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

by Johann Doläus; William Stephens

All the Parts of Animals and Vegetables are composed of Substances volatile and fixed, fluid and solid, as appears by their Analysis; and so are Salts and Minerals, so far as Chymists have been hitherto able to examine their Composition.

Sir Isaac Newton’s Opt. p. 350, 360.

It is very well known in the History of Physick, that very great Changes have been brought about in the human Body by the Force of Diet, especially in chronical Cases, where the Application of Medicines hath proved ineffectual. Chronical Distempers, as they are longer in coming to their Period, so they occasion a more universal bad Habit of Body; and where there is a pretty universal Depravation either of the Solids or Fluids of a human Body, or of both, it is not to be expected that sudden Changes can happen to Advantage: As the Progress is slow, and the Changes from a good to a bad State imperceptible, and by Degrees, the Changes to a good State must be so too. In acute Diseases indeed Medicines are more immediately necessary, because the Changes being quick and violent, immediate and sometimes violent Remedies become necessary; there being no Time to wait the slow and ordinary, tho’ more certain, Methods of Change by the Alimentary Powers.

The Gout, of all chronical Distempers, requires least the Application of violent or uncertain Remedies: Tho’ its pain be very intense, it comes very slow to its Period: Generally it is many Years, or the imprudent Application of Medicines, that brings it into the noble Parts, so as to endanger Life; purging by the Bowels hath frequently brought it into the Stomach; external Applications of repellent Plaisters have drove it into the Head; Applications of Mercurial Plaisters have brought on Paralytick Disorders: As we are not certainly acquainted with the particular Nature of the Gouty Matter, it is uncertain how to apply. That there is somewhat in the Part, not natural to the Body, which occasions the Pain, we know; what it is particularly we know not; the common Method of Nature is to evacuate it by the Pores of the Skin at certain Seasons, which requires the Part to be kept warm, and to attend upon the Operations of Nature for Relief; this, and the Uncertainty of Medicinal Applications, have brought Patience and Flannel to be Proverbial to the Gout.

Since the Cure of the Gout doth not with Safety admit the Application of sudden or violent Remedies, nor the Nature thereof require them; Physicians have, with very great Prudence, turned their Thoughts to other Methods of Cure; for this End, it was very proper to consider the Gout as the Distemper of the Rich and the Lazy, that it flows chiefly from Idleness and Fulness of Bread; that Persons afflicted therewith have naturally keen Appetites, and are apt to indulge in larger Quantities and cruder Kinds of Food, than the digestive Powers are able to deal with; that it chiefly happens to sedentary People; that upon the Approach of a Fit of the Gout, and during the Paroxysm, there are evident Marks of Indigestion in the Stomach and Bowels. If we add hereto the actual Relief that many Persons have found in the Use of a proper Diet, we shall not be at a Loss for a Reason, why Physicians should expect to find a more certain and easy Method of Cure in the Gout by Diet, than by any other Means.

It is not my Design at present to enter into the particular History of the Gout; this is very well known, and so accurately described by Dr. Sydenham, that it is needless; nor to enter into any long Detail of the History of the Alimentary Powers; this is likewise sufficiently known; nor to raise any Altercations about the particular Quality of the Gouty Matter, which is unknown, neither would the Knowledge thereof be much to my present Purpose. It will suffice to examine with Accuracy the Nature of Animal and Vegetable Diet, and the Habits they produce in the human Body, and to apply this to the Nature and Symptoms of the Gout.

The Knowledge of the particular Quality of the Gouty Matter is not absolutely necessary to our present Purpose; it is sufficient if it be made to appear, that the whole Habit of the Body may be changed by Diet. An Animal is entirely composed of the Food it is nourished by, the first Stamen, or Principle of Life, is most exceedingly small; and all that it afterwards receives its Growth from, may properly enough be called its Food: In oviparous Animals, and the same happens in viviparous ones, (tho’ it be not so much within the Compass of our Observation) the first Nourishment is the White of the Egg, a Fluid very analogous to the Serum of the Blood, and the Subject of the Encrease is originally so small as almost to escape the strictest Enquiry.

Many, if not most Authors, who have entered into the particular Quality of the Gouty Matter, have placed it in an acrimonious acid Salt, and upon that Scheme have gone into the Method of a Milk and Vegetable Diet for the Cure. The Cure upon this Scheme seems to me not very rational, because Milk and Vegetables in their natural State tend to Acidity; and the Chalky Substance of the Gout and Stone in the Bladder (which are pretty near akin) are soluble only by Aqua fortis, which is the strongest Acid. The Digestion of Animal Food, which is found to encourage, if not occasion the Gout, naturally tends to Alcalescence; and therefore there is more Reason to conclude the Gouty Matter to be Alkaline than Acid; but the Truth is, there are no evident Marks of either Acid or Alkali in the Animal Juices of an healthy Body, nor of any other Salt but Sea Salt, which is taken in with the Food, and as it is incapable of Change, passes thro’ the Vessels of the Body. There is indeed an Acidity discoverable in the Bowels and lacteal Vessels, which is doubtless owing to the acid Food, for it doth not change its Nature, till it be thoroughly assimilated with the Blood in several Circulations; for even in the Chyle an Acid is sometimes discoverable: This Acid is lost in the Milk, which is but one Change farther, tho’ even in this it is evident there is some Tendency that Way, because of its Disposition to turn sowre by standing. As there is doubtless Air in the Blood, there must be somewhat Nitrous, because there is no Air without Nitre, and Nitre is an Acid, but cannot come within Imagination of occasioning the Gout. That the Gout should consist in an Acid, and be curable by acessent Aliment, the Gouty Chalk dissolved only by Acids, and the Aliment that occasions it alkalescent, would be very strange. On the contrary, there is as strong Evidence that the Gouty Matter is not perfect Alkali, neither is there any such Thing in the Juices of an healthy Body; for tho’ Animal Juices naturally tend to Alkalescence, they putrify before they arrive at that State, so as to be incapable of Circulation: The Disposition of Animal Juices this Way is so strong, that if they were not continually diluted by fresh Portions of Chyle, they would arrive at that putrescent Alkaline State that would destroy the Animal, as is evident in the Case of Animals starved to Death. Twenty Days Fasting will not diminish the Quantity of the Blood so much as a large Bleeding, and in some Kinds of Consumptions the Diminution of the Solids and Fluids is much greater than could happen by being starved; but in the Case before us, the Juices turning Alkaline and Corrosive affect the tender Fibres of the Brain, and the Animal dies feverish and delirious: On the contrary, People have lived above twenty four Days upon Water only, which can happen no otherwise than by diluting the Fluids, and consequently keeping them from this Alkaline State. In short, if the Juices of an Animal Body were either Acid or Alkaline, so as to cause an Ebullition by Mixture of their Opposites, they would burst the Vessels.

I shall consider Vegetable Substances with regard to Diet, in the first Place, because they are the Original Food of all Animals, who either immediately are nourished thereby, or else feed upon such Animals as are nourished by them.