In the foregoing Letter are contained many useful Observations about the Use of Milk, and its wonderful Efficacy in the Cure of the Gout, from uncontestable Facts, in the Account of the Persons there named. I shall next lay down the Method of this Diet, by which many Persons here at Cassell were relieved. Whoever expects Benefit by this Method, must observe the following Rules. No one ought to go into this Diet without having his Body duly prepared; he must take Care by Degrees to change his Habit, and for the first Month to regulate his Diet, by strictly avoiding all Salt or smoaked Meats; Legumes, and stale, acid or feculent Liquors, and to eat white Meats sparingly, with clear small Drink, as small Beer or Barley Water, or Decoctions of the Woods: A Glass of Moselle or French Wine free from Acidity, may be allowed at Dinner, and Gruels and Broths made of white Meats. There is a necessary Caution to be used, that both in Meat and Drink, the Quantity taken be rather within the Appetite than beyond it; for from overloading the digestive Powers, arise Crudities, Flatulencies, and acid Humours, which are the Origine of many Disorders. Upon this Account it is necessary to purge the Bowels, two or three Times a Month, with Tincture of Jalap, Elixir Proprietatis, Rhubarb, some of the purging Pills, as the Arthritick or Mastich Pills; that the Viscidity arising from indigestions may be carried forth of the Bowels, and the Stomach be better disposed to receive and digest the Milk. I am of Opinion, the first Dose should be taken the first Day of the Month, preparatory to this Diet, the second after some few Weeks of this first Regimen, and the third the last Day of the Month; after this I advice the taking an Ounce of Crabs-Eyes, or prepared calcined Hartshorn, especially if there yet remains any Marks of Acidity in the first Passages. This further Caution is very absolutely Necessary, that not only in the first Month, but in all subsequent, all Passion, chiefly Anger and Grief be avoided, because of their pernicious Consequences; more especially the Use of Women during the whole Year.

SECT. 2.

All those who have other Distempers complicated with the Gout, as the Scurvy, Leprosy, bad Habit of Body, Stone or Gravel, Hystericks, the Pox, or other Distemper arising from the Impurity of the Blood, too great a viscidity or acrimony of the Juices, or a known or latent Acid in the Blood, are first to use Absorbent, Diuretick, Sweetening or other Medicines, proper to their particular Distempers, till the Acrimony or Tenacity of the Blood and Humours be corrected, the Acid expelled, and such complicated Disorders overcome, and then apply this noble Remedy of a Milk-Diet to the Cure of the Gout alone, from which they may certainly promise themselves Success: But if while the Body is ill prepared, or full of vitiated Juices, the Milk-Diet should be preposterously brought into Use, they will not only be disappointed in their hopes of Relief, but bring certain Destruction, and Increase of their Disorders; as actually happened to the Count de Perlebourgh, and a Lubech Consul in this Neighbourhood, who having a Complication of Distempers, made an improper Trial of a Milk-Diet.

SECT. 3.

The Milk in which the Cure of the Gout consists, ought to be excellent in its Kind; the Animal from whence it is taken, as described by Waldsmid, should be an Heifer, or Cow of a middle Age, of a good Habit, either of Red or a Black Colour, (though this need not so strictly be minded) neither fat nor lean, nor pregnant, and kept separate from the Bull: In Winter fed upon good Hay, Barley, Bran or Straw; in Summer at good Grass, and led in a Collar like an Horse. If any one can keep a Cow for their own Use, it is best, and they may more safely rely upon help from it; but if not, the Milk as the Milkmen sell it will do; taking Care however that the Cow be of a good Habit, well fed, and not too old.

SECT. 4.

As to the Quality and Quantity of the Milk, it is to be observed, that as soon as it is milked it should be warmed, but not so as to boil it. Let the Vessel full of Milk be put into boiling Water, and when it is so hot as to be conveniently supped, or at least so warm as when it came from the Cow, let it be taken after the Manner of Tea or Coffee. The Times of taking ought to be, two Pints in the Morning, some four or Five Hours before Dinner, as much about Noon, and as much about Seven in the Evening; but the Quantity cannot be exactly determined, because the Weakness or Strength of the Stomach must give a Rule in this Case; or let so much be taken as the Stomach can bear without Inconvenience, and the Patient may increase the Quantity daily till he comes to about forty Ounces. If the Stomach be weak, he may take it in a smaller Quantity, four or five Times a Day; if four Times, let two of them serve for Dinner and Supper, with some of the finest wheaten Bread; and a Draught of Milk may be repeated every four Hours; if the Milk be taken at five Times, it may be so ordered as to let three Hours intervene; those who are of more robust Constitutions, may be content with three Meals of Milk a Day; and it will not be amiss to take every Morning a Dose of Crabs-Eyes, or some other absorbent Powder: I usually take about twelve or fourteen Ounces of Milk in the Morning, Twenty four Ounces with Wheat Bread at Noon, and about Twenty Ounces at Night, half with Bread, and the other half drank as common Drink. Some allow the Use of white Meats at Dinner, lessening the Quantities by Degrees, and making up the Deficiencies by Food of Milk and Eggs, so that by Degrees the Milk and Eggs are entirely substituted in the Place of the Flesh Meat, and then by diminishing the Eggs daily, Milk becomes entirely substituted for other Food: This Method seems to me, entirely agreeable to tender Constitutions, and such as dont well bear sudden Changes. Some who have strictly adhered to Milk for fourteen Weeks, have indulged in the Use of poached Eggs without Salt, Barley boiled in Milk, fresh Butter without Salt, Custard and other Milk Foods; and in Summer, some Kinds of Fruits, as Strawberries, Peaches, &c. tho’ in my Judgment improperly, especially such Fruits as are cold, or seem to have a latent Acid, or such as weaken the Bowels. On this Head it may be observed in general, that the less whatever be used for Food differs in its Nature from Milk, it may be more freely ventured upon in the Milk-Diet; but the Prudence and Care of the Physician is to be relied on, according to the Diversity of Circumstances that may happen in different Constitutions.

