COLUMBIA LIBRARIES OFFSITE 
 
 .^.^AV.T.H SCIENCES STANDARD 
 
 HX64128156 
 RC629 .F68 1886 Gout and rheumatic g 
 
 RECAP 
 
 
 GDUI: 
 
 I\ V. 
 
 J ) J \ 
 
 ]i RHEUMAT1C,,.G.DIIT.. 
 
 NEW EETEOl) OP CUliEl 
 
 
 
 
1^^459 
 
 
EXTRACTS FROM OPINIONS OF THE PRESS, 
 
 Public Oeij^ion. 
 
 . . . Sufferers.*, from . these/; painful maladies, in 
 placing themselvesrunclel.%"tlie autllgr of this admirable 
 little work, will J:nqw that„ tjaeir respective cases will 
 
 ^■receive the henepij of "^"^'larg^ and icarefuU}'- studied 'ex. 
 
 •>perience. '*! ;'':, '♦ C' ^ '^ ,t 
 
 / *JffORS[i:N^'Al>VERTI^ER. 
 
 ^ . , . We now'pasfe-'iiro'Hi tl^e deleterious nature of 
 H Mercury and Colchicu!fi.to the new practice of Dr. Foakes. 
 
 This, of course, like n;iost really great discoveries, is 
 
 extremely simple. . '. ." 
 
 'WEST:^i'N^' Daily Mee^ctjey. 
 
 . . . An eminenif LonSori physician has just issued 
 a valuable little work, as the result of many years of care 
 and satisfactory experience, and he clearly demonstrates 
 that Gout and Rheumatic Gout are^ not only to be cured, 
 but also prevented. ... 
 
 ' COUET ClECULAR. 
 
 . '. . Dr. Foakes has written a very able and in- 
 teresting treatise on the subject, which we commend to 
 the notice of the public and the profession. . , . 
 
 Civil Seevice Gazette, 
 . . . . ^ Dr. Foakes' straightforward statement of facts 
 is ungarnished by technicalities, and has all the appear- 
 ance of being a harbinger of comfort to sufferers from these 
 painful forms of disease. 
 
 ViCTOEiA Magazine. 
 . . . Dr. Foakes has himself carefully worked for 
 years the method he advocates, and fearlessly appeals to 
 the results of the experience thus gained. . . . We 
 should like to remind our readers that Dr. Foakes is also 
 well known for his untiring energy and successful treat- 
 ment of Cholera during the fearful outbreak in 186G. 
 
OPINIONS OF THE PEESS. 
 
 BiKMINGHAM DaILY GaZETTE. 
 
 Dr. Foakes, the author of this valuable little treatise, 
 has evidently devoted much time and study to the treat- 
 ment of a disease which he designates as a "national 
 ■scourge." 
 
 Eka. 
 
 , , . "We can cordially recommend this hrochiire to 
 the attention not only to the members of the profession, 
 but to all who are, or who are in the habit of, suffering 
 from these painful diseases. 
 
 The Queen. 
 
 . . . The instructions given are scarcely sufficient 
 for self- treatment, though doubtless many martyrs to pain 
 would willingly consent to make the experiment, backed 
 by such an authority. 
 
 Weekly Times. 
 . . . Dr. Foakes' new method will be a great boon 
 to thousands of sufferers. 
 
 Beighton Times. 
 . The work is well worthy the attention of those 
 who suffer from any form of this disease. 
 
 Lincoln Gazette and Times. 
 
 . After showing the dreadful results of the 
 
 prevalent use of these dangerous remedies, Mercury and 
 
 Colchicum, Dr. Foakes passes to his new practice, which 
 
 s said to have been attended with wonderful results. ... 
 
 Malveen News. 
 
 . . . This little book ought to have a wide cir- 
 culation. . . . 
 
 Beighton Daily News. 
 
 . . Dr. Foakes has written a little book which may 
 ^vell inspire a hope of alleviation, if not of cure, in the 
 most confirmed sufferer from those distressing maladies, 
 Gout and Eheumatic Gout. . . . 
 
OPINIONS OF THE PRESS. 
 
 Hajvipshiee Advertiser. 
 
 , . . Sulierers from these complaints have reason to 
 be thankful to Dr. Foabes. 
 
 Bath and Cheltenham Gazette, 
 
 . . . The cases detailed of the results of the routine 
 ■treatment in Gout and Eheumatism are alarming ; and 
 Dr. Foakes traces to the use of Mercury what are called 
 "chalk-stones,'" and a change from Acute to Chronic Gout, 
 or to Chronic and Eheumatic Gout. 
 
 Bristol Mercury, 
 
 . . . Dr. Foakes has devoted constant systematic 
 attention to the pathology and treatment of these allied 
 disorders, and he seems to have been micommonly success- 
 ful in their cure. 
 
 Bath Journal. 
 
 . . . Dr. Foakes proves by the examples cited that his 
 simple means, intelligently applied, are sufficient to grapple 
 with the most obstinate cases. 
 
 Brighton Herald. 
 
 . . . This is a most interesting little treatise by one 
 who has evidently made a long and careful study of one of 
 the most painful and distressing maladies that flesh is heir 
 to. . . . 
 
 Naval and Military Gazette. 
 
 . The author's object is to prevent the frequency 
 and severity of the attacks, without using Mercury and 
 Colchicum, and without weakening the patient's con- 
 stitution. 
 
 The Sporting Gazette. 
 
 . . . The efficacy of Dr. Foakes' new method of 
 treatment of these diseases is fully substantiated by the 
 number of successful cases of permanent cure which are 
 cited, in some instances of long confirmed and Chronic 
 Gout. . . . 
 
 A 2 
 
OPINIONS OF THE PRESS. 
 
 The Medical Pkess and Circular. 
 We quite agree with the denunciation of the writer 
 against the abuse of Mercury. . . . Altogether, the 
 treatment of Gout recommended is sound and rational. 
 
 Chemical News. 
 
 . . . The author has for many years adopted a some- 
 what exceptional although a chemically sound treatment 
 for cases of Gout and Eheumatic Gout, which he describes 
 in the work before us. . . . The views of such men 
 as Dr. Foakes and Dr. Bennett are, we are glad to say, 
 beginning to gain, ground amongst the medical pro- 
 fession. . . . 
 
 Christian World. 
 
 . . . If the facts stated in this little volume are true 
 — and we are assured on private testimony that they are — 
 then Dr. Foakes will take rank as a benefactor of his 
 species. . . . We think it a public duty to call 
 attention to this book. 
 
 The Examiner. 
 . . . It is clearly written, and undertakes to show 
 how these maladies may be cured by simple and harmless 
 remedies, without recourse to such detestable poisons as 
 Calomel and Colchicum. 
 
 The Spectator. 
 . . . Lay opinion will certainly go with Dr. Foakes 
 in his condemnations of the poisons generally used. . . . 
 
 General Baptist Magazine. 
 . . . This book is really a very valuable one, and 
 embodies the results of long experience and careful study. 
 Dr. Foakes has earned, and deservedly, the grateful thanks 
 of all sufferers from these distressingly painful maladies, 
 who have been fortunate enough to avail themselves of his 
 sound, rational, and efficacious treatment. 
 
 Morning Post. 
 . . Will interest and instruct it readers. . . • 
 
GOUT & RHEUMATIC GOUT: 
 
 A NEW METHOD OF CURE. 
 
 BY 
 
 JOHN W. FOAKES, M.D., 
 
 OF THE IJXIYEESITY OF GIESSEK; 
 LICENTIATE OF THE SOCIETY OF APOTHECARIES, LONDON. 
 
 TENTH EDITION, 
 
 SIMPKIN, MARSHALL, & CO. 
 
 4, STATIONERS' HALL COURT. 
 
 1886. 
 [The Bights of Translation and Reproduction are Reserved.'] 
 

 /^^f 
 
 LONDON 
 FLEET FEINTING WOEKS^ 
 14, WHITEFEIAES ST., E.G. 
 
TO 
 
 THE RIGHT HONOUEABLE 
 
 Sir George Hamilton Seymour, G.C.B., G.C.H., 
 
 ETC., ETC., ETC., 
 
 THE FOLLOWING PAGES ARE INSCRIBED, 
 
 IN PLEASANT REMEMBRANCE OF THE PAST, 
 
 AND AS A TOKEN OP 
 
 THE AUTHOR'S 
 
 SINCERE REGARD AND ESTEEM. 
 
PREFACE TO FIRST EDITION 
 
 In the following pages no attempt has been 
 made to produce a scientific text-book, solely 
 for the perusal of those who, like myself, are 
 in the daily pursuit of increased medical know- 
 ledge ; but it is to the sufferers from Gout and 
 Eheumatic Gout that I more particularly address 
 myself. 
 
 With this end in view, I have written in the 
 plainest manner, avoiding, whenever I could, 
 technicalities, confining myself entirely to an 
 unvarnished statement of facts, and deahng 
 only with the details of these diseases and their 
 prescribed remedies, in a style which every 
 sufferer may understand. 
 
 This will, I trust, go far to show how much 
 already has been and can be done, not only to 
 cure these distressing maladies, but to prevent 
 their recurrence. The cases of cures could have 
 been swelled to a very large number, but as 
 their details would have appeared very similar 
 in print — although widely differing in each indi- 
 vidual patient — I am induced to think the selec- 
 tion made will, without wearying my readers. 
 
VI PEEFACE. 
 
 afford sufficient evidence of the successful results- 
 of my treatment. 
 
 Some years ago, I was urgently entreated by 
 my patients to publish my method of treating 
 Gout and Eheumatic Gout; but having witnessed 
 the recantations of so many of the published 
 opinions of some of the most distinguished of 
 my professional brethren — the apparent result 
 of their more matured experience — I declined to 
 put forth my treatment until I had, by time 
 and further experience, so thoroughly tested it, 
 , that I had cleared up every doubt which sug- 
 gested itself to me, as to its reliability in every 
 possible form of these disorders. 
 
 Perfectly convinced on all points of the value 
 of my method, and in deference to the pressing 
 sohcitations of some former patients, whose pro- 
 fessional acquaintance has ripened into friend- 
 ship, I now accede to their request, and issue 
 these few sheets upon Gout and Eheumatic 
 Gout, fully intending at some future period, 
 when the demands upon my professional time 
 will aUow, to publish a work upon those diseases,, 
 which will be written purely for the profession. 
 
 J. W. F. 
 
 2nd NovEMBEE, 1870. 
 
PREFACE TO TENTH EDITION. 
 
 In issuing the Tenth Edition of my work, 
 it is with no little satisfaction I am able to 
 assure my readers, that the increased experience 
 I have acquired in curing many hundreds of 
 severe cases of Gout and Eheumatic Gout, 
 has not inclined me to alter the opinions 
 or the treatment set forth in my First. On 
 the contrary, my continuous success has es- 
 tabhshed my adhesion to both more firmly 
 than ever ; and that (as I stated in my Sixth 
 Edition) my treatment has been of the greatest 
 benefit to many who were before hopelessly 
 suffering, is a fact of which I have daily most 
 convincing proofs. 
 
 In the course of his arduous profession, the 
 physician has no greater stimulus to his exer- 
 tions than the consciousness that the know- 
 ledge he has attained through care, study, and 
 deep researches, is of value; and that he is 
 enabled, by diffusing this knowledge, to relieve 
 
VUl PEEFACE. 
 
 sufferers from any painful malady. It is there- 
 fore with much gratification, I assure my 
 patients, that the good I have been enabled to 
 do them in the cure of their diseases, and the 
 grateful testimonies I have received from them, 
 have been the greatest pleasure of my pro- 
 fessional career. 
 
 I have had the gratification of finding since 
 the Ninth Edition of my work was issued so 
 many more converts to the principles of my 
 treatment, not only amongst my patients, but 
 amongst my brother practitioners, that I cannot 
 but hope time will develop, even more fully 
 than it has already done, a treatment which I 
 have proved to be so thoroughly reliable, and 
 which I am convinced is, at the present time, 
 the most valuable system of treatment in the 
 cure of Gout and Eheumatic affections. 
 
 John W. Foakes, M.D. 
 
 45, South Stkeet, 
 
 Grosvenor Square, London. 
 15t7i June, 1886. 
 
CONTENTS 
 
 Acute Eheumatism and the effects of Mercury, 8. 
 Alkaline drugs, their effect in Gout and Rheumatic Gout^ 
 
 7, 79. 
 Alkaline Urine, effect of, 78, 105, 113. 
 Author's method of treatment, 54. 
 
 Bennett, Dr., experiments with Mercury, 33. 
 Bile, flow of, from Liver not increased by Mercmy, 34. 
 Bladder, relief from Stone in the, 113 ; Stone in the, 79. 
 Blue Pill, its results, 29 ; personal experiments with, 29 ; 
 its effects on a dog, 32. 
 
 Calculus from Kidney, 112. 
 
 Calomel, effects on Eheumatism and Rheumatic Gout, 13. 
 
 Case of a gentleman, 21 ; of a lady of title, 13 ; of a lady 
 suffering from Acute Rheumatism, 8 ; of a lady suffer- 
 ing from Rheumatic Gout, 13 ; of a man cook, 68 ; 
 of a merchant, 70 ; of a waiter, 66 ; of a lady, 83 ; of 
 a tavern-keeper, 94 ; of a tradesman, 98 ; of a gentle- 
 man, 99 ; of Suppressed Gout, of a lady, 83 ; of a 
 lady, 88 ; of an admiral, 93 ; of a gentleman, 96 ; of 
 Gout, of a clergyman, 82 ; of a gentleman, 90. 
 
 Cases of inflammation of the lungs, 28 ; of pure Gout, 43 ; 
 of Rheumatic Gout, 66 ; of severe Rheumatic Gout, 
 CO ; of the evils of Colchicum, 21. 
 
X CONTENTS. 
 
 Cause of difficulty in the cure of Gout, 57. 
 
 Chalk Stones, 77. 
 
 Colchicum, 22 ; a temporary palliative, 3, and the increase 
 of Gout, 6, and self-doctoring, 20, 23 ; case of its evils, 
 21 ; effects of, 17, 18 ; effects in Gout, 3 ; opposed on 
 pruiciple, 25 ; personal experiments with, 36 ; warn- 
 ing against, 20 ; what it causes, 77. 
 
 Cure, prevention better than, 40 ; rapidity of, 71 ; the true 
 method of, 26. 
 
 Cure of Calculcus in the Kidney, 111. 
 
 Cure of Gout in the eyes effected, 90. 
 
 Cures of Gout effected, 15, 43, 65, 81, 88, 90. 
 
 Cures of Eheumatic Gout effected, 8, 13, 14, 21, 24, 60, 
 66, 68, 70, 72, 83, 84, 91, 94, 97, 98. 
 
 Cures of Suppressed Gout effected, 83, 88, 93, 98. 
 
 Depressing after-effects unknown by this method, 73. 
 
 Diet, 43 ; in Eheumatic Gout, 56, 59. 
 
 Drugs tested, 79 ; Alkaline effects of, 7, 79, 114. 
 
 Experiments with Mercury, 29 ; with Mercurial unction, 
 32. 
 
 Fever caused by Mercury, 77. 
 
 Gairdner, Dr., " on Colchicum," 17. 
 
 Gout, by what curable, 76 ; can be cured, 49, 80 ; increase 
 of, attributed to Patent Medicines, 6, to the use of 
 Colchicum, 6, to the use of Mercury, 6 ; Mercury, a 
 poison in, 34 ; method of cure, 38, 41 ; neutrahsed, 5 ; 
 prevented, 49 ; symptoms to be noted, 40 ; eradicated 
 by this method of treatment, 5 ; cures of, 15, 43, 66, 
 81, 88, 90, 102, 105, 106. 
 
CONTENTS. XI 
 
 'Gouty and bilious subjects contrasted, 49. 
 'Grey powder, effects of, on a dog, 32. 
 
 Kidney Calculus, 111. 
 
 Memory, loss of, by a gentleman, 108. 
 
 Mercurial unction, experiments with, 32. 
 
 Mercury, a poison in cases of Gout, &c., 34, and the 
 increase of Gout, 6 ; at best but a temporary pallia- 
 tive, 3, 78 ; causes fever, 77 ; causes contraction and 
 diseases of the joints, 77 ; its effects in Gout, 3 ; 
 its terrible effects, 8 ; opposed on principle, 25 ; 
 personal experiments with, 29 ; proof of its effects, 
 29 ; superseded by Ehubarb, &c., 35 ; treatment for 
 its expulsion, 54 ; unnecessary in liver complaints, 35 ; 
 Dr. Bennett's experiments with, 33. 
 
 Method of treatment for Gout, 38 ; for Eheumatic Gout, 
 53 ; of curing Gout, 41. 
 
 Non-injurious remedies for Gout and Eheumatic Gout, 79. 
 
 Patent Medicines, and the increase of Gout and Eheu- 
 matism, 6 ; their composition, 37 ; their mischief, 25, 
 81. 
 
 Personal experiments, with Blue Pill, 29 ; with Colchicum, 
 36 ; with Mercurial unction, 32 ; with Mercury, 29. 
 
 Practical results of experience, 76. 
 
 Eecent cures, 81 to 123. 
 
 Eheumatic Gout and the use of Calomel, 13 ; by what 
 curable, 76 ; case of, 70 ; cures of, 15, 23, 60, 66, 68, 
 70, 82, 83, 84, 91, 94, 97, 98, 104, 109, 110 ; diet in, 
 56, 59 ; Mercury, a poison in, treatment for, 34, 59. 
 
 Eheumatic temperament, 58. 
 
XU CONTENTS. 
 
 Elieumatism and the effects of Mercury, 8 ; Mercury a 
 poison, in, 34. 
 
 Self-doctoring, 23, 25 ; and Colcliicum, 20. 
 
 Stone in the Bladder, relief from, 113. 
 
 Strength supported by this method of treatment, 89. 
 
 Suppressed Gout, cures of, 88, 88, 93, 98, 108, 111, 115, 
 
 116, 118, 120, 121. 
 Symptoms to be noted by patients, 41. 
 
 Turkey Ehubarb, experiments with, 84. 
 
 Urate of Soda, 77. 
 
 Urine, analysis of, necessity for repeated, 75, 114. 
 
 Urine, alkaline, effects of, 78, 105, 113. 
 
 Warning against Colchicum, 20. 
 
 Appendix, 125. 
 
GOUT & RHEUMATIC GOUT: 
 
 A NEW METHOD OF CUBE. 
 
 In prescribing for any disease, it is one of the 
 most important duties of the physician to select 
 for his patients such remedies as shall be the 
 least baneful in their constitutional after-effects. 
 Unfortunately, however, in the anxiety to relieve 
 bodily suffering, resort is too often made to 
 medicines that at the time do no more than 
 suppress the symptoms of the complaint. As the 
 cause still remains, these symptoms return after 
 an interval, and have again to be checked by 
 similar means ; then, if the medicines taken be 
 such as accumulate in the system, the result 
 will be a change in the patient's state, concurrent 
 with the deterioration of his constitutional 
 vigour, from acute to chronic disease. 
 
 B 
 
2 GOUT AND KHEUMATIC GOUT I 
 
 The medical knowledge that can prevent this 
 change is never more valuable to patients than 
 when they are constitutionally predisposed to, 
 and are periodical sufferers from, Gout or 
 Eheumatic Gout. These views, I am sure, will 
 be supported by all physicians of extensive 
 experience in treating those complaints ; for 
 they will not fail to recall the condition of 
 numerous patients, in whom the results I have 
 indicated have baen so fully developed that at 
 last it was almost impossible to discriminate 
 between the effects due to medicines, and those 
 arising from the original complaint. 
 
 So much has been written upon the subject of 
 these painful, and, in too many instances, fatal, 
 disorders, but so little upon any reliable curative 
 treatment, that my principal object in writing is 
 to call the attention of those most interested to 
 a method of cure I have originated, by which 
 Gout and Eheumatic Gout can be so treated 
 that the frequency and severity of the attacks 
 are prevented, without using such depressing 
 and injurious medicines as Mercury and Col- 
 chicum, and without weakening or undermining 
 the patient's constitution. 
 
 When first consulted for these diseases, the 
 
A NEW METHOD OF CURE. S 
 
 constant complaint I hear from sufferers is that 
 the medicines which a year or two since gene- 
 rally relieved them, now no longer produce 
 the same effect, even when taken in much 
 larger doses. The frequent reiteration of this 
 statement from all classes led me to the con- 
 clusion that such agents were not curing the 
 disease ; that, even when they appeared to be 
 effectual at the time, they were only giving 
 temporary relief at the expense of permanent 
 injury to the sufferer's constitution. And 
 when, in addition to this fact, I found 
 that patients taking similar medicines had 
 more frequent attacks, and were left weaker 
 .and weaker after each succeeding attack, 
 until their state was such that increased doses 
 had not the power, as before, of warding off 
 even the pain attending the seizures, the proof 
 became irresistible that medicines of the nature 
 of Mercury or Colchicum only acted as tem- 
 porary palliatives of Gout or Eheumatic Gout, 
 and did nothing to free the patients from the 
 cause of their malady, or to retard the period 
 of its return. On the contrary, it was demon- 
 strated that in a few years — sometimes even 
 in a few months — persons treated in this way 
 
 B 2 
 
4 ' GOUT AND KHEUMATIC GOUT: 
 
 became so constitutionally debilitated that they 
 became sufferers from chronic disease. 
 
