swelling and redness will
take place, and an asthenic inflammation, produced in the way which I
fully pointed out in the last lecture, will be established. Hence the
pain, and other symptoms, which accompany a fit of the gout. Hence
likewise we see, why debilitating powers applied to the part will not
reduce the inflammation; and why a warmth, which aggravates every
really sthenic inflammatory affection, is so comfortable in this.

Almost any debilitating cause, when the system has been brought by
intemperance to the torpid state, which I have described, will bring
on a fit of the gout, but nothing more certainly than cold or
moisture: hence if a person have his feet chilled or wet, he will be
almost certain to have an attack.

Hence we see that the asthenic inflammation is not the disease, but
merely a symptom of it; and like other symptoms, fallacious in its
appearance; the disease is a state of indirect debility, to which our
attention ought to be directed.

When this inflammation is violent, and accompanied with great pain,
after several hours continuance, it excites the action of the minute
vessels, enables them to propel the blood, by which they are morbidly
distended, and restores the balance between the resisting and the
propelling force; and thus the inflammatory appearances will for a
time subside, but the torpor of the whole system remaining, and the
debility of the vessels returning, when their excitement, which was
the consequence of their action, has ceased, another asthenic
inflammation will take place, which will again cure itself as before;
so that during a paroxysm, several remissions will take place, as was
mentioned in the description of the disease. As, during the paroxysm,
the pain causes a considerable degree of excitement over the whole
system, the action of the stomach and other parts is roused by it;
during the fit likewise, little nutriment is taken, so that by the
action of the stomach and bowels, they get rid of their load; rest
likewise assists to accumulate the excitability, so that from all
these causes together, the body becomes restored to a state of
vigour, which, compared with its former torpidity, makes the patient
imagine that this friendly disease has restored him to a state of
unusual health, and even renovated the powers of his constitution.
Under this mistaken idea, he does not, when the fit leaves him,
abandon the mode of life, which brought on the disease; highly
seasoned