SECT. 5.

This Diet ought to be so long continued, until the whole gouty Matter be discharged forth of the Body, which is to be computed by the Degree and Length of the Distemper, and Observations upon the Cure in others. The longer it is continued, the more perfect Cure is to be expected; those that are over-run with the Distemper, are always to use it, others for an Year, and others for an Year and an half; some Persons who have, upon continuing it only for half an Year, thought themselves perfectly cured, and have returned too soon to their former Method of living, have so far exceeded, as to be seized again with the Gout, but returning to the Diet, have been cured; some more prudent, have continued the Diet for an Year, and then returned to their ordinary Manner of living by Degrees, always taking about sixteen Ounces or a Pint of Milk every Morning, and have thus for many Years been free. The best Time of Beginning the Diet is in the Spring, and that from the Beginning of May, to the End of April in the succeeding Year.

SECT. 6.

Some have in the Continuance of this Diet been seized with Oppressions and Difficulty of Breathing, Weakness in their Limbs, Coughs and Phlegm; but these Symptoms either vanish of themselves, or quickly give way to Elixir Proprietatis without an Acid, Spirit of Hartshorn succinated, Sal volatile oleosum, or any of the more fixed absorbent alkaline Medicines.

SECT. 7.

For those who are oppressed with an abundance of Humours, whose Bowels are full of Flatulencies, or are constipated, let them once in every Month or Six Weeks take a gentle Purge of Rhubarb, or of the Arthritick Pills, or half a Scruple of Pill Ruffi, or of Sylvius his Gum Pills: But if the Body be open, and the Milk passes too quickly through, it may suffice to take twenty Grains of Rhubarb; or if the Body be bound, take twenty Grains of Rhubarb in the first Draught of Milk, drinking the rest of the Quantity after it, or else in the Evening take twenty Drops of the Essence of Rhubarb with the Milk, and repeat it as often as there may be Occasion; but for the general, if it can be conveniently done, the purging Medicines should be used in the Decrease of the Moon.

SECT. 8.

If the Milk should occasion a Looseness, let it boil before it is used, adding a Grain of Salt and so supping it hot; if it do not succeed the first Time, try it a second Time, and a third; but if it doth not do then, take a Dose of Crabs-Eyes, Unicornu fossile, or Terra sigillata.

SECT. 9.

If the Milk should heat the Body, let a third Part of Barley Water, made with Raisins, be added to it; or if it occasion Thirst at any Time, Barley Water with Raisins; or in case of a Cough, the pectoral Decoction may be used between the Intervals of using the Milk.

SECT. 10.

If the Stomach be weakened by the Use of the Milk, the Patient may be allowed Sugar Biscuits, sopped in Spanish, Italian or Burgundy Wine, or any other that is neither Acid nor Foul; and if necessary, even a Glass of those Wines: Thus the Stomach will be fortified, and more easily perform its Office; if there should be a Necessity for it, some of the warm aromatic Powders may be brought into Use.

SECT. 11.

After this Diet hath been used twelve or fourteen Months, the Patient may begin to use Flesh Meats of easy Digestion, avoiding sharp, acid or salt Meats, but using such as we mentioned before, drinking Milk still, or small Beer well wrought, neither stale nor turbid.

SECT. 12.

The Cure being thus absolutely finished, it will be still necessary to take every Morning a Pint of warm Milk, and to be constantly cautious about your Diet, avoiding every thing acid or sharp.

SECT. 13.

To prevent the Milk from cruddling, some Sugar may be mixed with it, or even a little Salt, thus the Acid is prevented from gathering; but this should be done but seldom, and upon the most urgent Necessity.

SECT. 14.

Though there should not follow an immediate or sensible Change upon the Use of the Milk for some Time, yet the Patient ought not to be disheartned; for if these Rules be strictly observed, and the Patient be otherwise in a good Habit, the Pains will vanish by Degrees, and a due Strength and Tone return to the Limbs.

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