 Soon after directing my special attention 
 to the study and treatment of these diseases, 
 I was led on step by step to this settled con- 
 viction ; for the majority of the patients who 
 consulted me admitted that at some time or 
 other they had taken Mercury or Colchicum. 
 I was, therefore, impelled to test the medicinal 
 action of these two common remedial agents 
 in cases of Gout and Eheumatic Gout. When 
 by experiments I had completely satisfied 
 myself of the true action of those medicines, I 
 commenced a series of other experiments, to 
 discover, if possible, more reliable and less de- 
 pressing drugs, in the hope of finding a better 
 method of treatment ; for I was able now to 
 appreciate the reason why similar doses, acting 
 upon the same patient, had less and less power 
 to relieve the pain and disease, and why, after 
 a few attacks, he gradually, but surely, became a 
 sufferer from the chronic instead of the acute form 
 of the complaint. And I believe these experi- 
 ments have, for practical purposes, enabled me 
 to understand the causes of Gout and Eheumatic 
 Gout, and to originate a special treatment for 
 
A NEW METHOD OF CURE. 
 
 those complaints that will surely and speedily re- 
 lieve the patient's suffering and cure his disease. 
 
 Some years' experience of the results of this 
 method enables me to assert that my treatment, 
 while very speedily relieving the pain and 
 curing the attack from which a patient may 
 be suffering, at the same time neutralises the 
 cause of his malady, thus to a great extent 
 preventing its return; and as this treatment 
 cannot injure his constitution, it makes him 
 much less liable to the complaint. 
 
 After having seen the continuous improve- 
 ment in the health of those patients who have 
 for some time followed my advice, I feel justi- 
 fied in stating that, under my method of treat- 
 ment, attacks of Gout and Eheumatic Gout are 
 so much less frequent, and so greatly modified 
 in severity, that in many cases the constitutional 
 tendencies to those complaints may in time be 
 entirely eradicated. 
 
 For years I have witnessed with consider- 
 able pain the great increase in the number of 
 sufferers from Gout and Eheumatic Gout. In 
 England no class is exempt from these appa- 
 rently national scourges ; and it is most distress- 
 ing to find so few amongst those who consult me, 
 
6 GOUT AND EHEUMATIC GOUT : 
 
 who do not at first express tliemselyes hopeless 
 of finding remedies that will do more than afford 
 them temporary relief. 
 
 My observation and experience have led me 
 to the conclusion that this increase in the number 
 of Gouty and Kheumatic sufferers is to a great 
 extent to be attributed to the following causes : 
 viz., to the use of Mercury and Colchicum for 
 checking these and other diseases ; to the great 
 reliance sufferers place in patent medicines, 
 owing to their hopelessness of cure by other 
 means ; to the prevalent adulteration of many 
 articles of food, beer, wines, and spirits ; and — 
 from the facilities of railway and other means 
 of travelling — to the rapidly- decreasing neces- 
 sity for open air exercise ; and these conclu- 
 sions are daily strengthened and confirmed by 
 my experience of the results of my method of 
 treatment. 
 
 I have also been much impressed, during the 
 last few years, by the numbers of patients 
 consulting me about some form of subacute or 
 suppressed Gout, who have not had the mis- 
 fortune to be subjected to a treatment in which 
 Calomel and Colchicum had formed considerable 
 elements, but who, on the other hand, had taken 
 
A NEW METHOD OF CURE. ^ 7 
 
 Alkalies and Alkaline waters to excess. These 
 remedies had produced temporary relief, but 
 had not freed the sufferers from constantly- 
 recurring attacks of Gout, or the fear of them, 
 and had, moreover, left behind considerable 
 nervous depression. The subject of the use 
 and abuse of Alkalies, however, as tending to 
 induce suppressed Gout, is too large and im- 
 portant a subject to be cursorily discussed in 
 the space available in this work. 
 
 Now that the experiments of Dr. Bennett as 
 to the action of Mercury upon the liver* show 
 how little the profession generally have realised 
 the effects of the drug, I feel that my views 
 (which are entirely in accordance with Dr. 
 Bennett's facts on this subject) are much 
 more likely to be tested and adopted — as far as 
 Mercury is concerned — than they would have 
 been ten or twelve years since; yet I may 
 add that for the last twenty years I have 
 never given Mercury, because I have known 
 how disease could be cured without it. Nor 
 have I sanctioned its use, except in a few 
 cases, in deference to the opinions of those I 
 
 * British Medical Juunial, May 8tli, 1869. 
 
8 GOUT AND EHEUMATIC GOUT ! 
 
 have met in consultation, because I firmly 
 believe an immense amount of disease is 
 engendered by giving this mineral, and that its 
 disuse, by the substitution of other medicines 
 for it, will render such diseases as Gout and 
 Kheumatic Gout far less prevalent, less dan- 
 gerous in their results, and much less difficult 
 to cure. 
 
 In order to show the terrible changes that 
 arise in these diseases during some modes of 
 treatment, let me give the outlines of a case 
 which especially attracted my observation some 
 years since, and particularly interested me. 
 
 A lady, forty years of age, who until the time 
 in question had scarcely known what illness was, 
 and who was of a naturally robust constitution, 
 caught a severe cold from standing upon a damp 
 grass-plot, and in consequence was attacked by 
 Acute Kheumatism, which, after a few days, 
 settled in her right knee. This knee became 
 and remained slightly contracted, causing a per- 
 ceptible limp in walking. The contraction not 
 yielding to the treatment of her ordinary medi- 
 cal attendant during some eighteen months, the 
 complaint was pronounced to be Eheumatic 
 Gout, and the lady placed herself under the care 
 
A NEW METHOD OF CUKE. 9 
 
 of one of the leading surgeons of the day, who 
 assured her that her malady proceeded enthely 
 from the stomach, and that by undergomg a 
 treatment advised by him, of low diet and blue 
 pill, he would soon cure her. To this she sub- 
 mitted for three months, lived upon fish and 
 farinaceous food, took blue pill, or some form of 
 Mercury, with accompanying aperient draught 
 every second or third day, confined herself 
 entirely to the house, and was not allowed to 
 put her feet to the ground. At the end of the 
 three months, feeling she was daily getting 
 weaker, that the Rheumatic pains had be- 
 come so severe and continuous that she 
 had no sleep at night without narcotics, and 
 that a tendency to the same stiffening and 
 pains appeared in the joints of the fingers, 
 another medical authority was called in, when, 
 upon examination, it was found that her left 
 knee was as much contracted as the right had 
 been, and that her right knee had become so 
 much worse that, on being placed upon her 
 feet, she could not stand. Of course, the treat- 
 ment that had brought about such disastrous 
 results was abandoned, and the patient was 
 sent to the seaside for change of air. There 
 
10 GOUT AND RHEUMATIC GOUT I 
 
 lier general health improved, but the smaller 
 joints of the extremities continued to stiffen, her 
 knees to contract more and more, and gradually 
 she became quite helpless. At the end of five 
 years, the joints of her knees, ankles, elbows, 
 wrists, and fingers, were all more or less 
 stiffened and useless. She could neither stand 
 upon her feet nor use her hands ; and in this 
 state^she remained for some years afterwards. 
 Then by treatment some improvement was 
 made in the state of her arms and hands ; she 
 was rendered to a great extent free from pain, 
 and was able to discontinue the use of narcotics 
 entirely ; but the joint action of the knees and 
 ankles had been completely destroyed, and it 
 was not possible to recover it. 
 
 Now, what could have produced this terrible 
 change ? 
 
 My experience rephes, that it was caused by 
 the continued action of the Mercury in the blue 
 pill, which induced fever and disease about the 
 joints, while the constitution was enfeebled by 
 low diet and want of fresh air and exercise ; and 
 by the narcotics, which were given in the latter 
 portion of the treatment to allay pain and 
 procure sleep, which prevented the dissemina- 
 
A NEW METHOD OF CURE. 11 
 
 tion of the inflammatory irntation caused by 
 the Mercury, until this unhealthy perversion 
 changed the character of the fluids around the 
 joints of the knees, and then of the smaller 
 joints, so that they became immovable. By 
 the continued administration of narcotics, 
 moreover, the chance of an effort of nature to 
 expel the Mercury from the patient's system 
 was prevented, and, in consequence, the lady 
 remained a confirmed cripple to the hour of 
 her death, which occurred some twenty-six 
 years after the first attack of Kheumatism 
 following the cold before mentioned. It is 
 right to add that the patient whose case I have 
 related came of a remarkably healthy family, 
 and that on neither side were her parents 
 subject to Gout or Rheumatic Gout. 
 
 This case first drew my attention to the evil 
 consequences that arise in Gout and Rheu- 
 matism from the continuous administration of 
 Mercury, followed by narcotics. Since then I 
 have, unfortunately, seen very many cases in 
 which the effects of that medicine have been, 
 though less injurious, far from dissimilar ; and 
 from the time that by experiments I have 
 been better able to realise the consequences of 
 
12 GOUT AND RHEUMATIC GOUT : 
 
 Mercury iipon the linman frame, I have 
 abstained from giving the drug under any cir- 
 cumstances in these complaints. In the cases 
 treated by my method, such sad results as the 
 foregoing have never occurred, nor do I believe 
 them to have been possible. 
 
 When called in to see a patient who has 
 taken Mercury in any form for Gout or Eheu- 
 matic Gout, my first object is to remove all 
 traces of that drug from the system. This is 
 frequently a tedious task, and very trying to 
 tbe patient ; but I know from past experience I 
 can only do justice to sufferers by that course. 
 When the system has been so freed from the 
 injurious effects of Mercury, I have never yet 
 failed to find the original complaint change its 
 character, and become amenable to my remedies. 
 
 Acute Eheumatic Gout is a disease I have 
 not found difficult to cure on this principle, 
 and if taken in an early stage, with the treat- 
 ment I advocate, it can never in any case result 
 in the calamities daily witnessed and hourly 
 dreaded by so many. The case I have just 
 quoted may by some be regarded as extreme ; 
 but I regret to say thousands of English men and 
 women are suffering from the injurious effects 
 
A NEW METHOD OF CURE. 13 
 
 produced by the administration of Mercury, in 
 one form or another, for this disease. 
 
 Let me further illustrate my argument by 
 stating the case of a patient who, before coming 
 to me, had been treated for Kheumatic Grout 
 by repeated doses of Mercury in the form of 
 Calomel. 
 
 A lady of title, whose parents were sufferers 
 from Kheumatic Gout, and who herself had 
 been for some years afflicted with the same 
 complaint, finding herself getting worse and 
 worse, and more and more helpless under the 
 system adopted by her medical attendant, at 
 last placed herself under my care. Upon ex- 
 amination, I found both knees much swollen, 
 with considerable inflammatory action and 
 suffusion about their joints. She had the 
 greatest difficulty in rising from her chair un- 
 aided, and complained of much pain in the knees 
 themselves, as well as in her shoulders, which 
 pain was always considerably increased by any 
 change of weather. The tongue was coated, pulse 
 feeble, bowels constipated, conplexion sallow 
 and unhealthy, and urine highly- coloured. The 
 patient said she never perspired, and had not done 
 so for five or six years : that she had no appetite, 
 
14 GOUT AND RHEUMATIC GOUT : 
 
 and could not take half a glass of wine without 
 its producing violent headache. Added to which 
 she told me that for twelve months before con- 
 sulting me, she had been almost sleepless from 
 Rheumatic pains, which were so severe that she 
 considered an hour's continuous sleep in any 
 night quite an exception ; and this was her 
 state after she had been under various treat- 
 ments both in London and on the Continent. 
 Upon inquiring what medicines had been given 
 her, I found that she had at different times 
 taken large quantities of Calomel, and for the 
 few months previous to my being called in, 
 had been taking nearly every night, by the 
 advice of her physician, a pill composed of 
 Calomel, extract of Colchicum, and extract of 
 Colocynth; that there was no action of the 
 bowels if these pills were omitted ; and that the 
 formula was only varied by an occasional five- 
 gram dose of Calomel put upon the tongue, 
 when any very severe paroxysm of pain in the 
 joints, or any increase of fever occurred. 
 
 I considered the case to be one of Gout, 
 which by the treatment had been suppressed 
 and turned into Rheumatic Gout, and I saw no 
 Avay of cure without first freeing her constitu- 
 
A NEW METHOD OF CURE. 15 
 
 tion from the effects of the medicine she had 
 taken. 
 
 Of course, at first I had many difficulties to 
 contend with ; hut in a few weeks my patient 
 showed a marked improvement. The action of 
 the bowels became regular, the tongue clean, 
 the skin acted healthily, and the pains and in- 
 flammation in the knees subsided. In about 
 three months from that time this lady had an 
 attack of Acute Gout, from which I relieved 
 her in five days, and after another slight 
 seizure the disease was always controlled by my 
 treatment. She quite recovered the use of her 
 knees, and lost all Eheumatic pains. She could 
 eat, drink, and sleep healthily ; could walk two 
 or three miles without resting or being fatigued, 
 and went again into society, from which the 
 state of her health had previously excluded her, 
 I continued to attend to this lady and her family 
 for the next seven years, during which time she 
 followed my method of treatment whenever the 
 state of her health required my advice ; and 
 I find, on reference to my note- book, she 
 suffered only six attacks of Gout or Eheumatic 
 Gout during that time, and that with the 
 exception of one attack — brought on by stand- 
 
16 GOUT A.ND EHEUMATIC GOUT. 
 
 ing in the wet for six or seven hours on the 
 Derby- day in 1863, which caused a dangerous 
 illness of six weeks' duration — was not confined 
 to the house by this complaint more than three 
 days at a time, being always well by the fourth 
 or fifth day. Thus from the date that her 
 system was freed from all traces of Mercury, 
 any disarrangement or cold, which would 
 formerly have produced Eheumatic Gout, now 
 passed over without the appearance of the pre- 
 viously-dreaded enemy. Under former treat- 
 ment, and for two years before she consulted 
 me, this patient had rarely been well enough 
 to go about ; and she told me that, during that 
 time, she believed she was confined to the 
 house for at least nine months. 
 
 This is one of many similar cases that have 
 completely succumbed to my method of treat- 
 ment, and which, with other experience, leads 
 me to maintain that Mercury ought under no 
 circumstances to he given ; for whatever apparent 
 present benefit may be derived from its use, its 
 subsequent effect is to depress the vital power, 
 and so prevent the displacement of the poison from 
 the blood in the way that nature, even unaided, 
 would free the system from it. Furthermore, it 
 
A NEW METHOD OF CUKE. 17 
 
 promotes a greater tendency to fever, thus in- 
 creasing the deposit of nrate of soda around 
 the joints, which in time, and in gouty con- 
 stitutions, hardens and becomes what are popu- 
 larly called Chalk Stones, and brings about what 
 in the treatment of this complaint is most to be 
 dreaded — a change from Acute to Chronic Gout, 
 or Chronic Rheumatic Gout, 
 
 I will now refer to the writings of a 
 well-known physician to show the effect of 
 Colchicum, another supposed sheet-anchor in 
 the treatment of Gout and Eheumatic Gout. 
 
 The late Dr. Gairdner, in the fourth edition 
 of his work " On Gout," speaking of the use of 
 Colchicum, says (page 337) : — • 
 
 "The first bad effect seen from too early an adminis- 
 tration of Colchicum is that of a total failure of the 
 remedy. The local disease is mdeed reheved, but the 
 distress of the patient is in no degree mitigated. His 
 constitutional symptoms remain the same, and in no great 
 length of time an explosion takes place in some other 
 part, in all probability near the centre of the system. A 
 metastasis has been effected, but the serious consequence 
 is a prolonged disease, and a prolonged disease is a great 
 injury to the constitution." 
 
 In this opinion I perfectly agree : for in the 
 cases I have seen, where, in the early stages, 
 a sufficient quantity of Colchicum has been 
 
18 GOUT AND HHEUMATIC GOUT : 
 
 given in the hope of allaying pain, the disease, 
 it was true, disappeared from the extremities, 
 hut did not leave the patient. The malady was not 
 thrown off, but suppressed. An attack thus 
 treated, soon reappears in a worse form, and 
 larger doses of the drug are then required to 
 produce any effect, until finally the patient 
 shows unmistakable symptoms of Colchicum 
 poisoning, in the form of intense nervous de- 
 pression, which, if continued, might cause 
 partial paralysis of some vital organ, or a 
 dangerous diarrhoea : these s^miptoms only 
 cease when the doses of Colchicum are dis- 
 continued. Here is another instance, from the 
 same author (page 339) : — 
 
 " Some years ago I was desired to visit a gentleman 
 who had just gone through a very painful fit of the Gout, 
 under the care of a very eminent physician, now dead. 
 He had quarrelled with his doctor in consequence of the 
 troublesome, but very wise, advice the latter had given. 
 I found that the fit, from which this very foolish in- 
 dividual thought he was emerging, had not at all been 
 permitted to run its course. Notwithstanding its dura- 
 tion, no issue had been given to the disease. It bad 
 been stopped, in limine, by very heavy doses of Colchi- 
 cum, against all remonstrance on the part of his physician, 
 and the earnest entreaties of his wife, for even she had 
 learned by experience the folly of this course. The con- 
 sequence was a series of devious and perplexing symptoms, 
 with metastasis to different parts of the body. Each fresh 
 
A NEW METHOD OF CURE. 19 
 
 local manifestation of the disease was assailed by a re- 
 newed application of the poison. Every absurd error of 
 diet was meanwhile committed. After eleven weeks of 
 this practice, I was called to the case, and not permitted 
 the advantage of a consultation with my predecessor. iVt 
 this time, however. Nature was operating a cure after a 
 fashion very usual to her. The patient's excesses were 
 restrained by a total loss of appetite, and this continued 
 until the fierceness of the disease was in some degree 
 removed. There was little difficulty in managing him 
 while this state of things remained. But when appetite 
 revived, and his sufferings were in a degree abated, it was 
 impossible to deal with the perverseness of this man. It 
 was the month of May, and he was eager to go to the 
 clubs, and to Parliament, which to him was nothing 
 better than a club. He got well enough to do so, still 
 using, as I afterwards learned, Colchicum largely and 
 frequently. In this manner he hobbled on until the 
 month of July. I was again desired to visit him. He 
 was a pitiable spectacle of helplessness, pain, and 
 querulous impatience. Nearly every joint was seized. 
 In vain he now attempted to dictate. Everything was 
 decided for him. During half of July and throughout 
 August he underwent indescribable suffering. 
 
 '* I believe he had the folly and injustice to ascribe this 
 attack to his physician. I never saw him after the month 
 of October, when he left town ; but he died four years 
 after, of disease of the heart and hydrothorax. I have been 
 credibl} informed that he continued the use of Colchicum 
 with the same imprudence, till it failed in giving even 
 transitory relief, yet did not fail to inflict on him its own 
 peculiar evils." 
 
 Can anything be more instructive than tliis 
 as to the use and abuse of Colchicum ? In the 
 foregoing case the presumed remedy prevented, 
 in my opinion, the natural development of the 
 
 c 2 
 
20 GOUT AND KHEUMATIC GOUT : 
 
 disease, and, when the constitution was thus 
 undermined, the patient died from the effects 
 of poisoning by Colchicum. 
 
 This drug is largely resorted to by those 
 who doctor themselves. Their very ignorance 
 of all medical science, of all the disastrous 
 consequences that must sooner or later follow 
 the use of this dangerous medicine, causes 
 them to be deaf to all persuasion against it, 
 and as time advances, the disease increasing, 
 so is increased the dose of this poison — mis- 
 called a remedy ! 
 
 I would strongly warn all who imagine they 
 find a boon in patent medicines advertised to 
 cure Gout and Eheumatic Gout, that these pre- 
 parations invariably contain a greater propor- 
 tion of Colchicum than even the most staunch 
 friend of that drug can have the faintest belief ; 
 so that in resorting to their use they are resort- 
 ing to the use of an instrument which may 
 eventually cause their death. I cannot, there- 
 fore, in justice to my experience, speak too 
 strongly in its disfavour. I have seen such fatal 
 results occur from its use, such lamentable cases 
 have been submitted through it to my care, I 
 have seen so many lives, if not lost, embittered 
 
A NEW METHOD OF CUKE, 21 
 
 and made useless by it, that I feel bound 
 to hold out a warnuig against the drug in the 
 strongest and most serious language I can adopt. 
 
 One example amongst many will serve as an 
 illustration of the dire effects of Colchicum — 
 better than the most earnest words of warning, 
 and for this purpose I append the following :— 
 
 Some time since I had under my care a 
 gentleman whose case had been considered hope- 
 less, and whose complicated diseases, originating 
 in Eheumatic Gout, were daily wearing away 
 his life, to the profound grief and distress of those 
 who witnessed his sufferings. There seemed to 
 be no hope for him. He had been treated for 
 Jaundice, for Disease of the Kidneys, for Inflam- 
 mation of the bladder, and at one time — some 
 months before consulting me — for Aneurism of 
 the Heart. He was a sorrowful creature to look 
 upon. From contraction and swelling of the 
 joints, together with extreme debility, he was 
 obliged to be wheeled in his chair from the bed- 
 side to his place by the fire, and so back again — 
 the only change he had. His eyesight was very 
 dim, and his hearing greatly impaired. Daily 
 vomiting after any solid food made the very 
 sight of nourishment so obnoxious to him 
 
22 GOUT AND EHEUMATIC GOUT : 
 
 that it was difficult to persuade him to take any- 
 thing. A continuous thirst, which nothing could 
 alleviate, was one of the many slighter evils he 
 had suffered for seven weeks before I saw him. 
 His bowels were either constipated, or, for 
 three or four days together, in a state of un- 
 interrupted diarrhoea, so foetid that it was 
 necessary to constantly use chloride of lime or 
 other disinfectant in his room. His diseases at 
 length becoming so complicated, and there 
 appearing daily new difficulties to contend with, 
 his friends were hopeless that a cure could be 
 effected. In such a state I was asked to see 
 him and to give my opinion. I did so, and 
 my opinion could have been very easily given 
 in the one word — Colchicum ! I knew the 
 wretched enemy of old, and saw at once, in 
 every suffering and misery of the patient, the 
 diseases its use had caused. 
 
