavia, who being extremely tormented with a fit of the gout, an old Indian woman, coming to see him, undertook to cure him, and did it immediately by this Moxa; and, after many experiments of it there, had written this treatise of it in Dutch for the use of his countrymen, and sent over a quantity of the moss and matches to his son at Utrecht to be sold, if any would be persuaded to use them. That though he could not say whether experiment had been made of it here, yet the book was worth reading; and, for his part, he thought he should try it, if ever he should fall into that disease.

I desired the book, which he promised to send me next morning; and this discourse of Monsieur Zulichem busied my head all night. I hated the very name of the gout, and thought it a reproach; and for the good sign people called it, I could not find that mended an ill thing; nor could I like any sign of living long in weakness or in pain. I deplored the loss of my legs, and confinement to my chamber at an age that left me little pleasure but of walking and of air; but the worst circumstance of all was the sentence passed upon it of being without cure.

I had passed twenty years of my life, and several accidents of danger in my health, without any use of physicians; and, from some experiments of my own, as well as much reading and thought upon that subject, had reasoned myself into an opinion, that the use of them and their methods (unless in some sudden and acute disease) was itself a very great venture; and that their greatest practisers practised least upon themselves, or their friends. I had ever quarreled with their studying art more than nature, and applying themselves to methods, rather than to remedies; whereas the knowledge of the last is all that nine parts in ten of the world have trusted to in all ages.

But for the common remedies of the gout, I found exceptions to them all; the time of purging was past with me, which otherwise I should certainly have tried upon the authority of the great Hippocrates, who says it should be done upon the first motion of the humour in the gout. For poultices, I knew they allayed pain ; but withal, that they drew down the humours, and supplied the parts, thereby making the passages wider, and apter to receive them in greater quantity; and I had often heard it concluded, that the use of them ended in losing that of one’s limbs, by weakening the joint upon every fit. For plaisters that had any effect, I thought it must be by dispersing or repelling the humours, which could not be done without endangering perhaps some other disease of the bowels, the stomach, or the head. Rest and warmth, either of cloaths or bathings, I doubted would in a degree have the effects of poultices; and sweating was proper for prevention, rather than remedy. So that all I could end in, with any satisfaction, was patience and abstinence; and though I easily resolved of the last, yet the first was hard to be found in the circumstances of my business as well as of my health.

All this made me rave upon Monsieur Zulichem’s new operation: and for the way of curing by fire, I found twenty things to give me an opinion of it. I remembered what I had read of the Egyptians of old, who used it in most diseases; and what I had often heard of that practice still continuing among the Moors of Afric; so that a slave is seldom taken (as both Spaniards and Portuguese affirm) who has not many scars of the hot iron upon his body, which they use upon most distempers, but especially those of the head, and consequently in physic as well as in surgery. In the time of the Incas reign in Peru (which I take to have been one of the greatest constitutions of absolute monarchy that has been in the world) no composition was allowed by the laws to be used in point of medicine, but only simples proper to each disease. Burning was much in use, either by natural or artificial fires; particularly for illness of teeth, and soreness or swelling of the gums (which they were subject to from their nearness to the sea) they had an herb which never failed of curing it, and, being laid to the gums, burnt away all the flesh that was swelled or corrupted, and made way for new that came again as sound as that of a child. I remembered to have had myself, in my youth, one cruel wound cured by scalding medicament, after it was grown so putrefied as to have (in the surgeon’s opinion) endangered the bone; and the violent swelling and bruise of another taken away as soon as I received it, by scalding it with milk. I remembered the cure of chilblains, when I was a boy, (which may be called the children’s gout,) by burning at the fire, or else by scalding brine, that has (I suppose) the same effect. I had heard of curing the stings of adders, and bites of mad dogs, by immediately burning the part with a hot iron; and of some strange cures of frenzies, by casual applications of fire to the lower parts; which seems reasonable enough, by the violent revulsion it may make of humours from the head; and agrees with the opinions and practice I mentioned before, of Egypt and Africa. Perhaps blistering in the neck, and hot pigeons, may be in use among us upon the same grounds; and in our methods of surgery, nothing is found of such effect in the case of old ulcers as fire, which is certainly the greatest drawer and drier, and thereby the greatest cleanser that can be found. I knew very well, that in diseases of cattle, there is nothing more commonly used, nor with greater success; and concluded it was but a tenderness to mankind that made it less in use amongst us, and which had introduced corrosives and caustics to supply the place of it, which are indeed but artificial fires.

