There are few diseases however in which the excitement is equally increased or diminished over the body; some part being generally more affected than the rest; and this inequality produces the various phenomena or forms of disease; indeed no disease but increase or diminution of strength would take place, on the supposition that an equal increase or diminution of excitement all over the body, were produced by the hurtful powers causing the disease.
From what has been said, it necessarily follows, that every stimulus will not be equally efficacious in curing every form of disease; which is sufficiently confirmed by experience. Hence there may be some ground for the appellation of specifics, as some medicines may act more powerfully upon the part which is the principal seat of the disease, than others do.
In the cure of diseases we ought always to attend to two things most carefully: first, to employ the proper kinds of powers, and then not to overdo them, so as to convert either diathesis into the other; and by passing over the line of health, instead of the intended cure, to substitute one disease instead of another, and thereby bring life itself into danger.
LECTURE XIII. ON THE GOUT.
There is no disease, with which the human race is afflicted, whose nature has been more mistaken than that which is to form the subject of our present consideration. It has been regarded by most practitioners as a salutary effort of the body to expel some hurtful cause, and restore health; and therefore has been looked upon as desirable to the patient. To attempt to cure it, therefore, would have been wrong, had it been curable; but it has likewise been looked upon as beyond the reach of medicine, or perfectly incurable; and, on both these accounts, after having tried a variety of drugs, without any good effect, the physicians have at last abandoned their patients, to the care of patience and flannel, which, if the constitution be not very much shattered, will often see them through the disease.
But that it is a salutary disease I deny; and I affirm, that it restores health in no other way, than the indigestion of a habitual dram drinker would be relieved by a disease in the throat, which would, for a time, prevent his swallowing any more liquor; the consequence would be, that his digestive powers would recover their tone, and he would, after a few weeks, feel himself better.
In the same way the pain and fever, which attend gout, and at the same time the inability to move, with the weakened stomach, and bad appetite, prevent the continuance of the mode of life which brought on the disease; and thus, a truce being obtained, the exhausted excitability of the body is allowed to accumulate, and the constitution, of course, feels itself renovated.
Were the disease to be viewed in this light, it is probable that many patients might in future desist from their former mode of life, which brought on the disease; and we might venture to promise them, if they did, that they would have no return of the complaint. But the misfortune is, they think the gout has restored their constitution, and that therefore they may return to their old mode of living with impunity; in consequence of which, after a few months more, the excitability is again exhausted; symptoms of indigestion come on, and the stimulant mode of living is increased, with a view to bring on the disease, which is to cure these symptoms. In this way, each time, a greater and greater degree of indirect debility is induced, and at last the system becomes so enfeebled, that the asthenic inflammation is not confined to the extremities, but attacks the head, the stomach, the lungs, and often puts a period to the existence of the patient, which has for some time been miserable.
Besides, the idea, that the gout is incurable, is a false, and a very dangerous doctrine; this is very far from being the case, and I am firmly persuaded, not only from the nature of the disease, but from experience, that it may always be cured, if taken in time, and proper directions be followed. If, by the cure of gout be meant the administration of some pill, some powder, or some potion, which shall drive away the complaint, I firmly believe, that it never was, nor ever will be cured. Indeed, it is astonishing that such an idea should have ever entered the mind of any person, who has any knowledge of nature, or particularly of the human frame; for, if the gout is a disease of indirect debility, and the effect of intemperance, as will be shown by and by, then a medicine to cure it must be something to enable a man to bear the daily effects of intemperance, during his future life, unhurt by the gout, or any other disease; that is, it must be something given now, that will take away the effects of a future cause; as well might a medicine be given to prevent a man breaking his leg, or his arm, seven years hence.
But no rational physician, or surgeon, would give a medicine with this view, in such a case as I have supposed; on the contrary, he would caution his patient against mounting precipices, scaling walls, or bringing himself again into a situation, such as produced the accident; and if he took his advice, he would, in all probability, escape a broken limb in future.