 The only questions for solution were : Had this 
 drug too surely done its work ? Was this man, 
 not then forty years of age, to be hewn down in 
 the prime of life through this fatal mischief ? Or 
 was it possible that by my treatment I could cure 
 his disease and restore him to health ? 
 
 I felt so secure in my experience that I had 
 
A NEW METHOD OF CURE. 23 
 
 some hope, and imparted it to those most 
 anxious for his recovery. From that day — one 
 in the first week of January, 1866 — I con- 
 tinued my task. By means of close and strict 
 inquiry and much cross-examination, I made the 
 discovery I expected, viz., that the patient had 
 for two years previous to October, 1865, been 
 treating himself for Eheumatic Grout. He had, 
 he said, at that time ignored all medical advice, 
 finding that he derived no real benefit from it, 
 and that his purse grew considerably lighter ; 
 so that, from the perusal of some book he 
 mentioned, he determined to " cure himself." 
 This was the cure : Colchicum in smaU doses ; 
 Colchicum in larger doses ; a few bottles of a 
 French tincture ; then back to Colchicum in 
 larger quantities ; a bottle or two of some 
 patent specific highly recommended for the cure 
 of Gout ; back again to Colchicum in verij large 
 doses, with a meagre diet and cheap foreign Avines, 
 great enemies to English stomachs, and so on and 
 on, backwards and forwards, till disarrangement 
 of every description at last compelled him again 
 to seek that professional advice he had so foolishly 
 ignored. As 1 have already said, he had been 
 treated for almost every internal disorder that 
 
24 GOUT AND RHEUMATIC GOUT : 
 
 affects the system, and from the injudicious 
 use of powerful drugs, entailing additional 
 and unceasing suffering, he became the 
 wretched object I was called in to see. 
 
 I began by first attacking the seat of most of 
 his present miseries — the stomach. This I did 
 with the medicines I principally use in the cure 
 of Gout,* and then I attacked the inward fever 
 by other remedies. f The kidneys and bladder 
 under this treatment became more healthy in 
 their action, and at the end of sixteen days I 
 had so far conquered the internal wrong that 
 the bowels acted naturally, the skin towards 
 night had often a slight moisture, and the 
 thirst was greatly abated. From that time my 
 patient's amendment became gradually more 
 and more evident, and in three weeks I had 
 him downstairs. Five days afterwards I got him 
 out for an hour's drive, and within a month of 
 first seeing him he was able to transact con- 
 siderable business (which for twelve months 
 previously he could not do), and to take carriage 
 exercise every day. His joints were still stiff 
 and slightly contracted, particularly the left 
 
 * See page 41. f See page 58. 
 
A NEW METHOD OF CURE. 25 
 
 elbow and right knee, and these will, I fear, ever 
 partially remain so — a result which I attribute 
 to the use of Calomel in the earlier stages of 
 the disease. 
 
 In three months more the patient no longer 
 needed my professional attendance, as his appe- 
 tite had become healthy, and with attention to 
 a few of my dietary instructions, and an occa- 
 sional resort to my remedies, I felt convinced 
 he would become, excepting the slight lameness 
 and some stiffness in his arm before alluded to, 
 as well as ever he was in his life. 
 
 In quoting this case, my principal object is to 
 show some of the effects of Colchicum, and the 
 mischievous consequence of self-doctoring with 
 patent medicines, as well as the great value of 
 properly- selected remedies in the treatment of 
 such diseases as Gout and Kheumatic Gout, not 
 only in their earlier stages, but in their worst 
 and most complicated forms. In these maladies, 
 I believe that no remedy that really removes 
 from the system the cause of the complaint 
 ever produces permanent depression. This is the 
 result of my experience ; and hence I am opposed 
 on principle to the administration of Mercury 
 or Colchicum, both of which I believe to be 
 
26 GOUT AND KHEUMATIC GOUT : 
 
 positively injurious in their primary and secon- 
 dary effects, and in my opinion the injudicious 
 and excessive use of these drugs makes com- 
 plaints chronic, and causes patients to suffer 
 more than they would if the diseases were per- 
 mitted to run their course. 
 
 Nature when left to herself will, if her 
 organic powers are not entirely destroyed, 
 always to a great extent repair the mischief done ; 
 but when her operations are counteracted by 
 mistaken applications, her recovering efforts are 
 annihilated. Left to herself she has some chance ; 
 ignorantly interfered with she has none. 
 
 We all know that there is only one true method 
 of endeavouring to cure any disease ; and that is, 
 by discovering what are the changes that have 
 taken place in the system of the patient, and in 
 what particulars his present state differs from his 
 healthy condition. In a word, what in his or her 
 case causes the malady. When the cause has 
 been ascertained, the course to be followed is 
 to endeavour by the least hijurious remedies to 
 restore to a healthy state those functions which 
 are found to be ?t;i-healthy. The application of 
 the proper remedies will at once result in the im- 
 provement of the patient ; but it must always be 
 
A NEW METHOD OF CURE. 27 
 
 remembered that the depression of the patient's 
 constitution will be less, and the rapidity of his 
 recovery will be greater, in proportion to the 
 harmlessness of the remedies employed. 
 
 It is upon these principles I give the medi- 
 cines I use in the cure of Gout and Eheumatic 
 Gout, and in acute cases a few hours rarely fail 
 to remove all pain, and a few days to complete 
 the cure. Beyond this, I find that the tendency 
 of this treatment is to lesson the frequency 
 as well as the severity of the attacks. In fact, 
 I have many patients who, from being in a con- 
 stant state of dread lest any sudden cold or 
 exposure should bring on an attack of Gout or 
 Rheumatic Gout, now rest perfectly satisfied 
 that under my treatment they need fear no 
 such misery. 
 
 To show the means whereby I arrived at 
 my conclusions, the following details are ap- 
 pended : — 
 
 Some years ago, observing the very injurious 
 consequences of taking Mercury, I was led to 
 experiment, with a view of obtaining a medi- 
 cine that should produce a better effect upon 
 the human frame than this drug, and at the 
 same time avoid its mischievous results. 
 
28 GOUT AND EHEUMATIC GOUT : 
 
 Accident brought to my knowledge the case 
 of a young friend who, from exposure for two 
 hours in the night air during the month of 
 March, was next day seized with a severe attack 
 of inflammation of the lungs. As I knew him 
 io have been in good health two days before — 
 young, strong, and as unlikely to suffer such 
 an attack as any one I could have selected — I 
 made it a point to discover the cause of his ill- 
 ness. I learned from him that he had felt dull 
 and depressed, and that on the Friday he had 
 consulted a physician in London, who pre- 
 scribed five grains of blue pill at night and an 
 aperient in the morning. This he took, and it 
 had the effect of relieving the bowels seven or 
 eight times on the Saturday, and making him 
 feel exceedingly weak. That night he was for 
 two hours on the outside of a coach, much ex- 
 posed to cold, which he felt, as he expressed it, 
 ^' go through him like a knife.'' He slept badly, 
 and the next (Sunday) morning he was seriously 
 ill with acute inflammation of the right lung. 
 
 This case was one of those in which the use 
 of Mercury had evidently caused a great predis- 
 position to cold ; for the gentleman previous to 
 this illness had been hunting twice a week all the 
 
A NEW METHOD OF CURE. 29' 
 
 winter, occasionally wearing his wet clothing 
 for some hours, and yet had never enjoyed 
 better health. Looking upon this case as I 
 would, I could not believe that he would have 
 been so ill except for the Mercury. I then 
 made up my mind that I would prove its effect 
 upon the constitution by actual experiment upon 
 myself, and I found that, taking a blue pill at 
 the commencement of a feverish cold, the attack 
 lasted much longer ; that its effects were more 
 depressing, and the power to throw it off greatly 
 lessened, that there was always in a few days a 
 tendency to feverish symptoms, to rhenmatic 
 pains in the limbs, more O] less severe, accord- 
 ing to the quantity of blue pill taken, and that 
 I was more sensitive to all atmospheric changes. 
 I then tested the effects of five grains of blue 
 pill and a purgative for an attack of biliary dis- 
 turbance and headache. The following day after 
 taking the dose I felt less languid, and my head- 
 ache was gone. On the third and fourth days I 
 was not so buoyant, and experienced some re- 
 turn of the old symptoms. I repeated the dose, 
 and was again relieved, but not so effectually. 
 I continued to take this dose every third or 
 fourth day for about eight weeks. By this 
 
BO ii . GOUT AND EHEUMATIC GOUT : 
 
 time I found the medicine so much less apparent 
 in its results that I had to increase it to ten 
 grains to produce the former effect. This, 
 however, did not prevent a series of symptoms 
 occurring daily during the five weeks I con- 
 tinued this dose, that I could attribute to 
 nothing else than the effects of Mercury upon 
 the system. The action of my skin was less 
 healthy, and I did not perspire so freely. I 
 had more thirst, my appetite was more variable, 
 my digestive powers became slightly impaired, 
 and all the symptoms of biliary disturbance 
 were at times much aggravated, except for 
 a few hours after the action of the blue 
 pill. My tongue became habitually coated and 
 furred, my pulse was irregular ; I was con- 
 tinually taking cold upon cold, and each one 
 depressed me more and more. I became much 
 more sensitive to atmospheric changes, and 
 decided rheumatic pains appeared in my shoul- 
 ders, arms, and knees, after being exposed to 
 the rain for an hour or two ; added to which I 
 was more indolent and lethargic, and found I 
 had no other resource than to increase the quan- 
 tity of stimulants I was in the habit of taking. 
 In short, my system was suffering from chronic 
 
A NEW METHOD OF CURE. 
 
 mercurial poisoning, that would, had I bcS^ 
 the dose some few days longer — if it had not 
 produced salivation — have ended in either 
 Jaundice, or Gastric or Eheumatic Fever. I 
 then discontinued the blue pill, and altered the 
 treatment with the object of freeing my system 
 from its effects. As the remedies began to act 
 upon me the symptoms I have described 
 gradually subsided, and at the end of three 
 months I was again in a healthy state, with 
 a clean tongue, sound appetite, no flatulence 
 or indigestion, and no rheumatic or neuralgic 
 pains in my limbs. This experiment I made 
 at a time when I was living a very sedentary 
 life. I afterwards repeated it when I was 
 out every day in the fresh air, taking strong 
 walking exercise, and the result of the second 
 trial confirmed my former experience. The 
 same train of symptoms showed themselves, but 
 in some respects in a less severe form, except 
 that getting wet always produced rheumatic 
 pains, accompanied by more or less fever. 
 Still, they were perfectly recognisable as the 
 effects of the Mercury, and with its discon- 
 tinuance and alterative treatment they subsided 
 as before. In both these experiments I was 
 
32 GOUT AND EHEUMATIC GOUT : 
 
 particularly careful to regulate the doses so as 
 to avoid salivation — in which I was successful 
 — ^being most anxious to learn practically the 
 cumulative effects on the system of Mercury taken 
 in repeated small doses. 
 
 Knowing from experience the uncertain 
 action of Mercury taken internally, not only 
 upon different individuals, but upon the same 
 patient when given at different times, I then 
 tried Mercurial unction, and carried it to a 
 point just short of salivation, and in a still less 
 time I discovered it possible to produce all tlie 
 same symptoms. I then made a series of ex- 
 periments upon animals, and found that a 
 strong pointer dog, after a few grains of grey 
 powder, or a grain or two of blue pill, repeated 
 a few times once or twice a w^eek, was languid, 
 restless, thirsty, and most unwilling to go out 
 into the wet ; that, although at first the medicine 
 had the advantage of making his coat more 
 glossy and fine, after a few days the animal would 
 set his back up when taken on to damp ground, 
 and I had great difficulty in getting him to enter 
 a field of wet turnips. Indeed, there was no more 
 doubt in my mind as to the effects of Mercury 
 upon the animal than upon myself ; for when 
 
A NEW METHOD OF CURE. 33 
 
 I had so physicked the dog as to free his system 
 from the drug, all these symptoms disappeared, 
 and he was as willing as ever to bear cold and 
 exposure to wet. This treatment I repeated in 
 many instances on other animals, and invariably 
 with similar results. These experiments were 
 all made before the year 1861, and it is with 
 great satisfaction I am able to refer to those of 
 Dr. Bennett, made in 1867 and 1868, and re- 
 ported in 1869, as offering the strongest con- 
 firmation of my experience.* 
 
 * *' A belief in the Cholagogue action of Mercury upon 
 tlie liver is almost universal among medical men and 
 among the public at large. In every work on Materia 
 Medica, it is assumed as a settled fact that Mercury in- 
 creases the biliary secretion ; and every lecturer on Thera- 
 peutics inculcates it as a well-established truth. For cen- 
 turies, the treatment of diseases of the liver, especially in 
 our Indian possessions, has for its chief feature the various 
 methods of administering Mercury. Even at the present 
 day, although the abuse of this drug has been decried, its 
 employment is still thought necessary in some form or 
 other of hepatic disease. We shall not enter upon the dis- 
 cussion of its merits or demerits — the wonderful cures 
 which it has effected according to some, or the injured 
 health or shattered constitutions which it has produced, 
 according to others. 
 
 " There can be no doubt that the answer to the question 
 whether Mercury did or did not increase the biliary secre- 
 tion had become one of paramount importance ; but the 
 inquiry involved labour and difficulties which few were pre- 
 pared to encounter. We are proud to say that a Com- 
 
 D 
 
84 GOUT AND EHEUMA.TIC GOUT I 
 
 Of course, with the knowledge thus practi- 
 cally gained, there was no difficulty in detecting 
 numerous instances of the mischievous effects 
 of this drug, and 1 became quite satisfied that 
 under no circumstances and for no constitutions 
 should it be prescribed, whilst any less baneful 
 remedy could be found capable of producing the 
 required medicinal results, and that in cases of 
 Gout, Kheumatism, or Eheumatic Gout, it is a 
 positive poison. 
 
 After numerous experiments on the medicinal 
 action of different drugs, I satisfied myself that 
 the finest Turkey Khubarb in pills,* with an 
 occasional aperient in the form of Castor Oil or 
 
 inittee of members of the British Medical Association at 
 length undertook the task : and their report has definitely 
 determined that Mercury, in whatever manner, dose, or 
 form it may be administered, has not the shghtest influence 
 in increasing the flow of bile from the liver." — British 
 Medical Journal. 
 
 * This Ehubarb pill is not to be confounded with the 
 compound Ehubarb pill of the British Pharmacopoeia, 
 which is composed of Ehubarb, aloes, and myrrh. Its 
 medicinal action is entirely different. 
 
 I think it right to remark that I have been in the habit 
 6f employing only the finest Turkey or Eussian Ehubarb 
 for these pills. Now, however, this drug is not obtainable 
 in England ; and to ensure the genuine quality required 
 for my purpose, I import it direct for my own special use. 
 
A NEW METHOD OF CURE. 35 
 
 ■an Emulsion prepared from Castor Oil, and an 
 Aromatic tinctm^e which, thus combined, I knew 
 would act very vigorously on the liver, and 
 produce aU the effects claimed for Calomel, 
 or blue bill. By continuing the Ehubarb Pill 
 every night, I have regulated the action of the 
 bowels in the most severe cases of Gastric 
 Fever, in the treatment of which I have never 
 since given a grain of Mercury. Should the 
 bowels not act freely with the pill after the 
 first dose of Castor Oil, I repeat the Oil on the 
 second or third night, instead of the pill, and 
 in cases where the patient has taken much 
 powerful medicine, I sometimes increase the 
 ■quantity of Ehubarb in the pills. I have now 
 had about 20 years' experience of these 
 remedies, which have never yet failed me in 
 quickly producing all the presumed effects of 
 Mercury or Calomel, and my patients have thus 
 been saved from the injurious after-conse- 
 quences of these pernicious drugs. 
 
 I have no hesitation in stating, as an undeni- 
 able fact, that Ehubarb and Castor Oil, 
 administered in combination according to my 
 metliod, render the use of Mercury in any form 
 unnecessary in the treatment of those com- 
 
 D 2 
 
36 GOUT AND RHEUMATIC GOUT : 
 
 plaints in which the regulation of the action 
 of the liver is a necessity. 
 
 This fact I cannot too strongly impress upon 
 the notice of my brother practitioners, and 
 although it may not be accepted as such in 
 routine practice, it is nevertheless a truth, which 
 I have so thoroughly proved, that I am firmly 
 convinced if they will but test it as carefully 
 as I have done, they must arrive at the same 
 conclusions as myself. 
 
 Having thus endeavoured to prove the in- 
 jurious effect produced by Mercury, and having 
 described the substitutes I use for this per- 
 nicious drug, I will now refer to Colchicum, 
 with which medicine I also experimented upon 
 myself. In small doses frequently repeated, it 
 produced upon me, after the third or fourth 
 day, nervous depression, prostration of muscu- 
 lar strength, depression and irregularity of the 
 action of the heart, with nausea, thirst, and loss 
 of appetite — in larger doses, violent diarrhoea, 
 followed by partially paralysed action of the 
 bladder. These symptoms, however, soon 
 ceased on a discontinuance of the medicine, by 
 taking remedies to strengthen the digestive 
 organs, and by a general tonic treatment, and 
 
A NEW METHOD OF CURE. 37 
 
 I more speedily recovered from the effects of this 
 drug than from those produced by Mercury. 
 
 Having thus tested the effects of Mercury 
 and Colchicum separately, I must confess that 
 I did not care to try, to the injury of my con- 
 stitution, the drugs in such combination, as 
 they are commonly prescribed, or to be found 
 in some patented pills advertised to cure Gout, 
 Eheumatism, and Eheumatic Gout. For all 
 practical purposes it was sufficient for me to 
 be able, from actual experience, to recognise the 
 symptoms produced by each. These experi- 
 ments were made for guidance in my practice 
 — to enable me to reahse the exact effects of 
 Mercury and Colchicum, because I would not 
 give my patients drugs, the value of which 
 in these diseases I doubted, and the action of 
 which I had not taken the pains to test satis- 
 factorily ; and although such experiments 
 formed the basis of my method of treatment 
 when they were made, they were made too 
 roughly for me to desire to place them 
 before the medical world as scientific tests, 
 they being the result of treatment on one 
 person only. But now that experience and 
 success have strengthened my views, I feel 
 
38 GOUT AND RHEUMATIC GOUT : 
 
 that for the benefit of sufferers, and for the 
 practical information of my professional breth- 
 ren, there is no longer any reason to withhold 
 them. Having thus so thoroughly proved my 
 method, I do not hesitate to pledge myself to 
 its efficacy, and feel bound to make it known 
 as widely as possible. 
 
 The immediately preceding remarks are made 
 to show the reasons for my method, and to 
 prove that there are medicines which will pro- 
 duce, not only p-esent advantageous results 
 upon a patient's malady, but future benefits 
 to his constitution. 
 
 Those only whose lives have become a 
 burden to them from the injudicious recourse 
 to medicines which custom has forced into 
 use, will thoroughly appreciate the announce- 
 ment. Leaving, then, this statement of prin- 
 ciple to work its own way, I now turn to the 
 main subject of this work, viz., my method of 
 treating Gout and Eheumatic Gout. 
 
 GOUT. 
 
 In the treatment of Gout as well as of Eheu- 
 matic Gout, my method recognises as an 
 
A NEW METHOD OF CURE. B9 
 
 essential point of practice, that the physician 
 should never neglect any possible means of 
 supporting his patient's strength, by such 
 nourishing food and stimulants as will not 
 aggravate the malady, and throughout the 
 treatment the necessity for upholding the con- 
 stitution should never be forgotten. If this 
 system be carried out, the disease will be much 
 more easily cured, the period of convalescence 
 will more quickly arrive, and the chance of a 
 return of the complamt will be less. The 
 excess of pain that a patient undergoes in Gout 
 and Eheumatic Gout, tends greatly to wear out 
 the frame, and lessen not only the muscular but 
 the more vital powers, both of which therefore 
 need to be carefully upheld. But I fear, in the 
 physician's desire to subdue the inflammatory 
 symptoms attending these diseases, the excessive 
 strain imposed upon the nervous system and the 
 physical energies of the patient is too often, if 
 not altogether forgotten — made so secondary a 
 consideration that exhaustion frequently super- 
 venes before the physician is prepared for it. 
 Then comes the unfailing consequence of that 
 increased debility — the disease attacks the more 
 vital organs, and the result is fatal. 
 
40 GOUT AND RHEUMATIC GOUT : 
 
 The symptoms of Acute Gout are so well 
 known by the profession and the sufferers 
 themselves that they need no description here. 
 Nevertheless, it cannot be too strongly impressed 
 upon all afflicted with this complaint, that they 
 should try to notice — each one for himself — those 
 early warnings which presage an attack, and 
 then immediately seek the advice of a medical 
 man, who ought to be able to mitigate its violence, 
 and in many instances prevent it altogether. 
 I have been frequently told by patients that 
 they would prefer to allow the disease to run its 
 course, in the hope that it would find its way 
 out at the extremities, as when it did so they 
 felt so much less after- depression. This, I 
 believe, is by no means unlikely ; but I fail to 
 see the wisdom of the course when the question 
 is the simple one. Why not prevent the appear- 
 ance of the disease altogether ? The first change 
 from health to disease is so slight that in its 
 earliest stage harmless remedies can at once re- 
 store the patient to his normal condition, thus 
 saving him a fit of pain and disease that will be 
 certain to attack him a few days later. In this 
 view, what I most desire to impress upon all is 
 that ihe prevention of any disease is far better than 
 
A NEW METHOD OF CURE. 41 
 
 its cure, and to this end all medical skill ought to 
 be directed. This, however, no medical man 
 can achieve unaided. The patient must watch 
 for himself, and summon, without delay, the 
 aid of those whose knowledge and experience 
 may benefit him. If this simple caution were 
 invariably adopted, and poisonous remedial 
 agents less used, we should soon see a race of 
 far healthier men and women than we have 
 now, and hear much less of hereditary diseases 
 and their consequences. 
 
