a metastasis of the disease. Others have acquired
epileptic fits, probably from the disagreeable sensation of a chronically
inflamed liver; which they suppose the pain and inflammation of gout would
relieve. When gouty patients become much debilitated by the progress of the
disease, they are liable to dropsy of the chest, which they suppose a fit
of the gout would relieve. But in all these cases the attempt to procure a
paroxysm of gout by wine, or aromatics, or volatiles, or blisters, or
mineral waters, seldom succeeds; and the patients are obliged to apply to
other methods of relief adapted to their particular cases. In the two
former situations small repeated doses of calomel, or mercurial unction on
the region of the liver may succeed, by giving new activity to the vessels
of the liver, either to secrete or to absorb their adapted fluids, and thus
to remove the cause of the gout, rather than to promote a fit of it. In the
last case the tincture of digitalis, and afterwards the class of sorbentia,
must be applied to.

M. M. In young strong patients the gout should be cured by venesection and
cathartics and diluents, with poultices externally. But it has a natural
crisis by producing calcareous matter on the inflamed membrane, and
therefore in old enfeebled people it is safest to wait for this crisis,
attending to the natural evacuations and the degree of fever; and in young
ones, where it is not attended with much fever, it is customary and popular
not to bleed, but only to keep the body open with aloes, to use gentle
sudorifics, as neutral salts, and to give the bark at the decline of the
fit; which is particularly useful where the patient is much debilitated.
See Arthritis ventriculi, Class I. 2. 4. 6. and Sect. XXV. 17.

When there is not much fever, and the patient is debilitated with age, or
the continuance of the disease, a moderate opiate, as twenty drops of
tincture of opium, or one grain of solid opium, may be taken every night
with advantage. Externally a paste made with double the quantity of yeast
is a good poultice; and booterkins made with oiled silk, as they confine
the perspirable matter, keep the part moist and supple, and thence relieve
the pain like poultices.

The only safe way of moderating the disease is by an uniform and equal
diminution, or a total abstinence from fermented liquors, with the cautions
directed in Sect. XII. 7. 8. The continued use of strong bitters, as of
Portland's powder, or