Dolæus upon the cure of the gout by milk-diet / To which is prefixed, an essay upon diet

by Johann Doläus; William Stephens

SECT. 2.

These Things premised, I shall next examine how it comes to pass that Milk is endued with this mighty Power; but it is necessary first to enquire concerning the genuine Cause of the Gout. All the Symptoms testify the first and nearest Cause to be some viscid, sharp Liquor, endued with some acid or lixivial corrosive Salt, more or less fixed; this Salt indeed occasions such a singular smart Pain, that it seems to be specifick. I think it not only acid, but also somewhat austere, from the different earthy, cheesy Particles it contains. Hence it fixes its sharp stiff Points in the Membranes, Tendons and Nerves, and more readily thickens and coagulates the lymphatick Juices. Where and how this Liquor that causes the Gout is generated, I shall explain in a few Words. First then the Stomach and Bowels, whether from too great an use of Wine or Women, or from too sedentary a Life, and want of due Exercise, or from the particular Disposition of the stomachick Juices, or from bad Diet, become so affected, that by Degrees the Digestion or Dissolution of the Food is lessened; the Chyle thence produced, becomes more thick and viscid than formerly; so that this Chyle, thus delivered into the Blood, renders its Mass thicker, and of Consequence the several Secretions of the Humours, as the Lymph, animal Spirits, the mucilaginous Juices about the Joints are more slowly performed; thus the Stomach and Bowels become more tainted, the stomachick Juices and those separated by the Glands of the Intestines become more viscid, and the Difficulty of Digestion is increased; Part of the Food turns to Flatulency, and viscid sharp Slime in the Bowels; Part of the Chyle becomes infected with a corrosive acid Salt thence produced, and being again thrown into the Blood, the Lymph and other Juices become infected with the same acid Salt, which gives Birth to many Distempers. It is observable these viscid Juices, thus stopped in their Progress, and infected with this noxious Salt, so as to be more liable to an intestine than a progressive Motion, are the most subject to Corruption of any in the Body, and to contract a Thickness, and Inaptitude to Motion. Such an Humour is the Lymph, and more especially the mucilaginous Juice separated in the Glands of the Joints, in order to keep them moist and smooth for Motion. If therefore a sufficient Quantity of these acid Salts be brought into the Mass of the Blood, or the Humours impregnated with them, be lodged about the nervous or tendinous Membranes, and there acquire so extraordinary a Tenacity or Sharpness, as to be coagulated, the Gout thence arises, as is evident both from Reason and Experience. That this may more evidently appear, I shall next explain the Figure, Situation and Structure of these Glands.

SECT. 3.

These Glands, as described by Dr. Havers in his new Osteology, and as they discover themselves upon Dissection, are of two Kinds; some are small and thickly interspersed in the Membranes of the Joints, and with very few Exceptions of an equal Bigness, so as to render the Membrane perfectly Glandulous: In some Parts of the Membrane, in the Joints, and in the Furrows of the Bone, these Glands are so united as to form very remarkable and large conglomerate Glands. In some of the large Joints there is but one, as in the Hip Joint; in others, as in the Knee, four or five; they are of a red Colour, which is communicated from the blood Vessels; as to their Substance, soft and papillary, tho’ not tender and friable; they are in their Structure Conglomerate, consisting of divers Membranes, wove one within another, interspersed with small round Vesicles, which are not only contiguous, but adhere closely one to another, as the Membranes also do. By the Pores of these little Vesicles a mucilaginous Liquor is strained and secerned from the general Mass of the arterial Blood, and thence by the excretory Duct, with which all these Glands are furnished, is shed into the Interstices of all the Joints.

SECT. 4.

These Glands have a sufficient Number of blood Vessels, they dont come out of them in right Lines, but are observed to have many Convolutions, Windings, and Insertions; there seems to be a very particular Reason, from the Nature of the Liquor to be separated, for this Obliquity of the blood Vessels; for since that Liquor is to be viscid and mucilaginous, its Parts should proceed slowly, and not without Difficulty, through the glandulary Pores; and therefore the Vessels are contorted in the Manner we see, that the Motion of the Blood may be retarded, and more Time and Leizure given, both for the separating Particles of such a Nature, and for their Admission through the Pores of the Glands.

SECT. 5.

These Glands are of different Shapes, so as to fit the Furrows and Cavities where they are placed; some are long, others conical, broad at their Base and grow narrow towards the Top, so as to terminate in an Edge; some have a broad Base, and rise into a sort of Cone; some are like little Ridges; some like Fringe; some are broad and pretty flat.

SECT. 6.

As to their Situation, they are differently seated in the several Joints; in some they stand over-against the very Interstice of the Bones, and run in a little way between them, where the Ends of the Bones towards that Side are not contiguous, but so formed as in their Conjunction to make an Interstice, and these are commonly in the Manner of a Fringe; some are seated in some Sinus or Cavity, others planted upon the Membrane, which immediately covers the Articulation: In general they are so seated, that they cannot be injured by a Compression from the Bones; and yet there is this Contrivance, that the Bone does, either in the Inflexion or Extension of the Joint, lightly press upon them, so as to promote the Excretion of the Humour, which they separate into the Joints, when they are moved and stand most in need of it; and by this Means it seems to be most plentifully supplied, when there is occasion for the greatest Quantity of it, and to be proportioned to the present Exigence, according to the State of Rest, or the several Degrees of Motion in the Part when it is moved. And it is no small Security to these Glands, against the Obstructions which the mucilaginous Quality of the Liquor that they separate does naturally dispose them to, that they are solicited, and the Liquor expressed out of them by the Motion of the Parts where they are seated: The same sort of Glands are placed about the common Membrane of the Muscles, and about the Tendons.