 Having premised thus much on Gout and its 
 premonitory symptoms, I now proceed to detail 
 my method of cure. 
 
 In Acute Gout I generally give a dose of 
 my Emulsion the first and third night, and 
 on the first, second, and third day — three times 
 during the day — a powder, according to my 
 patient's constitution, composed of the finest Tur- 
 key Ehubarb and Calcined Magnesia, in water. 
 The quantity in the dose varies considerably, 
 and is determined by my experience and the 
 state of the patient. The effect of the Magnesia 
 thus combined with the Ehubarb is invaluable in 
 Acute Gout. It neutralizes the lithic acid in the 
 system, while its effect in conjunction with the 
 
42 GOUT AND RHEUMATIC GOUT I 
 
 Ehubarb, by inducing a more healthy action of 
 the liver, assists the natural assimilation of food, 
 and prevents the excessive formation of the acid. 
 As a proof of this, pain diminishes, the appetite 
 improves, the tongue cleans, the skin resumes its 
 functions, and the urine becomes more healthy. 
 When I find the urine is high-coloured and there 
 is much fever, I give Spirit of Nitrous Ether, 
 Cinnamon Water, and distilled water, until the 
 urine returns to a healthier state, and the fever 
 subsides. In other cases — which, of course, 
 depend on the special state of each patient dur- 
 ing an attack — I give a powder of Ehubarb 
 and Magnesia, administered in water, . three 
 times a day, with Emulsion at night ; and again, 
 in other instances, I give a combination of Mag- 
 nesia and Sulphur, with a similar draught at 
 night. Not in one case out of a hundred under 
 my care for pure gout have these remedies failed. 
 Generally my patients are free from acute pain in 
 twenty-four hours, or as soon as the powders and 
 Emulsion have acted fully. By that time the 
 Gout shows itself freely at one of the extremities. 
 This I keep covered with medicated cotton tO' 
 induce perspiration, and to sooth and protect 
 the part affected, and on the fourth or fifth day 
 
A NEW METHOD OF CURE. 43 
 
 my patient is generally able to walk about again. 
 Let it be clearly understood that this result 
 of treatment applies to pure gout as it is seen 
 in its earHer stages, and before the patient's 
 constitution has been much undermined by 
 
 drugs. 
 
 For diet, I allow fish, poultry, game, rice, and 
 clear soups ; indeed, avoiding anything rich or 
 greasy, almost any simple food the patient may 
 fancy. As soon as the Gout has declared itself 
 at the extremities, I allow, once or twice a day, 
 according to the patient's habits, a glass of 
 good, sound ChabHs in sodawater which is 
 specially prepared, and contains only a small 
 quantity of soda, or in oxygen water. 
 
 By these means I have cured numerous 
 patients ; and, as a cited fact is always more 
 satisfactory than a general statement, I will 
 now adduce one of the many cases from my 
 note-book in which I treated pure Gout suc- 
 cessfully on the above method. 
 
 A gentleman, the head of an influential Lon- 
 don firm, aged forty, sent to me at the com- 
 mencement of an attack of Acute Gout. I found 
 him in great pain, extending from the hip to, the 
 foot, with his pulse full and bounding, skin dry, 
 
44 GOUT AND RHEUMATIC GOUT : 
 
 tongue loaded, urine scanty, very liigh-coloured 
 and acid. His account of himself was, that he 
 had not felt well for some days before the Gout 
 showed itself, which it had done that morning. 
 An attack commencing as this did almost always 
 seized him in the spring and autumn, and gene- 
 rally kept him confined to his bed for three or 
 four weeks, and then usually another fortnight 
 elapsed before he was able to throw it off com- 
 pletely. It was about noon when I was sent 
 for. I ga"ve at once a powder of Ehubarb and 
 Magnesia, in water. This was repeated at four 
 o'clock. At night I ordered a dose of Emul- 
 sion to be given him. He suffered some pain 
 during the early part of the night, but, after an 
 action of the bowels at three in the morning, 
 it subsided so as to enable him to sleep. About 
 eight a.m. the powder was repeated, and when I 
 saw him about ten he had but little pain except 
 in the foot and ankle. His bowels had acted 
 freely, his tongue was less furred, pulse softer, 
 urine lighter in colour and much increased in 
 quantity ; his skin was moist, and he was ask- 
 ing for breakfast, his appetite, which had been 
 very uncertain for some days, having partially 
 returned. The Gout showed itself both in the 
 
A NEW METHOD OF CUEE. 45 
 
 foot and ankle, which I dhected to be kept 
 covered with medicated cotton. I continued the 
 powders three times during the day, which 
 produced three actions of the bowels without 
 any weakening effect. On the following day the 
 powders were repeated thrice, and the next day 
 the patient expressed himself as feeling quite 
 well, except that he had still pain from pressure 
 on the great toe of the affected foot. On the 
 fourth day, with one powder before breakfast, he 
 was able, to his great astonishment, to go into 
 the City, and in a week was quite well, taking 
 his ordinary exercise. My patient was told by 
 his former physician that it was impossible the 
 attack could have been cured in the time, that 
 the disease was only put back, and that he 
 would soon experience another and more severe 
 seizure to make up for it. Upon his relating 
 me this, I enquired, ^'Do you feel as if an 
 attack of Gout were hanging about you ?" He 
 replied, "No, and it is a long time since I have 
 felt so light and well." I then asked him, " Is 
 not your tongue cleaner than it has been for some 
 time ?" to which he answered, " Undoubtedly," 
 adding that he had not the slightest indiges- 
 tion, and that nothing now seemed, as it did 
 
46 GOUT AND EHEUMATIC GOUT : 
 
 before the attack, to disagree with him. From 
 the rapidity with which my remedies had 
 checked and released him from his pain, he 
 ■expressed his entire agreement and behef in my 
 statement that I considered him more free from 
 Gout than after any previous attack, and con- 
 sequently less liable to a return of the malady. 
 At the same time I desked, if indigestion, head- 
 ache, checked perspiration, or any of the many 
 warnings I pointed out to him, showed them- 
 selves, to let me know at once, and I could easily 
 prevent the threatened attack. I also told him 
 that a fit of the Gout could not come on with- 
 out certain premonitory symptoms, which were 
 indicative of an excess of lithic acid in the 
 blood ; that when these symptoms appeared I 
 could control them by neutralising the lithic 
 .acid, and prevent his indisposition continuing 
 until it had culminated in another attack. Of 
 this, as he admitted, he felt assured after the 
 proof I had given him. In three months after- 
 wards he had some slight threatenings, but I 
 prevented the mischief, as I told him I would, 
 by the same method. After Christmas, when 
 he expected a severe attack from some over- 
 indulgence while on a visit to a friend's country- 
 
A NEW METHOD OF CURE. 47 
 
 seat, I was sent for, and again prevented 
 the return of the disorder. I saw him occa- 
 sionally for another twelve months, during 
 which he was entirely free from Gout, and it 
 is only just to myself and my method to say 
 that he had lost all his former dread of the 
 disease, and in consequence was much more 
 careless in his mode of living. So that if from 
 this reason there were any threatenings I was 
 sent for, and two or three doses of my remedies 
 carried off the cause of the disarrangement. 
 Owing to his leaving England I lost sight of 
 him for three years ; but upon his return he 
 iold me he had had one severe seizure, from 
 sitting some time in wet clothes, since which, 
 he said, he had been free from the disease. 
 Now, under a treatment by which, with other 
 medicines, he had always taken Calomel and 
 Colchicum, this gentleman had, every spring and 
 autumn, for six or seven years regularly an attack 
 that lasted for five or six weeks, while between 
 each illness he never felt his system so free from 
 the malady as to render him safe against its return 
 at anytime. Fortunately for him he had a very 
 fine constitution, and directly he got about was in 
 the habit of taking violent walking exercise, which 
 
48 GOUT AND RHEUMATIC GOUT I 
 
 assisted to relieve liis system from the medi* 
 cines he had taken during such attacks. 
 
 The foregoing case of the cure of Gout 
 effected by my method of treatment is one 
 selected from a large number. But as no two 
 constitutions are precisely alike, so no two 
 attacks of Gout exactly resemble one another ; 
 hence great discrimination on the part of the 
 medical man is necessary to guide him as to 
 the administration of the remedies required, 
 and the time at which they should be given. 
 This, experience and practice alone can give ; 
 and although, when a medical man makes a 
 speciality of the cure of any class of disease, he 
 soon acquires very great facility, yet in all 
 cases his treatment, to be successful, must be 
 modified by the symptoms which arise during his 
 attendance, and the results of the analyses of the 
 urine, and this no method of cure can exemplify. 
 
 The different effect of a single medicine on 
 different constitutions is so well recognized 
 ^ that there is no need to enlarge upon that 
 portion of the subject. I can, however, lay 
 claim to this much, that in the varied ex- 
 perience of 20 years I have never seen a 
 case of metastasis to the heart, brain, or 
 
A NEW METHOD OF CURE. 49 
 
 stomach arise in the course of my treatment 
 for Gout, except where those organs or the 
 kidneys had been previously diseased ; that the 
 pain lasts a much shorter time than under any 
 other mode of treatment I have tried or seen 
 tried ; and that the tendency to a return of the 
 attack must be less frequent than when the 
 digestive organs have been debilitated by the 
 depressing influence of injurious drugs taken to 
 mitigate the pain. 
 
 One great object I have in view in writing 
 these pages is not only to show how Gout can 
 be cured, but to point out that, with dis- 
 crimination and experience on the part of the 
 medical man, aided by his patient, it is not 
 difficult to prevent. 
 
 Why is it that one man is more prone to this 
 disease than another ? Without doubt, it is 
 owing to hereditary or constitutional predis- 
 position ; for if two men of different tempera- 
 ments, the one gouty and the other not, 
 commit similar excesses, by overloading the 
 stomach with more food and wine than they 
 can digest, you will find that in the gouty 
 subject the imprudence brings on an attack 
 of Gout, whilst the other suffers only con- 
 
 E 
 
50 GOUT AND KHEUMATIC GOUT I 
 
 siderable nausea, and severe bilious disarrange- 
 ment. 
 
 Assume that both these men previous to their 
 excess enjoyed equally good health, and had 
 all their functions in their normal condition : 
 why then should an attack of Gout, arising 
 from repletion and indigestion, be considered 
 such a serious disorder as to be incurable by 
 some such harmless means as are ax-)plicable 
 in a case of biliary disturbance brought about 
 by a like cause ? 
 
 And what change shall we find to have 
 taken place in the condition of these two 
 men ? In the gouty subject there will be loss 
 of appetite, greatly impaired digestion, coated 
 tongue, irregular action of the Hver, costive 
 bowels, hot and dry skin, and restricted action 
 of the kidneys, as evidenced by the state of 
 the urine. These symptoms, if unchecked, all 
 favour the formation and accumulation of lithic 
 acid in the blood, which would soon terminate 
 in an attack of Acute Gout. 
 
 In the other subject we should find most of 
 the like symptoms of disordered digestion, ex- 
 cept that there might be more nausea, and pro- 
 bably vomiting or purging ; after which, the 
 
A NEW METHOD OF CUEE. 51 
 
 skin would act more freely, the kidneys would 
 secrete more urine, and by these means the 
 system would be freed from many impurities. 
 
 Is the belief unreasonable that, once he knows 
 how to interpret the indications of Nature, the 
 physician should find much more difficulty in 
 the cure of Gout than in that of biliary dis- 
 turbance ? 
 
 In the latter case, no medical man would hesi- 
 tate to promise a speedy cure by the most harm- 
 less means. Nature aheady having relieved the 
 overladen stomach by the vomiting or purging, 
 it would only be necessary to regulate the action 
 of the liver, and then, by another purge, to 
 carry off any impurities or undigested food 
 through the intestines. Should there, then, be 
 a greater difficulty in performing a cure in the 
 former case, by means equally harmless ? My 
 experience and treatment have taught me that 
 there should not ; and by first understanding and 
 then following the course that Nature has sug- 
 gested, I have found no difficulty in restoring to 
 healthy action the stomach, bowels, kidneys, and 
 skin. The accumulation of lithic acid about the 
 organs of digestion is thus checked, and all 
 danger of morbid action from that source is pre- 
 
 E 2 
 
52 GOUT AND RHEUMATIC GOUT : 
 
 vented ; so that whatever amount of disease may 
 remain Im^king in the system, it will be expelled 
 at the extremities ; all the vital functions will 
 return to their normal condition, pain will cease, 
 the patient's appetite revive, strength improve, 
 and in a few days ah symptoms of Gout will 
 have subsided. I have had no greater difficulty 
 in curing many such cases by the judicious ad- 
 ministration of the remedies I have indicated, 
 than in curing indigestion audits consequences. 
 But if a patient, instead of being treated with 
 a view to the healthy restoration of his vital 
 functions by the removal of the cause of his com- 
 plaint, is dosed with such specific poisons as Mer- 
 cury and Colchicum, in the hope of alleviating 
 the gouty symptoms, and by narcotics to prevent 
 a consciousness of the pain resulting from his 
 diseased state, little progress is made towards 
 his cure. All the functions will continue to act 
 in the same irregular manner, until at last — 
 after many hours, or even days, of excruciating 
 sufferings, it may be — a natural crisis of the 
 disease occurs, in defiance of the medicines, 
 and the poison too long retained in the blood 
 shows itself at the extremities in the form of 
 Gout. Or more frequently, if the constitution 
 
A NEW METHOD OF CUBE. 53 
 
 has been miicli enfeebled, the disease gradually 
 assumes a less pronounced form ; under the 
 depressing action of improper medicines, more 
 organic disturbances occur ; the patient becomes 
 daily weaker, from the poisonous effects of the 
 lithic acid with which his blood is charged, 
 and finaUy discovers that, instead of being an 
 occasional sufferer from Acute Gout, he now 
 suffers from a continuous subacute form of the 
 same disease, and that, in fact, his original 
 complaint has taken the form of Chronic or 
 Eheumatic Gout. 
 
 KHEUMATIC GOUT. 
 
 I shall now explain, as clearly as possible, my 
 method of treating Eheumatic Gout. In many 
 cases, I consider this complaint to be so much 
 the result of either Gout or Eheumatism (the 
 original disease assuming a new form from the 
 nature of tlie medicines used) that to treat it 
 with success — indeed, before an effectual 
 remedy can be suggested — practice alone must 
 teach us the extent to which a patient is suf- 
 fering from former drug-poisoning, and how 
 far his disease is comphcated by it. Every 
 
54 GOUT AND KHEUMATIC GOUT. 
 
 day I am more convinced that there are few 
 sufferers from Kheumatic Gout, with contrac- 
 tion and inflammatory action of the joints, 
 whose condition cannot be traced to the effects 
 of Mercmy, and few with depression and or- 
 ganic disturbances whose sufferings may not be 
 attributed to Colchicum. Assured of this, I 
 satisfy myself of the patient's predisposition to 
 Gout or Eheumatism, and prescribe accordingly. 
 If I have a patient who is of a gouty tem- 
 perament suffering from Kheumatic Gout, I 
 usually find that the seizures have commenced 
 with attacks of Gout, and that by degrees these 
 have assumed less and less the appearance of 
 pure Gout, and have taken the form of Kheu- 
 matic Gout. Having searched for, and found 
 indications of the consequences of Mercury, I 
 then commence my treatment by giving a 
 powder of Khubarb and Magnesia in water 
 (once, twice, or thrice a day, according to cir- 
 cumstances), and, at night, a dose of Emulsion. 
 The following day I repeat the same medicine 
 thrice, and at night, should there be much 
 febrile disturbance, a draught containing Spirit 
 of Nitrous Ether. If the powders produce 
 four or five actions of the bowels during the 
 
A NEW METHOD OF CURE. 55 
 
 day, I continne them, with this draught, at 
 night ; but if, as it sometimes occurs, they do 
 not act freely, I then substitute for the morning 
 powder a dose of Emulsion. After twenty-four 
 hours of this treatment I generally find my 
 patient with much less pain and fever, and 
 with the gouty inflammation showing itself 
 freely at the joints of one of the extremities. 
 This I cover with medicated cotton as pre- 
 viously described. The increased action of the 
 bowels arises generally from my remedies 
 causing the liver to act more freely, and thus 
 there is a greater flow of bile into the in- 
 testines. Then my patient's tongue begins to 
 clean, and his appetite to improve : whilst the 
 pains become less severe. At this period, by 
 carefully watching and analyzing the urine, by 
 the state of the tongue, by the action of the 
 bowels and skin, and by my own experience of 
 my patient's constitutional vigour, I am enabled 
 to determine whether it is necessary to act 
 more upon the kidneys or upon the intestines. 
 On these internal remedies for the flrst four or 
 five days I rely, occasionally increasing the 
 quantity of Rhubarb, or substituting for it 
 Sulphur, as the state of my patient guides me. 
 
56 GOUT AND KHEUMATIC GOUT : 
 
 In severe pain, without redness, I apply an 
 anodyne or stimulating embrocation to the 
 joints affected, after which I cover them with 
 medicated cotton, entirely excluding the air. 
 Directly the feverish symptoms and pain dimi- 
 nish, I allow my patients to take with solid 
 food, good Chablis in soda water. I begin with 
 one wine-glassful a day, and this I continue as 
 long as I find the liver and kidneys acting as I 
 require and the bowels as I wish. I then 
 gradually increase the quantity of wine. When 
 the attack is subsiding, the tongue quite cleansed, 
 and the urine more healthy, I substitute — 
 guided, of course, by my patient's constitu- 
 tion — for the Rhubarb and Magnesia powders. 
 Magnesia and Sulphate of Quinine, or a dose of 
 the decoction of Peruvian Bark and Sarsaparilla, 
 which I direct to be administered at eleven and 
 four o'clock, with the former draught at night. 
 In a few days these remedies go far to restore the 
 invalid to a state of convalescence, after which, 
 the use of mild tonics, continued attention to 
 the action of the bowels, a judicious diet, with 
 fresh air and gentle exercise, completely effect 
 the cure. Should any relapse occur, from im- 
 prudence on the part of the patient, or from ex- 
 
A NEW METHOD OF CUEE. 57 
 
 posure to cold before perfect recovery, I attack 
 the symptoms that present themselves, with one 
 or other of the remedies mentioned. 
 
 And here it would be well that I should take 
 the opportunity of reminding all sufferers from 
 Gout and Eheumatic Gout, that there are no 
 diseases which, during an attack, require such 
 constant supervision on the part of the medical 
 man, nor any in which, by injudicious or 
 ignorant treatment, such fatal results may so 
 speedily occur. For when once the blood is 
 charged in excess with the poison that causes 
 Gout or Eheumatic Gout, the complaint may 
 at any moment assume a dangerous form and 
 attack the vital organs ; and the indications of 
 such danger will be apparent only to a medical 
 man who has made the treatment of these 
 diseases his study. So that, however good the 
 method may be under which patients are being 
 treated, there may be times when the varying 
 of that method, by a trifling alteration in the 
 medicines prescribed, would make the difference 
 between a speedy restoration to health and a pro- 
 longed and painful illness ; and although I trust 
 much that I have written may save those who 
 are constitutionally predisposed to these diseases 
 
58 GOUT AND RHEUMATIC GOUT : 
 
 from attacks, by directing their attention to the 
 great good they may derive by checking pre- 
 monitory symptoms without the use of either 
 poisonous or patent medicines, still, it must be 
 borne in mind — would they avoid the dangers I 
 have mentioned — that those who attempt to 
 treat themselves without medical supervision 
 do so with but slight chance of success, and at 
 a terrible risk of fatal consequences. 
 
 Having thus stated my method of treatment 
 for a patient under an attack of Kheumatic 
 Gout, originating in pure Gout and confining 
 the sufferer to his bed, I now turn to Eheu- 
 matic Gout, where the patient is of Eheumatic 
 temperament. 
 
 In Kheumatic Gout of this character, where 
 the original malady has been Eheumatism, and 
 there is in consequence much debility, I have 
 frequently had great difficulties to contend 
 with. I give my powders, the Emulsion, and 
 a draught, for the first few days, as in the 
 former case. I have, then, sometimes found it 
 necessary to discontinue the powders, and sub- 
 stitute — if the feverish symptoms were severe 
 — small doses of Spirit of Nitrous Ether and 
 Tincture of Myrrh in water, every three hours, 
 
A NEW METHOD OF CURE. 59 
 
 with a pill of Ehubarb one night and a dose 
 of Emulsion the next. And after anointing 
 all the joints that are in pain with a suitable 
 embrocation, I cover them up completely in 
 medicated cotton. If the patient does not 
 suffer from very severe pain, by degrees, and 
 according to the action of the hver and state of 
 the urine, I increase the intervals between 
 the administration of the Spirit of Nitrous Ether 
 and Tincture of Myrrh, and, as the feverish 
 symptoms subside, I give in the forenoon a 
 powder with Magnesia and Sulphate of Quinine, 
 or a pill of Sulphate of Quinine and Magnesia. 
 If the effect is favourable, on the second or 
 third day I give the powder or the pill twice. 
 The diet should be as nourishing as it possibly 
 can be, without producing indigestion or 
 feverish symptoms, and the wine given in larger 
 quantities than in the former case. This phase 
 of the disease, however, is of so frequent occur- 
 rence, and requires such great care in watching, 
 that I only profess to generalize my method of 
 treatment, which experience often requires me 
 to vary in many instances. For this reason, and 
 rather than generalize further, I will detail the 
 particulars of a very severe case of Rheumatic 
 
60 GOUT AND RHEUMATIC GOUT I 
 
 <3rout, accompanied by great debility, which in 
 four months yielded entirely to my method of 
 cure. 
 
