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■Gourds are efteemed cooling and diuretic, are ufed in emul- nons, and efteemed good in fevers, and all diforders arifing from the acrimony of the blood or humours. Emulfions of thefe, and the other cold feeds, are anodyne, and are ge- nerally ufed to take off ftranguries occafioned by blifters. 'GOURY Pajhntim, in natural hiftory, a name given by the people of the Eaft Indies, to a kind of orpiment of a deep yellow colour, veined with red in feveral places, and in fome with white. It is found principally at the bottoms of moun- tains. They calcine it feveral times, and afterwards give it internally in intermitting fevers, and ufe it externally in ointments for the itch. GOUT (Cyd.)— As this difeafe receives different appellations, according to the places it affects, the following diftinetions will be found neceflary, to prevent confufion on this head. Arthritis is a word very differently underftood by different au- thors, fome exprefiing by it only what we call the gout., others making it the general name of that and many otherdifeafes of the fame nature and origin, anddiftinguifhing that particular fpecies of it which we call thenar by the xmmpodagra. Stahl, and from mm Junker, define the arthritis to be a fpaftic affection of the joints in any part of the body, afflicting the patient with a violent and lafting pain, and never coming to that falutary end, which nature ieemed to intend by her motions in it. The podagra in particular is thus defined to be a fpaftic and painful affection of the foot, taking its origin from a con- geftion of blood, which fhould have been voided by the hemorrhoidal veffels, and which finding no means of eva- cuation there, becomes very painful in its emotions, and growing into a ■habit afterwards recurs on any light oc- cafion.
When the arthritis is taken in its general fenfe, it compre- hends feveral difeafes fubdiftinguifhed by their feveral fpeci- fic names, as the hemicrania, the fpurious pleurify, the fciatica, the chiragra, the . gonagra, and finally the poda- gra, or gout in the feet.
Some authors take the word arthritis in a more fpecLfic fenfe than this, and yet diftinguifh it fufficiently from the podagra j thefe exprefs by it thofe fpaffic affections which happen in the upper limbs and parts of the body ; it is then made of the fame genus with the podagra? and diftinguifhed from it, as one fpecies from another by die following par- ticulars.
The arthritis affects young perfons, the podagra thofe more advanced in years. The arthritis is naturally the firft of thefe two difeafes in perfons who have them both, and as people afflicted with it grow into years, it very naturally degene- rates into a podagra. This is a diftinction of fome very judi- cious authors, yet in reality the feveral appearances of the arthritis, as taken in its moft general feme, differ no other- wife than as to the place they affect, and the times at which they happen ; for they all agree in their effential conditions and general caufes. The true arthritis is however to be care- fully diffinguifhed from what is called the arthritis vaga, the wandering, fimple, or fcorbutic arthritis. This very fuddenly flies from one part of the body to another, and changes place from the feet to the thorax, from thence to the hips, and fo on. "Junker's Confp. Med. p. 615. The rheumatifm and arthritis are difeafes alfo not greatly different from, but properly fubordinate to one another, and a light arthritis is very often called a fit of the rheuma- tifm. The rheumatifm is no other than a ftagnation of the mafs of blood about particular parts of the body ; taking its origin from a copious congeftion of the blood, particu- larly directed by nature to that part. The rheumatifm has its feat in the mufcular parts of the body, the arthritis princi- pally affects the joints of the feveral limbs. The rheuma- tifm naturally precedes the gout, and very often degenerates into it ; it is even certain that the rheumatifm and arthritis often are complicated together.. Simple congeftions and commotions of the blood differ extremely from the arthri- tis j firft in regard to their effects, for they ufually terminate in an eruption of the blood by fome means, but the arthri- tis never arrives at that end.
Secondly in their duration, for they are ufually terminated fome way within a very fhort period ; but this difeafe is of very long and terrible duration, they differ thirdly in regard to the parts they affect. The fimple congeftions affect the in- ternal parts and the blood veffels j but the arthritis affects the external, and the mufcular fibres. Finally they differ not lefs in regard to the event, for the fimple congeftions bring on inflammations and ulcerations, but the arthritis contracti- ons and extenuations of the limbs.