I mention all these reflections, to shew that the experiment I resolved to make was upon thought, and not rashness or impatience (as those called it that would have dissuaded me from it); but the chief reason was, that I liked no other, because I knew they failed every day, and left men in despair of being ever well cured of the gout.

Next morning I looked over the book which Monsieur Zulichem had promised me, written by the Minister at Batavia. I pretended not to judge of the Indian philosophy, or reasonings upon the cause of the gout; but yet thought them as probable as those of physicians here; and liked them so much the better, because it seems their opinion in the point is general among them, as well as their method of curing; whereas the differences among ours, are almost as many in both, as there are physicians that reason upon the causes, or practise upon the cure of that disease. They hold, that the cause of the gout is a malignant vapour that falls upon the joint between the bone and the skin that covers it, which, being the most sensible of all parts of the body, causes the violence of the pain. That the swelling is no part of the disease, but only an effect of it, and of a kindness in nature, that, to relieve the part affected, calls down humours to damp the malignity of the vapour, and thereby assuage the sharpness of the pain; which seldom fails, whenever the part grows very much swelled. That consequently the swellings and returns of the gout are chiefly occasioned by the ill methods of curing it at first. That this vapour, falling upon joints which have not motion, and thereby heat enough, to dispel it, cannot be cured otherwise than by burning, by which it immediately evaporates; and that this is evident by the present ceasing of the pain upon the second, third, or fourth application of the Moxa, which are performed in a few minutes time. And the author affirms it happens often there, that upon the last burning, an extreme stench comes out of the skin where the fire had opened it.

Whatever the reasonings were, which yet seemed ingenious enough; the experiments alledged, with so much confidence, and to be so general in those parts, and told by an author that writ like a plain man, and one whose profession was to tell truth, helped me to resolve upon making the trial. I was confirmed in this resolution by a German physician, Doctor Theodore Coledy, who was then in my family, a sober and intelligent man, whom I dispatched immediately to Utrecht, to bring me some of the Moxa, and learn the exact method of using it, from the man that sold it, who was son to the Minister of Batavia. He returned with all that belonged to this cure, having performed the whole operation upon his hand by the man’s direction. I immediately made the experiment in the manner before related, setting the Moxa just upon the place where the first violence of my pain began, which was the joint of the great toe, and where the greatest anger and soreness still continued, notwithstanding the swelling of my foot, so that I had never yet, in five days, been able to stir it, but as it was lifted.

Upon the first burning, I found the skin shrink all round the place; and whether the greater pain of the fire had taken away the sense of a smaller one or no, I could not tell; but I thought it less than it was: I burnt it the second time, and upon it observed the skin about it to shrink, and the swelling to flat yet more than at first. I began to move my toe, which I had not done before; but I found some remainders of pain. I burnt it the third time, and observed still the same effects without, but a much greater within; for I stirred the joint several times at ease; and, growing bolder, I set my foot to the ground without any pain at all. After this, I pursued the method prescribed by the book; and the author’s son at Utretcht, and had a bruised clove of garlic laid to the place that was burnt, and covered with a large plaister of Diapalma, to keep it fixed there; and when this was done, feeling no more pain, and treading still bolder and firmer upon it, I cut a slipper to let in my foot, swelled as it was, and walked half a dozen turns about the room, without any pain or trouble, and much to the surprise of those that were about me, as well as to my own. For, though I had reasoned myself beforehand into an opinion of the thing, yet I could not expect such an effect as I found, which seldom reaches to the degree that is promised by the prescribers of any remedies, whereas this went beyond it, having been applied so late, and the prescription reaching only to the first attack of the pain, and before the part begins to swell.

For the pain of the burning itself, the first time, it is sharp, so that a man be allowed to complain; I resolved I would not, but that I would count to a certain number, as the best measure how long it lasted. I told sixscore and four, as fast as I could; and when the fire of the Moxa was out, all pain of burning was over. The second time was not near so sharp as the first, and the third a great deal less than the second. The wound was not raw, as I expected, but looked only scorched and black; and I had rather endure the whole trouble of the operation, than half a quarter of an hour’s pain in the degree I felt it the first whole night.