 A patient consulted me for this disease in 
 March, 1862. He was about forty-eight years 
 of age. He commenced the history of his case 
 by telling me that his father and mother had 
 both died from the consequences of Kheumatic 
 Gout, and he felt quite sure that his own death 
 would result from the same disease. On 
 account of his continued suffering, life, he said, 
 had already become a burden to him. His 
 description of the origin of his malady was as 
 follows : His first attack came on some few 
 months after a very severe illness, during which 
 he had taken a large quantity of Mercury. The 
 attack of Eheumatic Gout was a very severe 
 one, and there was an interval of two or three 
 years before he was again a sufferer. In the 
 meantime, whenever he had the faintest threat- 
 ening of the disorder, he doctored himself with 
 Colchicum and various patented Gout pills, and 
 in this way he had some few attacks before the 
 year 1856. Then he had a very severe seizure, 
 which he was totally unable to throw off for 
 three months, and which left him shockingly 
 
A NEW METHOD OF CURE. 61 
 
 debilitated. During this attack he took very 
 large quantities both of Calomel and Colchi- 
 cum, from the effects of which he believed he 
 had never recovered. From that time until 
 my first visits to him, his fits of suffering, he 
 said, had become more frequent ; each year he 
 was less able to throw off the disease, and he 
 pronounced himself hopeless of finding a cure 
 or a mitigation of his pains. He could not 
 attend to any business for fear of being laid up 
 with Eheumatic Gout, and being unable to 
 keep his appointments. He knew from sad 
 experience that he might at any moment be 
 seized with a severe fit. A slight cold, or an 
 accidental blow on any part of his body, was 
 certain to bring on an attack. A chill, a fit of 
 indigestion, any mental excitement or annoy- 
 ance, were equally provocative of the same 
 result. When I first saw him he walked with 
 crutches ; he was obliged to sleep on the 
 ground floor next his sitting room, being 
 unable to get upstairs ; and from the continual 
 use of Colchicum, he was in a state of great 
 mental depression. He was very certain I 
 could do him no good, but consulted me, he 
 said, to satisfy the repeated persuasions of some 
 
62 GOUT AND RHEUMATIC GOUT I 
 
 friends whom I had cured of the same com- 
 plaint. 
 
 On examination, I found the usual signs — 
 feeble pulse, irregular action of the heart, coated 
 tongue, hot and dry skin, urine high coloured, 
 complexion pale and sallow, bad appetite, and 
 irritable bowels. There was at that time no 
 very great inflammatory appearance about his 
 knees or feet, although he complained of much 
 pain in his ankles, knees and feet. I commenced 
 my treatment by administering a powder of 
 Ehubarb and Magnesia three times a day. This 
 produced a slight increase in the action of the 
 bowels. On the second day I gave the powders 
 twice, and ordered a dose of Castor Oil at night. 
 On the following morning the bowels were well 
 relieved, and I found my patient suffering less 
 pain and in the possession of some returning 
 appetite. The powders were then continued 
 for two more days, when, upon examining and 
 finding no great improvement in the state of 
 the urine, I discontinued the powders, and gave 
 Spirit of Nitrous Ether and Tincture of Myrrh, 
 in water, three times a day. At the end of 
 three weeks of this treatment, with a dose of 
 Castor Oil every second or third night, as I 
 
A NEW METHOD OF CUEE. 63 
 
 found the bowels required it, the patient had 
 made great progress. His spirits had revived, 
 his pulse was fuller, tongue cleaner, bowels 
 more regular, the quantity of urine healthier, 
 and his appetite much improved. He could do 
 without his crutches, and walk up a few stairs 
 without much discomfort. 
 
 I now commenced a more tonic treatment, 
 giving Magnesia and Sulphate of Quinine at 
 eleven and four o^clock, and the Spuit of 
 Nitrous Ether and Tmcture of Myrrh only at 
 night. Ten days after I was able to mcrease 
 my tonic of Sulphate of Quinuae twice a day. 
 The effects of the strengthening i^rocess now 
 began to show themselves, the patient^s digestive 
 organs being greatly improved. He could eat 
 ahnost anythmg without discomfort, was aUowed 
 two glasses of sherry m sodawater daily, and 
 as his system regamed its tone, he was able to 
 expel the poison from the blood through the ex- 
 tremities. His knees graduaUy became better ; 
 but in the left foot and its great toe there was an 
 unmistakable appearance of inflammatory Gout, 
 such, he said, as he had not seen for some time. 
 In this attack, by the admmistration of the 
 powders of Khubarb and Magnesia, with a 
 
64 GOUT AND EHEUMATIC GOUT : 
 
 draught containing Spirit of Nitrous Ether at 
 night, instead of the Magnesia and Sulphate of 
 Quinine, I got rid of aU inflammatory appear- 
 ances on the fourth day. I then discontinued 
 the powders, and gave a pill of Magnesia and 
 Sulphate of Quinine twice a day, with a pill of 
 Ehubarb at night. This treatment I continued, 
 with a dose of Castor Oil, instead of the pill at 
 night, once a week. I persevered with these 
 remedies for nearly a month, and my patient 
 made almost daily improvement. At the end of 
 the month I increased the quantities of Sulphate 
 of Quinine (still watching to see that the action 
 of the liver and the state of the urine were as I 
 wished), and at the end of four months from 
 the commencement of my method of treatment, 
 the patient was able to go to the seaside, com- 
 pletely free from any gouty symptoms. All 
 suffusion and stiffness of the joints had subsided, 
 his digestion was perfectly healthy, and his 
 bowels were acting properly without medicine. 
 His pulse was regular, and his spirits were as 
 good as he or I could desire. In short, as he 
 himself expressed it, he felt '' quite another 
 man,'' and had no fear of the return of his 
 complaint. 
 
A NEW METHOD OF CURE. 65 
 
 I told him I saw but few traces of his old 
 disease, or its effects, in his system, and that 
 if he were prudent and avoided Calomel and 
 Colchicum, and did not neglect his digestion or 
 take severe cold, he would probably be a long 
 time without any attack of the disorder ; and 
 that, even in the event of a recmTence, the 
 seizure, under my treatment, would only be 
 likely to last three or four days. 
 
 In this case, in the early stage, I used an 
 embrocation to the joints, wrapping them in 
 medicated cotton, and keeping them thus 
 covered until all pain and discomfort had sub- 
 sided. 
 
 Meeting this patient in the course of the fol- 
 lowing winter, he told me that he had continued 
 as well as when I had last seen him, and that 
 he felt constitutionally much stronger. In 1865, 
 again meeting Ihm by chance, he informed me 
 that he was, and had been, quite well, with the 
 exception of a slight attack of pure Gout, which 
 passed off in three days, and that he had been 
 taking httle or no medicine, and did not believe 
 he had ever been better in his life. 
 
 I will now instance three cases of long- 
 standing Acute Rheumatic Gout, to show the 
 
 F 
 
66 GOUT AND RHEUMATIC GOUT : 
 
 rapidity with which the pain and the disease 
 were cured by my method, although the pa- 
 tients, from their various occupations, were 
 very differently circumstanced ; and undoubt- 
 edly the tendency to the complaint in each 
 case had been developed and was sustained by 
 very opposite causes. 
 
 A waiter in one of the old-fashioned London 
 wine stores came to me on the 5th September, 
 lb 65. He was then suffering so acutely from 
 Kheumatic Gout in his foot and ankle that it was 
 with great difficulty he could enter my room, 
 even with the aid of a strong stick. He stated 
 that he had been suffering a martyrdom from 
 pain in the foot for many months, for which he 
 had tried all sorts of medicines — patent and 
 otherwise — with but little benefit. He had also 
 been for four or five months under treatment at 
 the London Hospital with no better result. He 
 was almost without hope that any treatment 
 would cure him, as the medicines that formerly 
 slightly alleviated his pain had' completely lost 
 all effects except to depress him. I found 
 his foot and ankle much swollen, but without 
 redness ; his pulse was very feeble, tongue foul, 
 and much coated at the root ; his bowels were 
 
A NEW METHOD OF CURE. 67 
 
 either costive or irritable, and his urine gene- 
 rally high-coloured and scanty. I directed him 
 to go home, wrap up his foot in medicated 
 cotton, and take a powder of Ehuharb and 
 Magnesia in water three times a day, and con- 
 tinue this treatment until I next saw him. On 
 the 9th September he again came to me. 
 There was then a marked improvement in 
 all his symptoms ; all pain in his foot and 
 ankle had subsided since the 7th, and the 
 swelhng was now gone, so that he could wear 
 his ordinary boot, and walk without the support 
 of a stick ; his tongue was cleaning, his bowels 
 had acted copiously, his urine was passing very 
 freely, and he said he felt himself better and 
 less depressed than he had done for some 
 months. I made an alteration in the quantity 
 and proportion of the powders, which I now 
 directed him to continue to take only twice a 
 day. I saw him again on the 11th September, 
 when his foot and ankle were quite free from 
 all pain or swelling, and he was without the 
 slightest weakness in the foot. He told me 
 that after the action of the last powders he had 
 felt so much stronger that he had on the 10th 
 walked seven miles before breakfast, and on 
 
 F 2 
 
68 GOUT A.ND RHEUMATIC GOUT I 
 
 that morning; the 11th, had gone on foot from 
 Stoke Newington to London, to resume his 
 occupation, which he could now do. He added 
 that he had not walked so well nor so much for 
 six months. I gave him some general direc- 
 tions as to diet, &c. ; and when I again saw him,, 
 accidentally, some three or four months later, he 
 was then, and had continued, quite well. 
 
 The second case is that of a man-cook at one 
 of the City dining-houses in Oheapside, who 
 consulted me on the 4th September, 1865. 
 He told me he had been at intervals for many 
 years a sufferer from severe attacks of Acute 
 Eheumatic Gout, that he had had intense pain 
 in his right hand and wrist for many days, 
 during the whole of which time, and for some 
 weeks previously, his hand had been quite 
 powerless, and that the sensation was now 
 almost unbearable. On examination I found 
 his hand much swollen and inflamed, and on 
 his right elbow an open sore that had been 
 caused by the continuous application of mustard 
 poultices, employed in the hope of relieving 
 the pain. He was constitutionally much de- 
 pressed, with a very feeble pulse ; his skin was 
 acting very profusely, and his urine was very 
 
A NEW METHOD OF CURE. 69 
 
 scanty ; his tongue was clean, and his bowels 
 were acting regularly. He said he believed that 
 at different times he had tried, with little effect, 
 almost every patent medicine advertised to cure 
 his complaint ; that he had also taken large 
 quantities of Colchicum, which had now com- 
 pletely lost its power in relieving or even 
 mitigating his pain ; and that no medicines 
 seemed to act in any way to stop his attacks. 
 
 I directed him to take a dose of my 
 Emulsion at night, and on the following 
 morning a powder of Ehubarb and Magnesia 
 in water, which he was to repeat three times 
 a day, until I again saw him. On the 6th 
 September, he said all pain had left his hand, 
 after the action of the Emulsion and powders 
 on the previous day ; he had had no return of 
 the pain at night, was now quite free from it, 
 and he was able to use his hand. His pulse was 
 firmer, his bowels acting freely, and urine pass- 
 ing in much larger quantity ; and he said he felt 
 far better and stronger than for some time 
 past. On the 8th he was still improving, had 
 no return of pain, and was able to use his 
 hand better. I now changed his powder to one 
 of Magnesia and Quinine, to be taken twice a 
 
70 GOUT AND RHEUMATIC GOUT : 
 
 day. This he continued to take until the 14th, 
 when I last saw him ; then he was quite well, 
 with a good pulse, and his bowels, skin, tongue, 
 and urine in a healthy state, and without a symp- 
 tom of pain or weakness in his hand or wrist. 
 
 The third case was that of a merchant in the 
 city, who came to consult me on the 10th 
 August, 1865. He said he had been ill for three 
 months with his first attack of Eheumatic Gout, 
 to which he feared he was constitutionally pre- 
 disposed, as his father had been a great sufferer 
 from the same complaint. He had gone through 
 the ordinary treatment by Calomel and Colchi- 
 cum, with so little benefit that he was ordered to 
 go to Wiesbaden to drink the waters. This he did, 
 and for the time was reheved ; but on his return 
 to London the pain and inflamiliation showed 
 themselves in the great toe, when, further treat- 
 ment failing to remove the suffering, one of his 
 friends recommended him to consult me. When 
 I saw him he was qu.ite lame with Kheumatic 
 Gout in the foot, the toe of which was inflamed 
 and swollen, and in considerable pain. His 
 pulse was feeble, his tongue clean, bowels acting 
 regularly, and urine abundant. I prescribed a 
 powder of Khubarb and Magnesia in water three 
 
A NEW METHOD OF CURE. 71 
 
 times a day, and saw him again on the 12th ; 
 then his pulse was stronger, all pain and inflam- 
 mation had gone from the toe, and he said they 
 had ceased after the action of the medicine. I 
 now made a change in the quantity of his pow- 
 ders, and saw him again on the 14th, when, as all 
 the symptoms were still improving, I ordered 
 him a powder of Magnesia and Quinine, and this 
 he took twice a day until the 17th, when he was 
 able to wear his ordinary boot and to walk as 
 easily as before the attack, and he was in every 
 respect quite well, having had no symptom of 
 pain since the 11th. I gave him some general 
 directions in case he should have any threaten- 
 ings of an attack, either in consequence of 
 over-work or cold, together with instructions 
 as to what medicines to avoid should he again 
 be ill. I occasionally meet this gentleman, 
 with whom I have been on terms of intimacy 
 since his cure, and he assures me that from 
 that time he has never had another attack. 
 
 In the foregoing cases it will be seen that 
 each patient was free from pain in from twenty- 
 four to thirty-six hours, and that their cures were 
 effected under ten days, although the cases 
 were all those of Chronic Rheumatic Gout of 
 
72 GOUT AND RHEUMATIC GOUT : 
 
 some months' standing. In the two first cases the 
 patients' occupations were not such as to assist 
 my efforts : whilst in the last case the patient's 
 system was so thoroughly freed from the cause of 
 his malady by the seventh day, that, notwith- 
 standing his inherited constitutional predispo- 
 sition through his father, he has from that time 
 to this — now five years — been without any 
 threatening of another attack. 
 
 Before drawing to a close, I will add another 
 case in which my method was signally 
 effectual. A gentleman came to me, request- 
 ing my immediate attendance upon his wife ; 
 she was dangerously ill, and her own medical 
 man feared to take the entire responsibility of 
 her case any longer. 
 
 Upon my arrival, I found that the lady had 
 been for some weeks under treatment for an 
 attack of Kheumatic Gout, which during the 
 last few days had completely left the extremi- 
 ties, and that all the powerful medicines given 
 — including Calomel to salivation — had failed 
 to cause its return. 
 
 When I first saw her she was in a high fever ; 
 her pulse was one hundred and twenty. She 
 complained of great pain in the head, and had 
 
A NEW METHOD OF CUEE. 73 
 
 l)een slightly delirious the preceding night. 
 Her tongue was foul and raw; there was no 
 moisture on the skin; urine coffee-coloured, 
 and teeth loose ; she had kept no food upon her 
 stomach, and had been incessantly vomiting, 
 with intense pain, for four or five hours. The 
 abdomen on pressure was excessively tender ; 
 metastasis was undoubtedly taking place, and 
 it was clear that the disease, if not properly 
 removed from the stomach and intestines, 
 would in a few liours prove fatal. 
 
 I saw the patient was in great danger, and 
 at once administered a powder of Ehubarb and 
 Magnesia in water ; had her legs covered in 
 hot flannels, and hot- water bottles applied to the 
 feet. I then remained to see that the medicine 
 was not rejected by the stomach. No sickness 
 following its administration, and my patient 
 appearing more tranquil, I left, ordering another 
 powder to be given in four hours from that time. 
 Six hours after my first visit I returned, to 
 find my patient better. The powders had 
 caused the bowels to act freely, all vomiting had 
 ceased, and the tenderness of the abdomen was 
 considerably less. I ordered the powders to be 
 continued three times a day, and on the following 
 
74 GOUT AND RHEUMATIC GOUT : 
 
 day gouty inflammation began to show itself 
 unmistakably in both feet and ankles. The next 
 night my patient slept well for the first time for 
 many nights, and on the following morning all 
 the feverish symptoms were subsiding rapidly. 
 
 These powders in the daytime, an occasional 
 dose of Castor Oil, with a draught of Spirit of 
 Nitrous Ether and Tincture of Myrrh at night, 
 were the only remedies I used at this stage to 
 turn the disease from the dangerous course it 
 had taken. 
 
 In less than a fortnight my patient was free 
 from discomfort, and was able to put her feet 
 to the ground. 
 
 I cite this case to show the immediate effect 
 of my remedies in freeing the internal organs 
 from the disease, and driving it to the extre- 
 mities — its natural outlet. This, I believe all 
 medical men will support me in saying, is the 
 greatest test of the value of a remedy in this 
 usually unmanageable complaint, when metas- 
 tasis to any vital organ is taking place. 
 
 It would be beyond the scope of this book to 
 record many cases of the various cures I have 
 effected ; the proof of the value of what I write 
 I therefore leave to the testimony of those 
 
A NEW METHOD OF CURE. 75 
 
 patients whom I have not only cured, but kept 
 free from attacks of Gout and Eheumatic 
 Grout ; and if they express themselves to others, 
 on the effects of my method, with half the 
 warmth they have done to me, then I think it 
 will not be long before sufferers from these 
 diseases will learn to believe, not only that 
 they may look forward to a speedy alleviation, 
 but in most instances to a permanent cure. 
 
 I have said but little about the value of 
 analyses of the urine in these complaints : but 
 at the same time, I desire to record my belief 
 that without these analyses it is impossible for 
 any medical man to obtain such a knowledge 
 of a patient's condition as will enable him to 
 treat the disease with any hope of success. 
 So strongly am I impressed with the necessity 
 of constantly ascertaining the condition of the 
 urine, that I have made not less than 12,000 
 to 13,000 analyses during the past few years. 
 The results of these I have carefully tabulated, 
 so that I am able, in a moment, to refer to any 
 particular case or date. By this system of 
 analyses, I have been frequently able at once 
 to understand a patient's condition, and know- 
 ing this, have been successful in preventing the 
 
76 GOUT AND KHEUMATIC GOUT : 
 
 accumulation of the lithic acid, and thus, in 
 carrying off what would have culminated in 
 an attack of Gout or Eheumatic Gout. I 
 cannot, therefore, too strongly urge the neces- 
 sity of the practice, as its results will enable 
 the medical man to understand not only the 
 present stage and cause of the malady, but to 
 estimate by it the chances of the ultimate suc- 
 cess of his treatment. 
 
 In conclusion, I desire most strongly to im- 
 press upon my readers the following practical 
 results of my experience : — 
 
 Firstly, — That Gout and Eheumatic Gout, 
 whether in their acute or chronic forms, are in 
 the majority of cases curable by the adminis- 
 tration of Spirit of Nitrous Ether, Khubarb, 
 Magnesia, Sulphur, Castor Oil, Castor Oil 
 Emulsion, Quinine and other medicinal forms 
 of the Cinchona Bark, and Sarsaparilla, with 
 external lotions and embrocations. 
 
 Secondly, — When treated by my method of 
 using the above remedies, depressing after- 
 effects are almost unknown ; whilst it is equally 
 impossible that contractions of the joints should 
 
A NEW METHOD OF CUEE. 77 
 
 remain after the acute attack has passed, the 
 action of these remedies checking the pain and 
 the inflammation that results in the deposit of 
 Urate of Soda, or Chalk Stones. 
 
 Thirdly, — That in our climate Mercury in any 
 form causes fever, and induces diseases and con- 
 traction of the joints ; that it increases the ten- 
 dency to the formation of Urate of Soda, makes 
 the sufferer more hable to attack, by rendering 
 him more sensitive to damp, cold, and atmo- 
 spheric changes, and is one of the principal 
 causes of the alteration of these maladies from 
 the acute to the chronic form; and that its 
 effects on the system are cumulative, thus 
 laying the foundation of severe chronic disease. 
 Fourthly, — That Colchicum causes, in propor- 
 tion to the doses taken, loss of appetite, great 
 nervous depression, much functional disturb- 
 ance, and has the effect of greatly reducing the 
 vital powers ; that it prevents the natural outlet 
 of the disease by the extremities ; favours the 
 retention of poison in the blood ; and that its 
 administration in Gout, or Eheumatic Gout, is 
 by depressing the system, one great cause of 
 the malady eventually attacking the more vital 
 
78 GOUT AND RHEUMATIC GOUT : 
 
 parts, siicli as the brain, heart, kidneys, bladder, 
 and stomach ; and that by its continued use, the 
 natural action of every organ in the body is 
 perverted, and, in consequence, the sufferer be- 
 comes in time, not only physically and mentally 
 weakened, but hopelessly diseased. 
 
 Fifthly, — That in these complaints no form 
 of Mercury or Colchicum need be adminis- 
 tered, because these drugs at the best can only 
 act as palliatives. 
 
