In the same way a rational physician would advise a person recovering from gout, to abstain totally and entirely from the course of life which brought it on; and this being complied with, we might venture to predict, with as much certainty in the one case as in the other, that he would in future escape it.
What I have frequently endeavoured to inculcate in the course of these lectures, always appears to me of the utmost importance: I mean, the general diffusion of physiological knowledge, or a knowledge of the human frame; this knowledge ought to form a part of general education, and is, in my opinion, as necessary for a person to learn as writing, or accounts, or any other branch of education; for if it is necessary that a young man should learn these, that he may be able to take care of his affairs, it surely can be no less necessary, that he should learn to take care of his health; for to enjoy good health, as a celebrated practical philosopher observes, is better than to command the world.
If knowledge of this kind were generally diffused, people would cease to imagine that the human constitution was so badly contrived, that a state of general health could be overset by every trifle; for instance, by a little cold; or that the recovery of it lay concealed in a few drops, or a pill. Did they better understand the nature of chronic diseases, and the causes which produce them, they could not be so unreasonable as to think, that they might live as they chose with impunity; or did they know any thing of medicine, they would soon be convinced, that though fits of pain have been relieved, and sickness cured, for a time, the reestablishment of health depends on very different powers and principles. Those who are acquainted with the nature and functions of the living body, well know, that health is not to be established by drugs; but that if it can be restored, it must be by nicely adjusting the action of the exciting powers to the state of the constitution, and the excitability; and thus gently and gradually calling forth the powers of the body to act for themselves. And though I believe that most general diseases will admit of a cure, yet I am confident, that no invalid was ever made a healthy man by the mere power of drugs. If this is a truth, should it not be universally known? If it were, there would undoubtedly be an end of quackery, for all quack medicines, from the balm of Gilead, to the botanical syrup, are supposed to cure diseases, or at least asserted to do so, in this mysterious manner.
Dr. Cullen, in his Nosology, gives us the following definition of the gout.
"Morbus haereditarius, oriens sine causa externa evidente; sed praeeunte plerumque ventriculi affectione insolita; pyrexia; dolor ad articulum, et plerumque pedis pollici, certe pedum et manuum juncturis, potissimum infestus; per intervalla revertens, et saepe cum ventriculi et internarum partium affectionibus alternans."
Now, though this definition comprises a tolerably good general character of the disease, it contains some notions, depending on the prejudice of hypothesis, which, on a careful examination, ought not, I think, to be admitted.
In the first place, I would deny, that the gout, considered as a diseased state of the system, is hereditary. This may perhaps excite some degree of surprise; and, "I had it from my father," is in the mouth of a great majority of gouty patients.
If the diseased state of the system, which occurs in gout, were hereditary, it would necessarily be transmitted from father to son; and no man, whose father had it, could possibly be free from it. There are, however, many instances to the contrary. Our parents undoubtedly give us constitutions similar to their own, and there is no doubt, that if we live in the same manner in which they did, we shall have the same diseases. This, however, by no means proves the disease to be hereditary.
We shall hereafter see, that the gout is a disease of indirect debility, brought on by a long continued use of high seasoned food and fermented liquors. There is no doubt that particular constitutions are more liable to be affected by this mode of living than others; and if my father's constitution be such, I, who probably resemble him in constitution, shall in all probability be like him, subject to the gout, provided I live in the same way; this however by no means proves the disease to be hereditary. The sons of the rich, indeed, who succeed to their fathers estate, generally succeed also to his gout, while those who are excluded from the former, are also exempted from the latter, and for very obvious reasons, unless they acquire it by their own merit.
So that though the son of a gouty parent may have a constitution predisposing to the gout; that is, more liable to be affected by causes, which produce this disease, still, if he regulate the stimuli to the state of his excitability, he will remain exempt from it.