After four-and-twenty hours, I had it opened, and found a great blister drawn by the garlic, which I used no more, but had the blister cut, which run a good deal of water, but filled again by the next night; and this continued for three days, with only a plaister of Diapalma upon it; after which time the blister dried up, and left a sore about as big as a two-pence, which healed and went away in about a week’s time longer; but I continued to walk every day, and without the least return of pain, the swelling still growing less, though it were near six weeks before it was wholly gone. I favoured it all this while more than I needed, upon the common opinion, that walking too much might draw down the humour; which I have since had reason to conclude a great mistake, and that, if I had walked as much as I could from the first day the pain left me, the swelling might have left me too in a much less time.

The talk of this cure ran about the Hague, and made the conversation in other places, as well as in the visits I received while I kept my chamber, which was about a fortnight after the burning. Monsieur Zulichem came to me among the rest of the good company of the town, and much pleased with my success, as well from his own great humanity and particular kindness to me, as from the part he had in being the first prescriber of my cure, and from the opinion it gave him of a common good fortune befallen all that felt or were in danger of the gout.

Among others he told it to, Monsieur Serinchamps was one, an Envoy of the Duke of Lorrain’s, then in town; a person very much and very deservedly esteemed among all the good company in town, and to whom every body was kind upon the score of his own good humour, or his master’s ill fortunes: he had been long subject to the gout, and with constant returns of long and violent fits two or three times in a year. He was a man frank and generous, and loved to enjoy health whilst he had it, without making too much reflection upon what was to follow; and so, when he was well, denied himself nothing of what he had a mind to eat or drink; which gave him a body full of humours, and made his fits of the gout as frequent and violent as most I have known : when they came, he bore them as he could, and forgot them as soon as they were past, till a new remembrance. At this time he lay ill of a cruel fit, which was fallen upon his knee, and with extreme pain: when he heard of my cure, he sent to me first for the relation of it; and upon it, for my Moxa, and for Coleby to apply it. He suffered it; but after his pleasant way roared out, and swore at me all the while it was burning, and asked if I took him for a sorcerer, that I sent to burn him alive? yet, with all this, the pain went away upon it, and returned no more to the same place; but he was something discouraged by a new pain falling some days after upon his elbow on the other side, which gave him a new fit, though gentler and shorter than they used to be.

About the same time one of the maids of my house was grown almost desperate with the toothach, and want of sleep upon it, and was without remedy. The book gives the same cure for certain in that illness, by burning upon the great vein under the ear; and the man who sold it at Utrecht had assured Coleby he had seen many cures by it in that kind. We resolved to try; which was done, and the pain immediately taken away, and the wench perfectly well, without hearing of it any more, at least while she was in my house.

Thus passed the first experiment; upon which Monsieur Zulichem, giving an account of it to some of his friends at Gresham college, came to me before I left the Hague, formally to desire me from them, and from himself, that I would give a relation of it that might be made public, as a thing which might prove in appearance of common utility to so great numbers as were subject to that disease; and told me, that some of Gresham college had already given order for translating into English the little Batavian treatise. I commended the care of publishing it among us, and thereby inviting others to an experiment I had reason to approve; but excused myself from any relation of my own, as having too much business at that time, and at all times caring little to appear in public. I had another reason to decline it, that ever used to go far with me upon all new inventions or experiments, which is, that the best trial of them is by time, and observing whether they live or no; and that one or two trials can pretend to make no rule, no more than one swallow a summer; and so before I told my story to more than my friends, I had a mind to make more trials myself, or see them made by other people as wise as I had been.

During the confinement of this fit, I fell into some methods, and into much discourse upon the subject of the gout, that may be perhaps as well worth reflection by such as feel or apprehend it, as what I have told of this Indian cure. In the first place, from the day I kept my chamber till I left it, and began to walk abroad, I restrained myself to so regular a diet, as to eat flesh but once a day, and little at a time, without salt or vinegar; and to one moderate draught, either of water or small ale. I concluded to trust to abstinence and exercise, as I had ever resolved, if I fell into this disease; and if it continued, to confine myself wholly to the milk- diet, of which I had met with very many and great examples, and had a great opinion even in long and inveterate gouts. Besides this refuge, I met with, in my visits and conversation arising upon my illness, many notions or medicines very new to me, and reflections that maybe so perhaps to other men. Old Prince Maurice of Nassau told me, he laughed at the gout; and though he had been several times attacked, yet it never gave him care nor trouble. That he used but one remedy, which was, whenever he felt it, to boil a good quantity of horse-dung from a stone-horse of the Hermelinne colour, as he called it in French, which is a native white, with a sort of raw nose, and the same commonly about the eyes; that, when this was well boiled in water, he set his leg in a pail-full of it, as hot as he could well endure it, renewing it as it grew cool for above an hour together; that after it, he drew his leg immediately into a warm bed, to continue the perspiration as long as he could, and never failed of being cured. Whether the remedy be good, or the circumstances of colour signify any thing more than to make more mystery, I know not; but I observed, that he ever had a set of such Hermelinne horses in his coach, which he told we was on purpose that he might never want this remedy.