 Sixthly, — That the excessive use of Alkaline 
 drugs* or Alkaline waters of any description, 
 as evidenced by the patient's urine being either 
 alkaline or neutral, is constitutionally very in- 
 jurious. The effect of the continuance of this 
 condition is to impede the efforts of the system 
 to free itself of the excess of the lithic acid, and 
 to induce suppressed gouty irritation. This, 
 in a short time, is almost certain to cause an 
 irritable or inflamed state of the tissues of the 
 
 * On this subject I propose to write a separate treatise ; 
 but I may here say that the above remarks are based 
 ^pon analyses I have made during the last sixteen years 
 of some 18,000 specimens of the urine of patients suffering 
 from Gout or Rheumatic Gout. 
 
A NEW METHOD OF CUKE. 79 
 
 brain, the heart, or the kidneys, and may result 
 in chronic disease of one or other of those organs. 
 Then, there will probably follow loss of nervous 
 power, ending in some form of paralysis, disease 
 of the heart and its results, or the deposit by 
 crystallization of hthic acid in the kidneys, one 
 of the usual sequences of which, sooner or later, 
 is the formation of stone in the bladder, with its 
 attendant miseries. 
 
 And lastly, — That sufferers from the chronic 
 forms of these disorders will derive no perma- 
 nent benefit from any treatment that ignores 
 or overlooks the injurious effect of Mercury, 
 Colchicum, or the excessive use of Alkaline 
 medicines, on the patient's constitution ; whilst, 
 by the medical man who possesses the know- 
 ledge that will enable him to free his patient's 
 system from the injurious effects of those 
 medicines, it will be found that Gout and 
 Kheumatic Gout can be easily controlled and 
 cured by non-injurious remedies. 
 
 I have arrived at these conclusions after care- 
 ful study : I must therefore hold firmly to tenets 
 which my experience has taught me are truths. 
 
 So carefully have I worked the method I ad- 
 vocate, that for some years every drug I have 
 
80 GOUT AND RHEUMATIC GOUT : 
 
 used in the treatment of these diseases has been 
 submitted to such tests as satisfied me that it 
 was pure and of the finest quahty ; and aU the 
 medicines, too, which my patients have taken 
 have been made up by myself, or under my per- 
 sonal superintendence. These details I admit 
 were at first very irksome, but the knowledge 
 derived from this extra care was soon so appa- 
 rent, in the certainty with which my remedies 
 acted, that 1 have never ceased to feel gratified 
 at having been successful in developing a system 
 which has produced such satisfactory results. 
 
 I am quite prepared for many objections to 
 my method of cure, because I know it must be 
 tried and proved by time, practice and experi- 
 ence, before my brother practitioners will be 
 brought to acknowledge the great value of the 
 remedies I have indicated, and the immense 
 results to be obtained in the treatment of these 
 diseases by their careful and judicious adminis- 
 tration. 
 
 " Having given the results of my experience, 
 tested by many years' practice, I can afford 
 to await their verdict, assured that in time, 
 what I have now written must he accepted 
 hij the Profession as a great truth, which will 
 
A NEW METHOD OF CURE. 81 
 
 lead to important changes in the system of 
 treating many other diseases besides those 
 which are the especial subject of these pages ; 
 and that this may eventually occur is my earnest 
 hope. Then, if through my instrumentality, a 
 truth be disseminated that will check the 
 practice of administering medicines simply to 
 palliate symptoms, without preventing or re- 
 moving the cause of the malady, I shall feel I 
 have not worked in vain. 
 
 FUKTHEE INSTANCES OF CUEES. 
 
 The following cases of Gout and Eheumatic 
 Gout are selected from a large number of cures 
 I have effected since the publication of the 
 First Edition of this work. They have been 
 chosen to support the views then put forth, and 
 to show the benefit derived by patients from 
 the treatment I advocate. 
 
 Each case is only a short statement of the 
 patient's condition when consulting me, with the 
 results of my treatment, and the facts have been 
 extracted from the notes which my case-book 
 supplies. Further experience teaches me that 
 
 G 
 
82 GOUT AND RHEUMATIC GOUT I 
 
 I have rather under than over-estimated the 
 frequency with which Mercury and Colchi- 
 cum are prescribed in these diseases, and 
 the quantity of these drugs contained in the 
 patent medicine used by patients in self- 
 doctoring ; and as their injurious qualities are 
 now even greater certainties to me than 
 formerly, I have in many cases stated when 
 these medicinQS have been taken ineffectually. 
 I have also copied a few prescriptions from a 
 large number that contained these drugs 
 (omitting quantities) which patients have given 
 me as now useless to them. These facts, it is 
 hoped, will convince those who have the re- 
 sponsibility of treating patients suffering from 
 Gout and Kheumatic Gout, as well as many of 
 the patients themselves, that the fair trial of a 
 treatment which does not require any form of 
 Mercury or Colchicum, or the excessive]^use of 
 Alkalies, and which cannotinjure a patient consti- 
 tutionally, is well worthy of their consideration. 
 
 In curing the patients whose cases are given, 
 no medicines were used except those mentioned 
 in my book. 
 
 Case 385. — A clergyman, eighty-three yeara 
 
A NEW METHOD OF CUEE. 83 
 
 ■of age, consulted me on the 2nd September, 
 1871. He was then suffering from gouty pains 
 and soreness in the feet, and the discomfort 
 was so great that he could not walk more than 
 twenty yards. He said that, in spite of leading 
 a very abstemious life, he had for some years 
 been a sufferer from pure Gout, which attacked 
 him for a few days at lengthened intervals. 
 During the last two years he had taken Col* 
 chicum for the attacks ; and the disease theii 
 settled in his feet, and had not since left them. 
 He commenced my treatment on the night of 
 the 2nd September. On the 13th he was in 
 much less discomfort and was walking longer 
 distances with more ease. On the 9th October 
 he said he had gone a mile and a half without 
 discomfort, and that that distance was quite as 
 much as he had been able to walk when he had 
 been without the Gout ; on the 1st November 
 he was walking quite as well, and suffered little 
 or no soreness in the feet afterwards. 
 
 Case 355.— On the 24th July, 1871, 1 was sent 
 for by a lady who had been a great sufferer from 
 Eheumatic Gout, which had completely distorted 
 her hands. These were not now in acute pain, 
 
 G 2 
 
84 GOUT AND KHEUMATIC GOUT : 
 
 and the patient knew that nothmg could be done 
 for the hands ; but she required my advice to alle- 
 viate the pain in her back and left leg, which 
 latter was completely powerless, as also to relieve 
 the great depression from which she was suffering. 
 On analyzing the urine, I found she was labour- 
 ing under a form of suppressed Gout, and I pre- 
 scribed accordingly. By the 31st July she 
 was much better in all respects ; by the 3rd 
 August all pain was gone, and she had been 
 able to walk round a portion of the Exhibition 
 at Albert Gate. I then considered her suffi- 
 ciently improved to quit my personal super- 
 vision for a change in the country ; whence she 
 wrote on the 11th August that she had quite 
 lost all pain. I then commenced a more tonic 
 treatment, which she followed for a month, by 
 which time I deemed her well enough to dis- 
 continue the treatment, and up to the 4th May^ 
 1872, when I last heard from her, she had con- 
 tinued free from attacks. 
 
 Case 239.— On the 22nd April, 1871, a 
 North-country gentleman came to me for advice. 
 He was then suffering from Kheumatic Gout in 
 both knees and feet. He had had Gout at times 
 
A NEW METHOD OF CURE. 85 
 
 since 1863, but this last attack — which 
 commenced in the summer of 1870 — and 
 the treatment for it, had so completely 
 prostrated him that he seemed to have no 
 chance of rallying. He was in a most de- 
 pressed state, and talked of giving up his 
 Moors, as he felt he should never again he able 
 to shoot, being now incapable of walking 
 without great difficulty more than fifty or a 
 hundred yards on level ground. He said he 
 had been under what he considered the first 
 medical treatment, both in London and in the 
 North of England, and had taken the following 
 medicines* with so little benefit that he was 
 considerably weaker then than at the com- 
 
 "^ The following are selected from tlie prescriptions 
 given to this patient before he commenced my treatment. 
 They are translated mto English, all quantities and names 
 being omitted : — 
 
 June 28, 1870. 
 
 Take of — Tincture of Yellow Cinchona, 
 
 Ammoniated Tint are of Guaiacmn, 
 Iodide of Potassium, 
 Wine of Colchicum, 
 Mucilage of Gum Arabic, 
 Water. Mix. 
 
 Make into a mixture. Take one-sixth part twice a day. 
 
§6 GOUT AND RHEUMATIC GOUT I 
 
 mencement of his attack, whilst the disease 
 seemed to have taken a chronic form in both 
 knees and feet. I changed in some measure 
 bis diet and wines, and told him he had better 
 remain in London, to enable me to judge of the 
 effect of my remedies. This he consented to da, 
 and I commenced mv treatment, which he fol- 
 
 Jan. 13, 1871. 
 
 Take of — iSulpliate of Quinine, 
 Bicarbonate of Potash, 
 Tincture of Orange Peel, 
 Wine of Colchicum, 
 Compound powder of Tragacantli, 
 Iodide of Potassium, 
 Spirit of Chloroform, 
 Water. Mix. 
 Make into a mixture. Take one-sixth part twice a day. 
 
 Jan. 15, 1871. 
 
 Take of — Iodine, 
 
 Iodide of Potassium, 
 
 Eectiiied Spirits of Wme. Mix. 
 
 To be painted upon the affected part once a day. 
 
 Jan. 30, 1871. 
 
 Take of — Ammoniated Tincture of Guaiacum, 
 Carbonate of Magnesia, 
 Carbonate of Potash, 
 Camphor Mixture, 
 Solution of Acetate of Ammonia, 
 Water. Mix. 
 
 The sixth part is to be taken every three or four hours. 
 
A NEW METHOD OF CURE. 87 
 
 lowed ; and by the 27th he was much better and 
 could walk downstairs with comparative ease. 
 On the 3rd May there was still further improve- 
 ment, and he told me on the previous day he 
 had walked nearly three miles without much 
 discomfort. I now found his progress so satis- 
 factory that I told him he might return home, 
 and that if any unusual symptom appeared 
 I could advise him by correspondence. He 
 wrote to me on the 13th May — " I am able 
 to walk better than for two or three years, and 
 without any after bad effects ; my knees have 
 improved, but there is room for further improve- 
 ment, and I am satisfied I am going on in 
 the right way.'' He continued to improve, 
 
 Take of — Liniment of Belladonna, 
 ,, Aconite, 
 
 Hydrochlorate of Morphia, 
 Rectified Spirits of Wine, 
 Boiling Water. 
 
 Make a lotion. Add Carbonate of Potash. 
 
 Jan, 80, 1871. 
 
 Take of— Mercurial Pill, 
 
 Acetic Extract of Colchicum, 
 Extract of Colocynth, 
 Powder of Ipecacuanha, 
 Hydrochlorate of Morphia. 
 
 Make two pills. To be taken night. 
 
88 GOUT AND RHEUMATIC GOUT ! 
 
 and I saw him in London on the 17th June, 
 and then he told me he had walked for four 
 hours one day in the previous week on very 
 hilly ground without inconvenience. On the 5th 
 July he reported to me that he had slight swell- 
 ing and discomfort in the right instep, hut that 
 after taking my medicines this had nearly 
 disappeared ; by the 11th all pain, swelling, and 
 stiffness had gone, and he was walking as weU 
 as before. On the 17th I again saw him in 
 London, and he said he felt stronger and better 
 than he had ever expected to be again. I told 
 him that he now required no more of my treat- 
 ment, except such as would enable him to keep 
 his general health in order. On the 22nd 
 August he wrote me from the Moors, on which 
 he was then shooting, that he had been out 
 from ten to twelve hours a day, and often in 
 much wet, yet that he continued quite well. 
 
 Case 278. — A lady, whose age was about 
 twenty-five, consulted me on the 16th June, 
 1871, for a rheumatic affection. She was ex- 
 tremely depressed, with her extremities always 
 cold and clammy. She had for some time past 
 suffered from pains flying about her knees. 
 
A NEW METHOD OF CURE. 89 
 
 ankles, and feet, and they had now become very 
 acute, but there was not then the slightest ap- 
 pearance of redness or swelhng. The pains came 
 on after a severe cold caught six months before. 
 Her former medical attendant had treated her for 
 Eheumatism, and had prescribed Colchicum until 
 the system became so depressed that she would 
 take no more. She then tried other treatment, 
 but soon Colchicum was again administered with 
 the same effect ; whilst the pains now settled so 
 firmly in the joints that she was very hopeless 
 anything could benefit her. I saw this was 
 another case of suppressed Gout, and com- 
 menced treating my patient accordingly. On 
 the 20th she had well-marked Gout in the left 
 foot, in which she was suffering great pain ; but 
 this she seemed willing to bear, as she told me 
 she felt her system had been relieved of a great 
 weight. Shortly after this, as the Gout came out, 
 all other pains disappeared, except in the knees, 
 and with this loss of pain all her depression 
 vanished. My patient continued to improve, 
 her knees got quite well, and on the 7th July 
 she had only stiffness, in the bone of the left 
 foot. She was then able to leave London for a 
 short visit, and on her return a fortnight after- 
 
90 GOUT' AND RHEUMATIC GOUT : 
 
 wards she was quite well, and told me her 
 friends thought her looking ten years younger 
 than before she commenced my treatment. 
 
 Case 287. — A gentleman came to me on the 
 6th June, 1871, to ask my advice as to his 
 state, which no treatment that he had hitherto 
 followed seemed to benefit. He told me that 
 his occupation was very sedentary, having the 
 management of the books of a large firm at the 
 West- end. He complained of great pain in the 
 head, and behind the balls of the eyes, both of 
 which were dreadfully bloodshot ; this pain was 
 more intolerable at some times than at others, 
 and on these occasions it was so bad that he 
 feared to lose his sight. There was no appear- 
 ance of Elieumatism or Gout about him, but 
 he had taken Colchicum until it so depressed 
 him that he was obliged to discontinue its use. 
 I commenced a treatment for the purpose of 
 clearing his system, and the effect of this was 
 that on the 13th June there was an improve- 
 ment, showing itself in less redness about the 
 eyes, and less pain in the head and at the back 
 of the eyeballs ; but there was shght rheu- 
 matic pain in the right ankle and knee. Upon 
 analyzing the urine, I found my treatment must 
 
A NEW METHOD OF CURE. 91 
 
 be for suppressed Gout. The effect of this 
 treatment was that on the 17th, when he came 
 to me, he said that on the 14th the Gout had 
 shown m the feet ; it was then well developed 
 in the right hand. All inflammation had left the 
 eyes, the headache had gone, and his sight wa& 
 as good as ever. By the 29th June the gouty 
 symptoms were aU subsiding, and there was no 
 return of inflammation in the eyes ; he had once 
 or twice a threatening of pricking in the eyes» 
 but the action of the medicine had always the 
 power to stop it, and on the 13th or 14th 
 August he was well enough to leave London 
 with his family for the seaside. He had some 
 little discomfort at first from the glare of the 
 ocean ; but after a few hot baths he quite re- 
 covered, and on the 6th September wrote to tell 
 me that he was well enough to bathe in the 
 open sea with benefit. Now in this case nothing 
 was clearer than that my remedies had the 
 power to remove the Gout from its dangerous 
 position in the eyes to a point where it was com- 
 paratively harmless — in the hands — and finally 
 to free the system from it altogether. 
 
 Case 329.— On the 19th July, 1871, I was 
 
92 GOUT AND RHEUMATIC GOUT : 
 
 consulted by a man who was employed at a 
 tavern in Poplar. When he came to me the 
 poor fellow was so helpless with pain that he 
 was lifted out of the vehicle in which he came 
 and with difficulty brought into my house. He 
 told me his age w^as twenty- six, that he had had 
 Gout during two years, at first at intervals, but 
 the last time for nearly six months. This attack 
 had been upon him since the 9th April, and he 
 had been during that time for six weeks con- 
 fined to his room. He was suffering from severe 
 Eheumatic Gout. He was in great pain in both 
 knees and in his right ankle, and since April 
 had not done a day's work. He had been under 
 medical treatment, but latterly had only taken 
 a patent Gout Tincture, which had done him no 
 good after the first few doses. He commenced 
 taking my medicine that night ; after its action 
 he felt much better, and his knees were free 
 from pain. On the 24th July he came to me ; 
 he had been able to walk from Oxford Street to 
 South Street, and had on his usual boots, which 
 he had not worn for three months. His knees 
 and left ankle were well and free from pain, but 
 his right ankle was not quite strong. Up to the 
 31st July his knees continued quite well and 
 
A NEW METHOD OF CURE. 93 
 
 he had no pain in the feet, and his right foot 
 was getting its natural shape. He said he had 
 walked that day from London Bridge, and could 
 get along nearly as well as ever, except up and 
 down stairs; that he felt better than he had 
 done for twelve months, and had been doing 
 regular work for four days. He continued the 
 treatment I advised, and again saw me on the 
 7th August ; then he felt quite well, with all 
 his joints free from the disease, in proof of 
 which he stated he had that day walked from 
 Poplar to my house in two hours and ten 
 minutes, and intended walking back. On the 
 16th August he wrote me : — '' I can walk about 
 all right, and feel better in myself than I have 
 done for twelve months.'' 
 
 Case 415. — An Admiral in the Eoyal Navy 
 consulted me on the 30th September, 1871. 
 He said he was of a gouty family ; that he 
 was himself first attacked with the disease in 
 1851, and had suffered at intervals until 1870, 
 at which time, after a visit to Wiesbaden, an 
 attack came on and remained in the foot for 
 about three weeks, gradually subsiding under 
 Vichy Water. In the spring of 1871 he 
 
'94 GOUT AND RHEUMATIC GOUT I 
 
 was ill with Bronchitis, from which he had 
 never before suffered. This attack of Bron- 
 chitis returned from time to time, and left him 
 with great pain in the chest, and often with a 
 choking feeling in the throat. I only saw him 
 on the 30th September, from which time my 
 treatment was continued ; and he corresponded 
 with me as to its results, sending me frequently 
 the urine for analysis. On the 14th October 
 he wrote me that he was decidedly better, and 
 on the 20th all choking feeling in the throat 
 was subsiding, and that it did not now dis- 
 turb his sleep. He continued my treatment 
 through the month of November, then he dis- 
 continued all medicines. On the 1st January, 
 1872, he wrote to say he was quite well in 
 every respect. 
 
 I attributed Bronchitis in this case to the 
 medicines which had been used by the patient 
 for the cure of Gout. My treatment, being 
 well followed, eventually relieved the system, 
 and so effected the cure. 
 
 Case 199.— On the 14th March, 1871, I was 
 consulted by a tavern-keeper, who told me he 
 had been a sufferer for some four years irom 
 
A NEW METHOD OF CUEE. 95 
 
 Eheumatic Gout, but that the disease had so 
 increased during the last twelve months that 
 he was obliged to go out of business, and 
 had now been ill with it since the 12th 
 November. He had been all this time under 
 medical treatment, had taken quantities of 
 blue pill and Colchicum. He was very de- 
 pressed, and at the time he came to me had 
 Eheumatic Gout in the left hand, the right foot, 
 .and both knees so badly as to incapacitate him 
 from walking. On the 14th he commenced my 
 treatment : on the 20th his left hand was 
 decidedly better, and he said he had been walk- 
 ing two miles, for the first time for six mo:i(hs« 
 His general health and spirits were considerably 
 improved, and he continued to make such pro- 
 gress, that on the 20th April he told me he 
 had walked eight miles on the 15th, and felt 
 well enough to resume business ; that on the 
 17th June he was quite well, and afterwards 
 able to walk four or five hours every day. I 
 •did not see him again u.ntil the end of the fol- 
 lowing October ; then he told me he had been 
 in perfectly good health. It is satisfactory 
 for me to add that this patient is now able to 
 take the management of a larger business than 
 
96 GOUT AND RHEUMATIC GOUT : 
 
 before, and that his health is in every respect 
 equal to his work. 
 
 Case 210. — A gentleman, aged seventy-five, 
 came to consult me and place himself under my 
 treatment on the 12th April, 1871. He was 
 suffering severely from great and continuous 
 ]3ain in the right shoulder and arm, which latter 
 he was unable to straighten. He was expe- 
 riencing a numbness and want of power in the 
 fingers of the same hand, and at the time had 
 severe chronic cough. He had been in this 
 state for some months, and had tried many 
 remedies without any permanent benefit. He 
 at once commenced my treatment, and on 
 the 26th April the pain in his shoulder had 
 greatly diminished, and he could with more ease 
 extend his arm. The numbness in the fingers 
 had also ceased, but he complained now of 
 *' pins and needles " in the hand. On the 1st of 
 May he was in so much better health that he 
 was able to go to Scotland for fishing ; thence he 
 wrote to me, on the 18th of May, that he wa& 
 continuing my treatment, that now the natural 
 sensation in the fingers had returned, the 
 fingers themselves were more manageable, and 
 
A NEW METHOD OF CURE. 97 
 
 that his arm was stronger. He continued 
 to improve, and when I saw him in London, 
 on the 6th June, he was quite well, and could 
 extend his arm freely and without any pain in 
 his shoulder. The feeling in the hand and 
 fingers was now perfectly restored, and he was 
 altogether in so satisfactory a state that I con- 
 sidered he required no further treatment. This 
 case was one of suppressed gouty irritation, 
 which no medicines had before tended in any 
 way to neutralize, and thus to free the constitu- 
 tion from its consequences. 
 