The figns of the fciatica are a vehement and excruciating pain in the hip, which remains a long time, and is felt principally in the tendons, and in the junctures of the bones. This fpafm fo violently affects the mufcles of the whole fide, that the pa- tient is compelled to walk in a crooked pofture. The other arthritic complaints, as the hemici^nia, &c. are defcribed under their feveral heads, and the general me- thod of cure is the fame in all of them, and the following is the proper treatment. Method of curt. The material caufe, which, is a plethoric Jaabit, is to be removed by bleeding at proper times, and by
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applying leeches to the hemorrhoidal veins to promote a dif- charge that way; and in perfons of a moift habit, cupping is very proper. After this, the crudities of the primse vise, efpe- cially fuch as are of a bilious nature are to be abfferged, and gently carried off as they always are the occafion of all fpaftic pains, being greatly exafperated. The digeftive falts, fuch as tartarum vitriolatum, arcanum duplicatum and the like, are very good abftergents ; and the proper method, of evacuating the matter is by gentle laxatives, fuch as purg- ing draughts of fena and rhubarb, with a little foluble tar- tar. Glauber's fait or the common purging fait, called Ep- fom fait, fucceeds alio very well ; and great fervice is done by the medicated wines, impregnated with the abflergent diuretic and purging ingredients. The violent emotions of the blood and its fulphureo-faline acrid quality are to be attemperated, and the rigors of the folids foftened and taken off. This is excellently done by nitrous medicines with faline abfor- bents ; and in the more robuft habits, fometimes the ftronger acids are neceflary : after this nature is to be afTifted in making an equal and regular diftribution of the humors. This is to be done in perfons of choleric habits, by means of the neutral falts, and the drinking large draughts of warm and difcutient decoctions, fuch as a tea made of the herb veronica, which has of late years been celebrated as a medicine able to cure all the difeafes of this kind alone. In other habits, the temperate alexipharmics are to be added on this occafion, fuch as decoctions of the woods of faffafras and guaiacum, and of china and farfaparilla, and pimper- nel root. Junker's Confp. Med. p. 623. Finally, the vehement fpaftic and painful ffatc of the parts is to be mitigated and taken off. To this purpofe, fmail dofes of cinnabar, with the powder of earth-worms are to be given, and with thefe the gentle diaphoretics j at the fame time that thefe are given internally, there may be applied externally fpirit of wine with camphor mixed with tincture of faffron. The acid fpirit diftilled from ants, and the fpirit of earth-worms. Tincture of caftpr may alfo be ap- plied in this manner, and in fome cafes Venice ioap diffolved in fpirit of wine or our famous opodeldoc ointment. A cerate with a large portion ofgalbanum has alfo been known to have good effect, and fome have applied with fuccefs the common foap plaiffer ; others prefer bags with the warm vegetables, fuch as the leaves of germander, ground pine, origanum, and ferpyllum, with the roots of pimpernel, an- gelica, and folomon's feal, and the feeds of anife and dau- cus fylveftris ; others make thefe bags in a fhorter way a , ufing only oat-meal, elder flowers, and faffron, and fprink- ling the bag over with camphorated fpirit of wine, or elfe dipping it all over in hot wine, and applying it imme- diately to the part. Some greatly recommend alfo the ap- plying cheefe beaten to a fort of paffe to tlie part, covering it with a piece of a hare-fkin ; and many fpeak largely of the effects of fuffumigations made by burning under the part the flowers of ftaechas, or of maftic and olibanum, with the woods of faflafras and guaiacum, with rhodium and yellow faunders. The vapour of the decoctions of warm and aromatic herbs is alfo greatly recommended, and fome prefcribe gentle rubbing on the parts with a flefh brufh, or with flannels which have before been thoroughly impregnated with the fumes of the before mentioned dry fumigations. Thefe are the principal me-ans of a cure ; but there is not lefs judgment required in the time and manner of giv- ing arid applying them, than in the felecting them. In the time of the fits, it will be proper for the patient to take three or four times a day, a powder prepared of nitre and tartar vitriolated, each half an ounce, crabs eyes faturated with lemon jtfice three drams, cinna- bar four fcruples ; thefe are to be all perfectly mixed to- gether, and a fcruple weighed out for every dofe, and af- ter thefe it will be proper to take fome gently diaphoretic draught ; during the internal ufe of thefe, rags dipped in camphorated fpirit of wine, impregnated with faftron, are to be applied to the parts : and to keep the bowels lax and foluble, a glyfter of the common emollient kind is to be given as occafion fhall require, with a fmall quantity of nitre diffolved in the decoction ; and afterwards fmall dofes of the common Epfom fait will be very proper for the keeping them in a due lax ftate. After a fortnight's conti- nuance in the ufe of the nitrous powders, it will be proper to take every day two or three dofes of a mixture of tincture of fait of tartar, and fpirit of fal armoniac, of which twenty five drops are a dofe, and every night a fmall dofe of the ftorax pill may be taken when the violence of the fit is abated. The gentle alexipharmics are to be taken without keeping up a hot regimen, and the frequent waffl- ing the feet in warm water, impregnated with an alkaline fait from the afhes of vegetables, orotherwife, proves of the greateft fervice to compleat the carrying it off, and reffore the parts to their natural tone. Junker's Confp. Med, p. 623. When the fits are thoroughly off, bleeding fhould never be omitted fpring and autumn, and in people of fucculent ha- bits, cupping upon the parts is often very ufeful ; with wo- men, the monies are to 'be confidered before all things, and. brought to their regular periods before any hope of a
cure