The Count Kinski, Ambassador from the Emperor to the treaty at Nimeguen, gave me a receipt of the salt of harts-horn, by which a famous Italian physician of the Emperor’s had performed mighty cures upon many others as well as himself, and the last year upon the Count Montecuculi: the use of this I am apt to esteem, both from the quality given it of provoking sweat extremely, and of taking away all sharpness from whatever you put it in; which must both be of good effect in the cure of the gout.

The Rhyngrave, who was killed last summer before Maestricht, told me his father the old Rhyngrave, whom I knew very well, had been long subject to the gout, and never used other method or remedy than, upon the very first fit he felt, to go out immediately and walk, whatever the weather was, and as long as he was able to stand, and pressing still most upon the foot that threatened him; when he came home he went to a warm bed, and was rubbed very well, and chiefly upon the place where the pain began. If it continued, or returned next day, he repeated the same course, and was never laid up with it; and before his death recommended this course to his son, if he should ever fall into that accident.

A Dutchman, who had been long in the East Indies, told me, in one part of them where he had lived some time, the general remedy of all that were subject to the gout, was rubbing with hands; and that whoever had slaves enough to do that constantly every day, and relieve one another by turns, till the motion raised a violent heat about the joints where it was chiefly used, was never troubled much, or laid up by that disease.

My youngest brother told me he had a keeper very subject to it, but that it never laid him up, but he was still walking after his deer, or his stud, while he had the fits upon him, as at other times, and often from morning to night, though in pain all the while. This he gave me as one instance that poor and toiling men have sometimes the gout, and that many more may have it, who take no more notice of it than his keeper did; who yet he confessed used to bring the fits of gout upon him by fits of drinking, which, no doubt, is a receipt that will hardly fail, if men grow old in the custom.

Monsieur Serinchamps told me, a Lorrain surgeon had undertaken to cure it by a more extraordinary way than any of these, which was by whipping the naked part with a great rod of nettles till it grew all over blistered; and that he had once persuaded him to perform this penance in a sharp fit he had, and the pain in his knee so violent, as helped him to endure this remedy. He said it was cruel; that all where he was whipped grew so angry, and swelled as well as blistered, that he thought it had given him a fever that night. The next morning the part was all as stiff as a boot, and the skin like parchment; but that keeping it anointed with a certain oil likewise of nettles, it past in two days, and the gout too, without feeling any more pain that fit.

All these things put together, with what a great physician writes of cures by whipping with rods, and another with holly, and by other cruelties of cutting or burning, made me certainly conclude, that the gout was a companion that ought to be treated like an enemy, and by no means like a friend, and that grew troublesome chiefly by good usage; and this was confirmed to me by considering that it haunted usually the easy and the rich, the nice and the lazy, who grow to endure much, because they can endure little: that make much of it as soon as it comes, and yet leave not making much of themselves too : that take care to carry it presently to bed, and keep it safe and warm, and indeed lay up the gout for two or three months, while they give out, that the gout lays up them. On the other side, it hardly approaches the rough and the poor, such as labour for meat, and eat only for hunger; that drink water, either pure, or but discoloured with malt; that know no use of wine, but for a cordial, as it is, and perhaps was only intended: or if such men happen by their native constitutions to fall into the gout, either they mind it not at all, having no leisure to be sick, or they use it like a dog, they walk on, or they toil and work as they did before; they keep it wet and cold; or if they are laid up, they are perhaps forced by that to fast more than before, and if it lasts, they grow impatient, and fall to beat it or whip it, or cut it, or burn it; and all this while, perhaps, never know the very name of the gout.