 Case 155. — I was consulted on the 7th 
 February, 1871, by a market-gardener, aged 
 forty. He said that for thirteen years he had 
 been a sufferer from Eheumatic Gout, that his 
 present attack had lasted some time, and had 
 quite incapacitated him from attending to his 
 business for the three previous months. He 
 had taken numerous patent medicines and a 
 great deal of Colchicum, which now no longer 
 gave him relief, but caused the usual dreadful 
 depression. For that reason he had discon- 
 tinued it. I found him suffering seriously from 
 the disease in the left knee and ankle, also in 
 
 H 
 
98 GOUT AND RHEUMATIC GOUT : 
 
 the foot, which he was hardly able to put to the 
 ground. He commenced my treatment on the 
 7th February, which he continued regularly. 
 On the 9th, when I again saw him, he was in 
 much less pain in all affected joints, and 
 could walk better ; and when he came to me on 
 the 18th February, I found his joints quite 
 free from the disease ; he seemed well, and said 
 he felt so, and that he had walked to my house 
 from the Victoria Station without the slightest 
 inconvenience or pain, and intended to walk back. 
 
 Case 135.— On the 4th February, 1871, a 
 tradesman who had been laid up with Eheumatic 
 Gout since the 24th December, 1870, came to 
 me. He had been confined to his room from 
 that time until the day before I saw him ; then, 
 feeling somewhat better, he determined to come 
 out and see me. He said he had been a terrible 
 sufferer from Eheumatic Gout for eight years, 
 the attacks having gradually turned from Acute 
 Gout to Chronic Eheumatic Gout. He had been 
 under numerous treatments, and taken, he be- 
 lieved, nearly every patent medicine, and now he 
 was almost without hope, as for the last twelve 
 months he had never been free from the disease. 
 
A NEW METHOD OF CURE. 99 
 
 or fit for three days together to attend to his 
 business. He then had Eheumatic Gout in both 
 feet and knees, and said the pain was fl}ing 
 about all parts of his body. I told him to go 
 home and to bed, and take the medicines I 
 ordered, I went to see him on the 7th, and 
 then the attack had developed itself ; he had it 
 in both knees and feet, elbows and hands ; he 
 had had no sleep for two nights. On the 8th 
 he was not in much pain, and had slept for six 
 hours ; from that time till the 17th he slept from 
 six to seven hours during each night. Then all 
 pain had gone, and he only felt tenderness 
 in the affected joints. On the 23rd he was 
 well enough to come and see me, and on the 
 1st March he went to Bristol to visit a relative 
 who was ill. He continued to improve under 
 my treatment, and on the 13th March he was 
 well enough to walk two miles in his ordinary 
 boots — a distance he had not accomplished for 
 twelve months previously. He had continued 
 well and able to work uninterruptedly to May, 
 1872, when I last heard from him. 
 
 Case 243. — A gentleman, about sixty years 
 of age, came to me on the 24th May, 1871. 
 
 H 2 
 
100 GOUT AND BHEUMATIC GOUT I 
 
 He said he was then suffering from Kheumatic 
 Gout in his knees and ankles, that he had httle 
 hope of ever being better, as he had been under 
 treatment for many months with no permanent 
 benefit, that it was now with the greatest diffi- 
 culty he could walk, or even get up from his 
 chair, and that the action of going downstairs 
 was great pain to him. He gave me his old 
 prescriptions, which he said had done him no 
 good, and I believe he told me that two medical 
 men had declared there was nothing for him 
 but to bear his state, as he would not ever be 
 any better. 
 
 The prescriptions copied and translated are 
 selected from a large number given in the three 
 previous years by former medical attendants.* 
 
 For three months before I saw him he took 
 little or no medicine. He commenced my treat- 
 ment on the 24th May; on the 2nd June he 
 was much better, the stiffness in the knees 
 
 'i^ June 18, 1869. 
 
 Take of — Calomel, 
 
 Acetic Extract of Colcliicum, 
 Compound Extract of Colocynth, 
 Extract of Belladonna. 
 Mix and make into pills. 
 One to be taken either every other night or twice a week. 
 
A NEW METHOD OF CUEE. 101 
 
 decreasing, and he continued to improve until 
 the 24th June. On the 27th June he was 
 much better, and could walk downstairs with 
 comfort. On the 28th he caught a severe cold, 
 and was seized with an attack of Acute Eheu- 
 matic Gout, which confined him to his bed, 
 attacking his elbows, arms, knees, and feet. 
 He was in considerable pain for a few hours, 
 but by the 3rd of July there was a great im- 
 provement; on the 6th, all acute pain had 
 ceased, and from that date his improvement 
 was uninterrupted. On the 22nd July he 
 was able to walk about, and by the 3rd 
 August was quite well, walking as well as he 
 desired. In June, 1872, I met this patient in 
 the City ; and he said he had continued well, 
 and free from any gouty irritation since he had 
 last seen me, and could now with ease walk 
 
 Nov. 23, 1869. 
 
 Take of — Bicarbonate of Potash, 
 Sulphate of Quinine, 
 Iodide of Potassium, 
 Wine of Colchicum, 
 Bromide of Potassium, 
 Mucilage of Gum Arabic, 
 Water. Mix. 
 Make a mixture. One- eighth part to be taken twice a 
 day. 
 
102 GOUT AND KHEUMATIC GOUT : 
 
 for two or three hours a day, without suffering 
 any inconvenience. 
 
 Case L. 237.— On the 6th August, 187e5, I 
 was consulted by a very eminent physician 
 about his wife's health. She was a sufferer 
 from a most excruciating pain extending from 
 the right hip down the leg, in the track of the 
 sciatic nerve. The pain was intermittent, and 
 came on every night at ten p.m., lasting until 
 the following morning at ten a.m. After this 
 the leg was free from pain till the following 
 night. In this state she had continued for 
 nearly two years, during which time she had had 
 the advice of four or five distinguished medical 
 men, without deriving any permanent benefit. 
 Latterly the pain had become more severe, and 
 she had been obliged to take considerable 
 quantities of opiates to enablejher to get rest. 
 Their effect, beyond the suppression of the 
 sensation of pain, had now been to completely 
 disarrange her powers of digestion. On exami- 
 nation I found the patient's general health 
 much impaired and her system considerably 
 fevered by the quantity of stimulants — such as 
 stout, port wine, and brandy — and tonics that 
 
A NEW METHOD OF CUEE. 103 
 
 had been given to combat the depression, and 
 that, although she perspired freely in other 
 parts of her body, she had no perspiration 
 from the hip to the foot on the side in which 
 the pain occurred. Her tongue was foul, her 
 appetite most uncertain, and she suffered great 
 thirst at times. On analyzing the urine, I 
 found the origin of the disease to be gouty, 
 and I commenced to treat her with the inten- 
 tion of freeing her system from the gouty 
 poison. On the 16th August there was moisture 
 on the hip, knee, and foot ; and, at the same 
 time, there was a decided decrease in pain and 
 an improvement in the patient's sleep. On the 
 28th August she was steadily improving, and 
 slept until two a.m., without taking any nar- 
 cotics, and was much stronger. On the 18th 
 September she was free from pain in the 
 night — for the first time for nearly two 
 years — and slept well. She continued to 
 improve, and by the 1st. November she was 
 quite free from pain, without any indication 
 of gouty irritation, and much stronger in 
 her general health. I saw her as late as 
 the 19th January, 1878, and she told me 
 that she had not had any return of the 
 
104 GOUT AND RHEUMATIC GOUT I 
 
 disease, or indeed pain in the leg in any 
 form. 
 
 Case 0. 89.— On the 6th February, 1877, I 
 was consulted by a lady who had suffered for 
 nearly nine years from Rheumatic Gout, 
 which had now become chronic, and had so 
 affected her that she was sometimes for weeks 
 scarcely able to walk from one room to an- 
 other. She came to England from New 
 Zealand for medical treatment, which was 
 followed for more than two years without pro- 
 ducing any improvement in her condition. I 
 found that she had gouty swelling and inflam- 
 mation in both knees, ankles, and feet, and had 
 been unable to walk 200 yards (owing to 
 acute pain) for the previous six months. This 
 patient had once been severely salivated, by 
 Mercury, given accidentally when in the 
 Colonies, and from that time she had suffered 
 more acutely and frequently in all her joints. 
 I treated her first with the view to free the 
 system from Mercury and then from Gout ; she 
 gradually improved, and at the end of three 
 months was quite well. On the 5th June my 
 patient was able to walk from Bayswater to 
 
A NEW METHOD OF CURE. 105 
 
 my house and back.. About a month after this 
 date her husband called to thank me for what 
 I had done for his wife, and to say she had 
 quite recovered her former walking powers and 
 health. 
 
 Case 0. 238.— On the 18th May, 1877, a 
 gentleman consulted me on his condition, for 
 which he stated he was very hopeless of ob- 
 taining relief, as he had been for more than 
 six months under medical treatment without 
 benefit. He had a " bruised feeling " under the 
 left foot, which prevented his walking, and he 
 was exceedingly low, from the fear of a return 
 of Gout in the foot. He had abstained from all 
 but the lightest and plainest food, frequently 
 going a week together without meat. I ex- 
 amined him and analysed his urine. I found 
 that the medical advice he had followed was 
 suppressing the Gout, and the medicines he 
 had been taking had induced an alkaline con- 
 dition of the urine. I changed the medicines 
 that were producing this alkaline condition 
 and advised him to live more freely and 
 naturally. On the 29th May, he was without 
 discomfort of any sort in the feet, and felt that 
 
106 GOUT AND EHEUMATIC GOUT : 
 
 he was much stronger and better, in spite of 
 having dined out three or four times a week. 
 At this time the patient's improvement was 
 such that I could allow him to go into the 
 country, and from there he corresponded with 
 me. Under my plan he continued to improve, 
 and did not suffer any return of his complaint, 
 although, by way of precaution, he still, from 
 time to time, followed my advice up to the 
 19th August. 
 
 Ca^e K. 158.— On the 30th March, 1875, 
 a clergyman from one of the West Indian 
 Islands placed himself in my hands in con- 
 sequence of having derived some benefit from 
 the advice contained in my book, and which he 
 had followed before coming to England. He 
 had been a sufferer from attacks of Gout for 
 more than twenty years ; at first, in acute, 
 but for the last ten years in more chronic 
 form ; indeed, latterly his health had com- 
 pletely given way under the disease and its^ 
 treatment, nearly all his joints being so tender 
 that he could with difficulty walk. He said the 
 disease, he felt, was gradually sapping all his 
 nervous energy. He was therefore resolved ta 
 
A NEW METHOD OF CURE. 107 
 
 come to England to try the effect of rest and 
 change of chmate. His case was one of pure 
 Grout, considerably complicated by the conse- 
 quences of the medicines he had taken ; and I 
 told him I could not undertake to obtain per- 
 manent relief except under a continuous treat- 
 ment of some months. To this he assented, 
 and I commenced to treat him. On the 28th 
 April he walked three miles ; subsequently he 
 had two acute attacks during my treatment, but 
 on the 14th February, 1876, was quite well 
 and able to return to his home and his duty. 
 In June of last year (1877) he wrote me as 
 follows : — 
 
 *' For sixteen months now I have had no 
 attack. When I feel Gouty symptoms, a dose 
 of Khubarb and Magnesia removes them. . . . 
 This week I have ridden on horseback longer 
 distances than I have done for years : day 
 before yesterday, thirty-six miles ; yesterday, 
 fifteen ; to-day, twenty miles. I now do more 
 work than most men. I have six churches under 
 my care, at distances of eighteen, sixteen, 
 twelve, and ten miles from my residence. Be- 
 sides this, I have ten other minor stations 
 that I have to visit. I have to keep six 
 
108 GOUT AND RHEUMATIC GOUT l- 
 
 animals for my work, but the more I work 
 the better I feel." 
 
 Case P. 13.— On the 5th October, 1877, 
 there w^as brought to me a gentleman suffering 
 from great general debility, and pain in the 
 left side of the head, accompanied by thickness 
 of speech, inability to articulate distinctly, and 
 impaired memory. He was so helpless, that his 
 condition had to be described to me by a friend 
 who came with him. He had long been a 
 sufferer from Chronic Gout, and had consider- 
 able deposits of chalk upon his fingers. These, 
 however, showed no signs of irritation, and he 
 did not complain of any gouty pain in his 
 joints. One medical man, and his friends, I 
 believe, considered him to be suffering from 
 softening of the Brain. I examined him, and, 
 after analyzing the urine, satisfied myself he 
 was suffering from suppressed gouty irritation, 
 affecting the nerves on the left side of the head, 
 face, and tongue. For this I treated him. On 
 the 9th October his memory was improving, and 
 on the 16th there was further change for the 
 better, but no indication of gouty irritation in 
 his feet or hands. On the 18th he was un- 
 
A NEW METHOD OF CURE. 109 
 
 usually irritable, and on tlie 19tli the pain in 
 his head ceased, and he had a distinct attack 
 of Gout in the httle finger of the left hand. 
 His memory became clear, and his speech 
 was no longer indistinct. The Gout continued 
 at the extremities, and on the 26th October 
 he had very severe pain in both hands, with a 
 considerable chalky deposit on the second 
 finger of the left hand ; this broke and dis- 
 charged. The patient then became quite free 
 from any discomfort in the head, and entu^ely 
 recovered his memory, speech, and mental 
 power. This was a case of Suppressed Gout, 
 recognisable alone by the analysis of the urine, 
 and for which any other than a treatment to 
 clear the patient's system of Gout would have 
 ended most disastrously. 
 
 Case P. 10.— On the 2nd October, 1877, a lady, 
 who had been for some time under my care, 
 brought to me her daughter, who was suffering 
 from Eheumatic Gout, and who had been under 
 various treatments for it since the 23rd May. 
 When I saw her she had great pain and 
 swelling in both feet and in her right knee; 
 also pain in her shoulders, which was greatly 
 
110 GOUT AND RHEUMATIC GOUT. 
 
 increased by movement, and she was in so 
 helpless a condition, that she could not get up 
 or down stairs, except on her hands and knees. 
 She had been under several medical men, 
 and had also tried the Bath waters without 
 benefit. I saw no difficulty in curing her. 
 Ey the 16th October she was able to walk 
 short distances, and the swelling of all her 
 joints was subsiding. By the 2nd November 
 she was quite well and free from all pain, and 
 with only slight swelling of the right knee. 
 She was able to walk four or five miles at a 
 stretch. This patient, I am happy to say, has 
 had no return of the complaint, and continues 
 quite well to the present time. 
 
 Case 0. 94.— On the 5th February, 1877, a 
 gentleman, living in the West of England, 
 consulted me by letter as to his state, sending 
 me urine to analyze. He was suffering severely 
 from Chronic Eheumatic Gout, which had 
 attacked nearly all his joints, at the extremities, 
 and in this condition he had been for some 
 time. He was fearful he should never be better. 
 I, however, saw nothing to prevent his re- 
 covery, and commenced treating him. His 
 
A NEW METHOD OF CURE. Ill 
 
 progress was gradual. At the end of three 
 months he was well, and able to leave home 
 for change of air, and in July he came 
 to me quite free from his old complaint. On 
 the 6th January, 1878, he wrote from the 
 country as follows : — 
 
 " Since I saw you last July, I have been 
 wonderfully well of the Eheumatic pains — in 
 fact, I never thought I should have been so 
 loell again." 
 
 Case G. 103.— On the 29th January, 1873, a 
 gentleman came to me, complaining of very 
 severe pain in his right shoulder, extending 
 into his neck and head. He believed it had 
 been caused by severe cold. I examined him, 
 made an analysis of the urine, and then told 
 him the pain was the result of suppressed 
 gouty irritation, from his blood being loaded 
 with an excess of lithic acid, and that I also 
 found his kidneys were seriously affected. He 
 admitted that at times he had felt slight dis- 
 comfort in his back, but, as it had not lasted, 
 he considered it unimportant. 
 
 I prescribed ; saw him on the 31st January, 
 1st and 4th of February, when all pain in the 
 
112 GOUT AND RHEUMATIC GOUT : 
 
 shoulder, head, and neck had ceased, and, with 
 the exception of shght pain in one knee, he felt 
 fairly well. The analysis of the urine, at this 
 date,^ still indicated an undue acidity in the 
 blood, as well as serious mischief in the 
 kidneys. To relieve this, I strongly advised a 
 continuance of treatment, but, as he had some 
 important business in the North of England, 
 requiring his immediate presence, he decided 
 to leave London without following this ad- 
 vice. 
 
 On the 27th February, I received a message 
 from this patient, begging me to come to him 
 immediately, at the Charing Cross Hotel, as he 
 feared he was dying. On my arrival, he said 
 he had been in agony for three or four hours, 
 from pain in the right kidney, which seemed as 
 if a dagger was being driven into it. I sent 
 my prescription to the chemist's, waited for its 
 return, and having given my patient the first 
 dose, left him under the charge of an attendant, 
 as the pain he was suffering was so intense 
 that he could not have been left alone with 
 safety On my return, in three hours, he said 
 all pain had ceased two hours after he had taken 
 the medicine, when he felt a sharp pain pass 
 
A NEW METHOD OF CURE. 113 
 
 from the kidney downwards, and afterwards all 
 pain had subsided. He felt so well that he 
 proposed to get out of bed and dress himself. 
 This I would not allow, and, recognising that 
 the calculus had passed from the kidney into 
 the bladder, changed my treatment to expel it 
 from the bladder. This plan he followed with- 
 out any return of pain in the back or kidney 
 until the 2nd of March, when, at 2 a.m., he 
 had an attack of very severe pain in the 
 bladder, and, after considerable straining, 
 passed a stone weighing nearly 2^ grains, accom- 
 panied by a large clot of blood. When I saw 
 him on the same day he was much more com- 
 fortable ; and, on the 4th of March, had quite 
 recovered, and was able to attend to his busi- 
 ness as usual. On this day I again analysed 
 the urine, and found no indication of the former 
 unhealthy state of the kidneys, which had been 
 caused by the pressure of the calculus. 
 
 In this case the patient's blood had for some 
 time been charged with an excess of lithic acid ; 
 this had caused indigestion, for which he had 
 taken considerable quantities of alkalies, as 
 soda and potash. The effect of this treat- 
 ment had been to retard the passage of the 
 
114 GOUT AND KHEUMATIC GOUT I 
 
 lithic acid from the blood, and cause it to 
 crystallize in the kidney. My analysis enabled 
 me to recognise this condition, and, by medi- 
 cines, to cause the passage of the stone into 
 and through the bladder. 
 
 Had this patient's case been misunderstood 
 and the stone been left in the bladder, it would 
 then have increased in size, and, in a few 
 months, an operation for its extraction would 
 have been necessary. 
 
 In the last four years I have had fifteen nearly 
 similar cases, all, in my belief, resulting from 
 suppressing Gouty irritation by the excessive 
 administration of alkaline medicines, which, 
 by rendering the urine alkaline or neutral, 
 changes the form of the acidity, and causes it 
 to deposit in the kidney. 
 
 Since writing the above I have had so much 
 valuable knowledge imparted to me through the 
 analysis of the urine, that I must insist that no 
 medical man can properly treat the Gouty unless 
 he makes careful and continuous analysis. 
 Without this, in my opinion, he has no right 
 to expect to understand his patient's real condi- 
 tion. An imperfect knowledge of the contents of 
 the urine in any sort of Gouty attack is one 
 
A NEW METHOD OF CURE. 115 
 
 of the principal reasons why treatment is 
 erroneously directed against the symptoms, even 
 where the removal of the cause of the disease 
 is a necessity as the only means by which the 
 patient's life can be saved. 
 
 To explain my meaning I will mention two 
 cases of Gout which, for some days, had been 
 treated unsuccessfully — one for inflammation of 
 the bladder, and the other for bronchitis. By 
 analysis I proved the patients to be suffering 
 from Grouty irritation, which, with a proper 
 treatment for Gout, was speedily cured. 
 
 Case W. 51. — On the 5th December, 1880, I 
 was requested to go into the country to see an 
 old patient who had been previously under my 
 care for Gout. On my arrival at his house I 
 was met by his medical attendant, who explained 
 that the patient had taken a severe cold, which 
 in two days had been followed by what he con- 
 sidered to be inflammation of the bladder ; 
 but in spite of every treatment to relieve that 
 condition, the serious symptoms still continued* 
 He explained what medicines he had given, 
 and as these were such as, with inflamma- 
 tion of the bladder, should have benefited the 
 
 i2 
 
116 GOUT AND RHEUMATIC GOUT I 
 
 patient, he was quite at a loss what plan to 
 adopt in consequence, and had sent for me. I 
 examined the patient, and found his symptoms 
 were those of inflammation of the bladder. 
 There was extreme irritation in passing water, 
 and great tenderness over the region of the 
 bladder"; his pulse was high, his tongue was foul, 
 and the action of the bowels slightly constipated. 
 I asked if the urine had been analyzed, and was 
 informed that this had not been the case. I at 
 once made my analysis, and pronounced the 
 attack to be one of suppressed Gout; a treat- 
 ment for Gout was at once commenced, in 
 six hours there was action of the bowels, and 
 early the next morning the Gout was fully 
 developed in the left foot, and the irritation of 
 the bladder had subsided. The treatment for 
 Gout was continued, and in four days the 
 patient was able to put his foot to the ground 
 without pain ; in a week he was well, and he 
 had no return of any symptoms of inflam- 
 mation of the bladder. Now, had the Gouty 
 irritation not been developed at an extremity, 
 in my opinion the patient could not have 
 survived a week from the day I first saw him. 
 Case W. 20. — Is one where the patient had 
 
A NEW METHOD OF CUEE. 117 
 
 been supposed to be suffering from bronchitis, 
 for which he had been treated for a week with- 
 out any apparent benefit, and twice or thrice 
 during that time he had had very severe 
 spasmodic attacks, in which he had been nearly 
 suffocated, I saw the patient on the 3rd of 
 November, 1880. There was considerable fever, 
 and the temperature had been as high as 103^ 
 for two nights. The treatment had been one 
 to relieve the bronchial irritation only, and the 
 urine had not been analysed, as, although the 
 patient had been subject te slight attacks of 
 Gout, this had not been considered necessary. 
 
