III. I come now to mention the remedies which are proper in that state of the gout in which a feeble morbid action takes place in the blood-vessels and viscera.
I shall begin this head, by remarking, that this state of the gout is often created, like the typhus state of fever, by the neglect, or too scanty use of evacuations in its first stage. When the prejudices which now prevent the adoption of those remedies in their proper time, are removed, we shall hear but little of the low state of the arthritic fever, nor of the numerous diseases from obstruction which are produced by the blood-vessels disorganizing the viscera, by repeated and violent attacks of the disease.
To determine the character of a paroxysm of gout and the remedies proper to relieve it, the climate, the season of the year, the constitution of the atmosphere, and the nature of the prevailing epidemic, should be carefully attended to by a physician. But his principal dependence should be placed upon the state of the pulse. If it do not discover the marks which indicate bleeding formerly referred to, but is weak, quick, and soft, the remedies should be such as are calculated to produce a more vigorous, and equable action in the blood-vessels and viscera. They are,
1. Opium. It should at first be given in small doses, and afterwards increased, as circumstances may require.
2. Madeira or Sherry wine alone, or diluted with water, or in the form of whey, or rendered more cordial by having any agreeable spice infused in it. It may be given cold or warm, according to the taste of the patient, or the state of his stomach. If this medicine be rejected in all the above forms,
3. Porter should be given. It is often retained when no other liquor will lie upon the stomach. I think I once saved the life of Mr. Nesbit by this medicine. It checked a vomiting, from the gout, which seemed to be the last symptom of his departing life. If porter fail of giving relief,
4. Ardent spirits should be given, either alone, or in the form of grog, or toddy. Cases have occurred in which a pint of brandy has been taken in the course of an hour with advantage. Great benefit has sometimes been found from Dr. Warner's tincture, in this state of the gout. As these observations may fall into the hands of persons who may not have access to Dr. Warner's book, I shall here insert the receipt for preparing it.
Of raisins, sliced and stoned, half a pound.
Rhubarb, one ounce.
Sena, two drachms.