But to follow my experiment: I passed that summer here at Nimeguen, without the least remembrance of what had happened to me in the spring, till about the end of September, and then began to feel a pain that I knew not what to make of, in the same joint, but of my other foot: I had flattered myself with hopes, that the vapour had been exhaled, as my learned authors had taught me, and that thereby the business had been ended; this made me neglect my Moxa for two days, the pain not being violent, till at last my foot began to swell, and I could set it no longer to the ground. Then I fell to my Moxa again, and burnt it four times before the pain went clear away, as it did upon the last, and I walked at ease, as I had done the first time; and within six days after, above a league, without the least return of any pain.

I continued well till this spring, when, about the end of March, feeling again the same pain, and in the same joint, but of the first foot; and finding it grow violent, I immediately burnt it, and felt no more after the third time; was never off my legs, nor kept my chamber a day. Upon both these last experiments I omitted the application of garlic, and contented myself with a plaister only of Diapalma, upon the place that was burnt, which crusted and healed in very few days, and without any trouble. I have since continued perfectly well to this present June; and with so much confidence of the cure, that I have been content to trouble myself some hours with telling the story, which, it is possible, may at one time or other be thought worth making public, if I am further confirmed by more time and experiments of my own, or of others. And thereby I may not only satisfy Monsieur Zulichem, but myself too, who should be sorry to omit any good I thought I could do to other men, though never so unknown.

But this cure, I suppose, cannot pretend to deal with inveterate gouts, grown habitual by long and frequent returns, by dispositions of the stomach to convert even the best nourishment into those humours, and the vessels to receive them. For such constitutions, by all I have discovered, or considered upon this subject, the remedies (if any) are to be proposed either from a constant course of the milken diet, continued at least for a year together; or else from some of those methods commonly used in the cure of a worse disease (if at least I may be bold with one that is so much in vogue); the usual exceptions to the first are not only so long a constraint, but the weakness of spirits whilst it continues, and the danger of fevers whenever it is left off. There may, I believe, be some care necessary in this last point, upon so great a change; but for the other, I have met with no complaints among those that have used it; and Count Egmont, who has done so, more I believe than any other man, has told me, he never found himself in so much vigour as in the midst of that course. I have known so many great examples of this cure, and heard of its being so familiar in Austria, that I wonder it has gained no more ground in other places, and am apt to conclude from it, that the loss of pain is generally thought to be purchased too dear by the loss of pleasure.

For the other, I met with a physician, whom I esteemed a man of truth, that told me of several great cures of the gout, by a course of guiacum; and of two patients of his own, that had gone so far as to be fluxed for it, and with success. And indeed, there seems nothing so proper, as what pretends to change the whole mass of the blood, or else a long course of violent perspiration. But the mischief is, that the gout is commonly the disease of aged men, who cannot go through with these strong remedies, which young men play with upon other occasions; and the reason, I suppose, why these ways are so little practised, is because it happens so seldom that young men have the gout.

Let the disease be new or old, and the remedies either of common or foreign growth, there is one ingredient of absolute necessity in all cases: for, whoever thinks of curing the gout without great temperance, had better resolve to endure it with patience: and I know not whether some desperate degrees of abstinence would not have the same effect upon other men, as they had upon Atticus, who, weary of his life as well as his physicians, by long and cruel pains of a dropsical gout, and despairing of any cure, resolved by degrees to starve himself to death; and went so far, that the physicians found he had ended his disease instead of his life, and told him, that to be well, there would need nothing but only resolve to live. His answer was noble; that, since dying was a thing to be done, and he was now so far on his way, he did not think it worth the while to return. This was said and done; and could indeed have been so by none but such a man as Atticus, who was singular in his life as well as his death, and has been ever, I confess, by me as much esteemed in both, as any of those that have made greater figures upon the busy scenes of their own times, and since, in records of story and of fame.

But perhaps some such methods might succeed with others upon the designs to live, as they did with him upon those to die; and though such degrees may be too desperate, yet none of temperance can, I think, be too great for those that pretend the cure of inveterate gouts, or indeed of most other diseases to which mankind is exposed, rather by the viciousness than by the frailty of their natures. Temperance, that virtue without pride, and fortune without envy, that gives indolence of body, and tranquility of mind; the best guardian of youth, and support of old age; the precept of reason, as well as religion; and physician of the soul, as well as the body; the tutelar Goddess of health, and universal medicine of life, that clears the head, and cleanses the blood, that eases the stomach, and purges the bowels, that strengthens the nerves, enlightens the eyes, and comforts the heart: in a word, that secures and perfects the digestion, and thereby avoids the fumes and winds to which we owe the colic and the spleen; those crudities and sharp humours that feed the scurvy and the gout, and those slimy dregs, out of which the gravel and stone are formed within us; diseases by which we often condemn ourselves to greater torments and miseries of life, than have perhaps been yet invented by anger or revenge, or inflicted by the greatest tyrants upon the worst of men.