 I made my analysis, and in this case, as in 
 the former, found that the patient's system was 
 loaded with hthic acid, and that his attack was 
 really one of suppressed Gout. 
 
 I ordered a treatment for Gout, this induced 
 profuse persphation, which had the effect of 
 decreasing the bronchial irritation, and lowering 
 the pulse and temperature, and the patient at 
 night was more tranquil. On the following 
 night he was much more quiet, had three hours' 
 comfortable sleep, and was awoke by severe 
 pain in the right elbow and hand; this, on 
 examination, proved to be caused by an attack 
 
118 GOUT AND RHEUMATIC GOUT I 
 
 of acute Gout in that limb. With the attack in 
 the arm the bronchitis ceased. On the follow- 
 ing night the patient slept quite comfortably, 
 his temperature was normal, and in a week 
 the attack of Gout was cured. In this case, 
 also, I believe this patient would not have lived 
 more than three days under the intense bron- 
 chial irritation from which he was suffering on 
 my first visit to him. 
 
 Case E. 145.— On the 27th of June, 1881, 
 a gentleman who had been treated for some 
 time for heart disease consulted me. He had 
 derived but little benefit from treatment, and 
 he wished me to say whether his condition 
 was the result of a diseased heart or suppressed 
 gouty irritation. He was extremely ill, suffer- 
 ing at times from great oppression of breathing, 
 with considerable pressure in the vessels of the 
 head, pain in the region of the heart, and sleep- 
 lessness ; he was quite unable to take any exer- 
 cise in consequence of palpitation and pain in 
 the heart, and the breathlessness that resulted. 
 I examined him carefully, and made an analysis 
 of the urine : and from this I judged that his 
 disease was caused by suppressed gouty irrita- 
 
: A NEW METHOD OF CURE. 119 
 
 tion, and my treatment was directed to free his 
 system from the excess of hthic acid. On the 
 5th of July he was considerably better. On the 
 18th of July there was further improvement, 
 the discomfort in breathing had considerably 
 decreased, and a night or two previously he 
 had had from four to five hours' quiet sleep, 
 for the first time for some weeks. The pressure 
 in the vessels of the head was also considerably 
 less, but he had severe numbness in both arms. 
 I still continued my treatment for suppressed 
 gout, applying stimulating embrocations to the 
 spine and arms. 
 
 On the 2nd of August the action of the 
 heart was much more healthy and free ; he had 
 had no oppression in his breathing for one week? 
 although he had been taking a considerable 
 amount of exercise. All pressure in the head 
 had ceased, and he was free from numbness in 
 the arms. On the 21st of August his symptoms 
 were those of continued improvement, there was 
 no discomfort in his heart, or oppression of 
 breathing, he felt so well that he wished to 
 go to the Highlands for some shooting, and I 
 considered that he might now do so without 
 danger. On his return from Scotland, on the 
 
120 GOUT AND RHEUMATIC GOUT. : 
 
 1st of September I again saw him : he told me 
 he had been shooting in the Western Highlands 
 between the 23rd and 29th of August, he had 
 had httle or no discomfort, and that he felt quite 
 well. He said on the 24th of August he had 
 walked more than twenty miles, shooting on 
 very hilly ground, without inducing pain in the 
 heart, and that, although he had three hard days' 
 shooting between the 23rd and 29th, he felt 
 perfectly well. I had been analyzing the urine 
 during the period he was under treatment, 
 and had found a gradual decrease in the amount 
 of lithic acid in his blood, proportionate to the 
 improvement in his health, and my analysis on 
 the 1st of September showed that there was little 
 or no gouty acidity in his system. This was a 
 case in which, had treatment for disease of 
 the heart been continued, the most serious 
 results must have followed. His cure was due 
 to the relief from the excess of lithic acid with 
 which his system was charged. 
 
 Case B.C. 141.— On the 31st of August, 1881, 
 a gentleman came to me suffering from great 
 pain and soreness in the soles of his feet, he 
 had been completely incapacitated for walking, 
 
A NEW METHOD OF CURE. 121 
 
 except very short distances, for three or four 
 years. He had come from Australia to England 
 in the hope of recovering his health, and had 
 consulted four or five other medical men before 
 coming to me. On making an analysis of the 
 urine, I found that he was suffering from 
 excessive gouty acidity of system, and for this 
 I treated him. 
 
 On the 11th of September his symptoms 
 were those of improvement, he had much less 
 pain in the soles of his feet, and was able to 
 walk considerably better. On the 21st of Sep- 
 tember the pain and stiffness in the feet had 
 almost entirely ceased ; his general health had 
 improved in every respect, and there was much 
 less gouty irritation in his system. 
 
 On the 25th of September he was quite weU, 
 his feet were perfectly sound, so that he could 
 walk nine or ten miles without the slightest 
 difficulty. This was a case of suppressed gouty 
 irritation, by relieving which the pain and dis- 
 comfort in the feet entirely subsided. 
 
 Case B.C. 161. — A patient came to me on 
 the 16th of September, 1882, complaining of 
 great pain in the left shoulder and numbness in 
 both arms and fingers, with occasionally severe 
 
122 GOUT AND EHEUMATIC GOUT ! 
 
 shooting pains in the fingers ; he had tried the 
 Bath Waters, and had been under other treat- 
 ment, without being benefited, and he was- 
 strongly impressed that his attack would end in 
 paralysis. I found he was suffering from gouty 
 irritation, and treated him to relieve his system 
 of this. On the 22nd of September there was 
 considerable improvement — the shoulder was not 
 so stiff, and the numbness in his arms was 
 decreasing. 
 
 On the 4th of October there was a decrease 
 of the pain in the shoulder, and the numbness, 
 was less ; there was no pain in either feet or 
 knees, which he previously had. 
 
 On the 24th of October the left shoulder was 
 nearly well, he was able to put on his great- 
 coat without assistance, and the numbness in the 
 arms was decreasing and more intermittent. 
 
 On the 26th of November the shoulder was 
 quite well, he had no numbness in the arms or 
 fingers, and he felt well in every respect. I 
 then told him I saw no further necessity for 
 treatment, as my analysis showed that there 
 was no gouty acidity in the blood. I did not 
 see this patient again until the 31st of March, 
 1883, when he called on me in consequence of 
 
A NEW METHOD OF CURE. 123 
 
 his having a severe chill. He had had no return 
 of pain in the shoulder or numbness in his arms, 
 and, with the exception of the chill, he was, and 
 had been, perfectly well. This also was a case 
 of suppressed gouty irritation, which had pre- 
 viously been mistaken for paralysis. Any treat- 
 ment for paralysis would in all probability 
 have ended in serious organic disturbance, which 
 would have culminated in some seizure, in con- 
 sequence of the deterioration of the patient's 
 constitution. 
 
 In none of the foregoing cases had the patients 
 any increase of gouty pain at the extremities, 
 because my treatment made the gouty acid in 
 the blood more soluble, thus preventing its 
 deposit at the extremities, and causing it to 
 leave the system more naturally. 
 
125 
 
 APPENDIX. 
 
 Dr. Bennett's Eeport, sKghtly abridged to 
 save space, is taken from the British Medical 
 Journal of May 8tli, 1869. It runs thus : — 
 
 ** Conclusions regarding the Cholagogue Action of Mercury^ 
 
 '' The foregoing observations seem to us clearly to show 
 " that blue pill, calomel, and corrosive sublimate, when 
 " given to dogs in either small, gradually augmented, or 
 '* in large doses, do not increase the biliary secretion ; 
 " they do not even influence it so long as neither 
 " purgation nor impairment of health are produced, but 
 " they diminish it as soon as they produce either or both. 
 " It may be urged that, although we have proved this 
 " regarding dogs, it does not follow that on man these 
 " drugs will have the same action. It must be admitted 
 " that some animals are altogether insensible to remedies 
 " which produce powerful effects on others ; that different 
 '* doses are often requisite to occasion similar results ; and 
 " that there may be peculiarities so very decided as to 
 " render it impossible to infer what will be the action of 
 ** a remedy on one animal from its influence upon another. 
 " But have we any reason to conclude that in the 
 " present instance there exists such difference in the 
 " action of mercury as to prevent any inference being 
 ** drawn from the dog regarding man ? All the facts with 
 " which we are acquainted show that it is legitimate to 
 *' infer that the action of mercury ought to be regarded as 
 " similar in both cases. We have demonstrated that, as 
 ** regards its action upon the salivary glands, mouthy 
 
126 APPENDIX. 
 
 " intestine, appetite, and general nutrition, the influence 
 *' of mercury is the same. We therefore infer that it is 
 " in the highest degree probable that its action on the 
 " hepatic secretion will also be the same. The only 
 " difference that there seems to be between the dog and 
 " man as regards the action of mercury, consists in the 
 ** fact that in the dog larger doses are generally required 
 "to produce the same effects as those observed in man. 
 ' ' But even here it may be argued that more marked 
 " results are required to satisfy the observer, and hence 
 " the greater dose necessary. These circumstances, 
 '* therefore, cannot be held as affecting the conclusion at 
 " which we have arrived. 
 
 " We have not deemed it worth our while to experiment 
 " upon any other animal, for we are unable to see how 
 *' such experiments could materially strengthen our 
 "position. * ''' ''' ''' In addition to the therapeutical 
 " facts previously mentioned, which, after all, are the 
 " most important, there are these, that the qualitative 
 " composition of canine is the same as that of human bile, 
 " and that the dog, like man, can feed on a flesh, 
 " vegetable, or mixed diet. '^ ^^ ^' ^' 
 
 " But it may be supposed that mercurials possess some 
 " specific power of exciting the biliary secretion by acting 
 " on the orifice of the common bile-duct, and so 
 " stimulating the secretion through the nerves which 
 " connect it with the liver, just as pyrethrum and vinegar 
 " stimulate the salivary glands when they are applied to 
 " the orifices of the salivary ducts. It might also be 
 «' objected that, inasmuch as in our experiments the 
 " common bile-duct has been divided, the nerves alluded 
 *' to might have been so injured that stimulation of the 
 " orifice of the common bile-duct could no longer excite 
 " the secretion. It remains to be shown, however, that 
 " mercurials do specially excite the orifice of the bile-duct. 
 " It is not probable, at any rate, that their influence on the 
 " biliary secretion was, in the cases of dogs 6, 7, and 8, 
 "prevented by division of hepatic nerves. In these 
 " experiments the common bile-duct was simply divided 
 "*' with as Httle injury to neighbouring parts as possible 
 
APPENDIX,. 127 
 
 ** (in previous experiments a portion of the bile-duct was 
 *' removed), and these animals did not suffer in the least 
 ** from the shock after the operation ; so that nervous 
 *' injury could not have been extensive. Moreover, in the 
 *' case of dog 7, the parts around the common bile-duct 
 " were dissected after death, and the nerves proceeding 
 " from the solar plexus to the liver were found at some 
 ** distance from the duct, and had apparently suffered no 
 ** injury at the place where it had been divided. The 
 *' Committee, therefore, do not attach any value to this 
 *' objection. 
 
 " But some may say that, although we have proved that 
 *' mercury diminishes the biliary secretion in dogs, and 
 " that in man its action will in all probability be the same, 
 *' yet our experiments have been performed on animals in 
 *' a state of health ; and that, had they been made on 
 *' dogs with diseases such as those in which mercury has 
 *' been supposed to increase the hepatic secretion, it would 
 *' possibly, in the case of such dogs, have been increased. 
 *' With such an hypothesis we need not seriously occupy 
 " ourselves until the objectors prove that, in any case, 
 *' whatever, mercury can increase -the biliary secretion in 
 ^' man. 
 
 " We have been unable to discover any facts brought to 
 " light in this or any other age which prove that mercury 
 *' stimulates the biliary secretion. So far as we can make 
 ■*' out, the notion that it does so, originates in some vague 
 *• statement made by Paracelsus,* or the authors of his 
 " time, as to the good effects of mercury in what he has 
 " called ' icteritia." But, we repeat, not only do we not 
 •*' know how such a notion has arisen, but we are ignorant 
 *' how to make direct observations on the subject in man. 
 ** We have already stated that such observations are, in 
 *' the present state of physiological chemistry, impossible. 
 " We do not deny the possibility of mercury being useful 
 *' in some diseases of the liver. We simply say that the 
 
 * Paracelsus (Ajir. Phil. Theoph.), Opera Medico -Chemica 3 
 torn., 4to. Francof., 1G03-1G05.— i>>e Icteritiis, vol. i., p. 329. 
 
128 APPENDIX. 
 
 ** notion of its doing good by increasing the biliary 
 '* secretion is untenable." 
 
 " Results of preceding observations on the Cholagogue Action 
 " of Pilula Hydrargyri and Calomel. 
 
 "1. Pilula hydrargyri, when given in doses which did 
 " not produce purgation, caused no increase of the biliary 
 " secretion. 
 
 " 2. Pilula hydrargyri, when given in doses which 
 *' produce purgation, diminished the biliary secretion. 
 
 "3. Calomel, given in doses of one-twelfth of a grain 
 " from six to fourteen times a-day, and in doses of two 
 " grains from two to six times a-day, did not produce 
 " purgation or increase the biliary secretion. 
 
 ♦' 4. Calomel, when given in doses which produced 
 *• purgation, diminished the biliary secretion. — Report of 
 " the Edinburgh Committee on the action of Mercury, 
 ** Podophylline, and Taraxacum on the Biliary Secretion. 
 ♦* By John Hughes Bennett, M.D., F.R.S.E, Convener and 
 " Reporter." 
 
 In the same paper the value of the above 
 report is evidenced by the following extracts 
 taken from its leading article : — 
 
 "A belief in the cholagogue action of mercury on the 
 " liver is almost universal among medical men and among 
 *• the pubhc at large. In every work on Materia Medica, 
 ** it is assumed as a settled fact that mercury increases 
 " the biliary secretion ; and every lecturer on therapeutics 
 " inculcates it as a well-established truth. For centuries, 
 *' the treatment of diseases of the liver, especially in our 
 " Indian possessions, has had for its chief feature the 
 *' various methods of administering mercury. Even at the 
 *' present day, although the abuse of this drug has been 
 *' decried, its employment is still thought necessary in 
 *' some form or other of hepatic disease. We shall not 
 
APPENDIX. 129 
 
 ^' enter upon the discussion of its merits or demerits — 
 " the wonderful cures which it has effected, according to 
 ^' some ; or the injured health and shattered constitutions 
 ■" which it has produced, according to others. 
 
 " There can be no doubt that the answer to the 
 ■*' question, whether mercury did or did not increase the 
 *' biliary secretion, had become one of paramount impor- 
 ■" tance ; but the inquiry involved labour and difficulties 
 " which few were prepared to encounter. We are proud 
 " to say that a Committee of members of the British 
 *' Medical Association at length undertook the task ; and 
 '* their report " [pre^^ously inserted] '' has definitely deter- 
 " mined that mercury, in whatever manner, dose, or form 
 " it may be administered, has not the slightest influence 
 ■** in increasing the flow of bile from the liver. 
 
 "'If,' says the reporter, 'the refutation of a wide- 
 •*' spread error be as important as the establishment of a 
 •** new truth, the practical advantage of demonstrating 
 " that mercury is not a cholagogue cannot be too highly 
 •*' estimated.' We agree with the remark, however, made 
 *' by Mr. Flower, as President of the Physiological Section 
 ■*' of the British Association last year at Norwich, where 
 *' the Eeport was read : viz., that this is understating the 
 *' value of the result. The refutation of a wide-spread 
 " error of this kind is much more important than the 
 " establishment of a new truth, masmuch as the injury 
 " inflicted by the universal assumption of a false rule of 
 ''medical practice produces injury which it is impossible 
 "to estimate. Whatever opinion, therefore, be held as to 
 " the value of mercurials in hepatic diseases, no one can 
 " doubt that, looking at their powerful effects on the 
 " human frame for good or for evil, the conclusions 
 " involved in the Report, if correct, constitute an immense 
 " gain for medical knowledge. 
 
 " The thanks of the profession are due to Dr. Bennett 
 " and his coadjutors for their labours. The demonstration 
 '' which they have effected, of the fallacy of the commonly 
 
 K 
 
130 APPENDIX. 
 
 " received idea as to the action of mercury on the Uver, is 
 " hkely to be a benefit of no less importance than the 
 *' aboHtion of universal blood-letting in acute inflamma- 
 ** tions — especially in pneumonia. 
 
 '' With a view of exhausting all that had been alleged 
 "concerning the influei>ce of drugs on the liver, the 
 " Committee investigated, in the same careful way, the 
 " action of podophylline and taraxacum ; and clearly show 
 " that these drugs have not, any more than mercury, the 
 " slightest influence as cholagogues. 
 
 ** It is unnecessary to dwell upon the importance of the 
 "results at which the Committee have taken so much 
 " pains to arrive. If the refutation of a wide-spread error 
 "be as important as the establishment of a new truth, 
 " the practical advantage of demonstrating that mercury 
 "is not a cholagogue cannot be too highly estimated. 
 " Although, in recent times, the administration of 
 " mercurials for hepatic diseases has greatly diminished, 
 " their employment is still very general, and in India 
 " almost universal. Eecent cases demonstrate that long- 
 " continued salivation and great loss of health have been 
 " produced in the attempt to remove old abscesses or other 
 *' chronic diseases of this organ, and there are few of its 
 " lesions in which it is still not thought advisable to try 
 " small or full doses of the drug." 
 
 In the Medical Times and Gazette of October 
 the 2nd, 1869, the following remarks are 
 made : — 
 
 "Whatever good effects may be obtained by using 
 " mercury are still facts which no change of theory can 
 '" alter. Modern researches only alter our interpretation 
 " of the facts, and not the facts themselves ; and if 
 
APPENDIX. 131 
 
 *' mercury does not increase the amount of bile secreted 
 " by the Hver, as has been hitherto supposed, but, in 
 *' reahty, diminishes the supply, it foUows that we must 
 " look upon our results from a different point of view, and 
 *' admit that our knowledge of the action of this drug, as 
 *' of most others, is simply empirical." 
 
 After recapitulating the experiments given in 
 the above Eeport, the Medical Times goes on 
 to say :— 
 
 "The Edinburgh Committee appointed by the British 
 " Medical Association consider that these facts show that 
 " mercury has the same action on a dog that it has on 
 *' man. This is an important fact, and it seems to be 
 " warranted by the report. 
 
 ***** 
 
 **It will be sufficient now to point out a few of the 
 *' objections which may be brought against the conclusions 
 " adopted by the Committee. We have already seen that 
 " no valid argument can be raised against observations 
 *' made upon dogs, inasmuch as the symptoms produced 
 " in these animals were very similar to what we meet with 
 ** in man ; ' the only difference that there seems to be 
 ** between the dog and man, as regards the action of 
 *' mercury, consists in the fact that in the dog larger doses 
 *' are generally required to produce the same effects as 
 *' those observed in man.' With many it will be looked 
 " upon as an objection that while these results were 
 " obtained in healthy dogs, we cannot argue that they 
 *' would be the same in disease. This is an argument 
 •* much easier to state than to answer ; but the difficulty 
 ** of replying to it does not strengthen the position of its 
 ** supporters. 
 
 '* When all the known facts of a case are in favour of 
 *' one view, it may easily be argued that similar results 
 
 K 2 
 
132 / , APPENDIX. 
 
 t' would not W obtained in persons in disease ; it is clear, 
 *' however, that the objectors have the more untenable 
 "position, since, although their hypothesis cannot at 
 * • present be refuted, they have actually no facts to warrant 
 *' them the assumption ; while, on the other hand, careful 
 *' observations have been made and a theory framed in 
 *' accordance with the facts. And so it is that as science 
 *' progresses old views, long cherished, have to make way 
 *' for the new, so it is that we have to give up what was 
 *' taught in our youth, to find in our maturer years that 
 " our hypotheses are incorrect. But if this is true in the 
 " case of mercury, what can we say in favour of other 
 *' drugs ? In truth, with all our experience, we know but 
 " little even yet of therapeutics ; hitherto we have made 
 ' ' theories and explained away facts in accordance with the 
 * ' notions we held about their action, and those 
 ** notions were ever changing with the prevailing fashion 
 *' of the day. 
 
 " We have by degrees lost that faith in mercury which 
 *' it was the privilege of our forefathers to possess ; it has 
 " been shown that inflammations and fever can be cured 
 " without it ; some even have ascribed many of the dire effects 
 " of syphilis to its use. Still there remained a belief with 
 *' many that it had some influence on the hepatic secretion. 
 " Even this last hope seems vanishing, and we may soon 
 *' come to the conclusion that its only use in doses short of 
 " salivating is to purge ; for this purpose a more harmless 
 *' drug may perhaps be substituted. 
 
 a There is one advantage which comes from the 
 " scientific work of the present day. In upsetting old 
 ''theories, it paves the way for new ones; it does this, 
 *' too, by more accurately recording facts, and so making 
 *' the new views more nearly approximate to truth. It is 
 ' ' better to have no theories at all than to cherish 
 *' erroneous ones : it is better still that men should doubt, 
 *' if in the end they are led from scepticism to belief." 
 
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