I do not allow the pretence of temperance to all such as are seldom or never drunk, or fall into surfeits; for men may lose their health without losing their senses, and be intemperate every day, without being drunk perhaps once in their lives: nay, for aught I know, if a man should pass the month in a college-diet, without excess or variety of meats or of drinks, but only the last day give a loose in them both, and so far till it comes to serve him for physic rather than food, and he utter his stomach as well as his heart, he may perhaps, as to the mere considerations of health, do much better than another that eats every day, but as men do generally in England, who pretend to live well in Court or in town; that is, in plenty and luxury, with great variety of meats, and a dozen glasses of wine at a meal, still spurring up appetite when it would lie down of itself; flushed every day, but never drunk; and, with the help of dozing three hours after dinner, as sober and wise as they were before.

But that which I call temperance, and reckon so necessary in all attempts and methods of curing the gout, is a regular and simple diet, limited by every man’s experience of his own easy digestion, and thereby proportioning, as near as well can be, the daily repairs to the daily decays of our wasting bodies. Nor can this be determined by measures and weights, or any general Lessian rules; but must vary with the vigour or decays of age, or of health, and the use or disuse of air, or of exercise, with the changes of appetite: and thereby what every man may find or suspect of the present strength or weakness of digestion : and in case of excesses, I take the German proverbial cure, by a hair of the same beast, to be the worst in the world; and the best to be that which is called the monks diet, to eat till you are sick, and fast till you are well again. In all courses of the gout, the most effectual point, I take to be abstinence from wine, further than as a cordial, where faintness or want of spirits require it: and the use of water where the stomach will bear it, as I believe most men’s will, and with great advantage of digestion, unless they are spoiled with long and constant use of wines or other strong drinks. In that case they must be weaned, and the habit changed by degrees, and with time, for fear of falling into consumptions, instead of recovering dropsies or gouts. But the wines used by those that feel or fear this disease, or pursue the cure, should rather be Spanish or Portugal, than either French or Rhenish; and of the French, rather the Provence or Languedoc, than the Bourdeaux or Campagne; and of the Rhenish, the Rhingaw and Bleker, of which at least it may be said that they do not so much harm as the others.

But I have known so great cures, and so many, done by obstinate resolutions of drinking no wine at all, that I put more weight upon the part of temperance, than any other. And I doubt very much whether the great increase of that disease in England, within these twenty years, may not have been occasioned by the custom of so much wine introduced into our constant and common tables: for this use may be more pernicious to health, than that of taverns and debauches, according to the old stile, which were but by fits, and upon set or casual encounters. I have sometimes thought that this custom of using wine, of our common drink, may alter, in time, the very constitution of our nation, I mean the native tempers of our bodies and minds, and cause a heat and sharpness in our humours, which is not natural to our climate. Our having been denied it by nature, is argument enough, that it was never intended us for common use; nor do I believe it was in any other countries, there being so small a part of the world where it grows; and where it does, the use of it pure being so little practised, and in some places defended by customs or laws. So the Turks have not known it, unless of late years; and I have met with many Spaniards, that never tasted it pure in their lives; nor, in the time when I was in France, did I observe any I conversed with to drink it unmixed at meals. The true use of wine is either as I mentioned, for a cordial; and I believe there is not a better to such as drink it seldom: or else what the mother of Lemuel tells her son, “Give strong drink to him that is ready to perish, and wine to those that are heavy of heart; let him drink and forget his poverty, and remember his misery no more” At least it ought to be reserved for the times and occasions of feast and of joy, and be treated like a mistress rather than a wife, without abandoning either our wits to our humours, or our healths to our pleasure, or that of one sense to those of all the rest, which I doubt it impairs. This philosophy, I suppose, may pass with the youngest and most sensual men, while they pretend to be reasonable; but, whenever they have a mind to be otherwise, the best way they can take is to drink or to sleep, and either of them will serve the turn.

(1677)

MLA Citation

Temple, William. “An essay upon the cure of the gout.” 1677. Quotidiana. Ed. Patrick Madden. 3 Oct 2007. 26 Apr 2017 <http://essays.quotidiana.org/temple/essay_upon_the_cure/>.

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