21 Rules in the Treatment of Arthritis
Out of Wirtzung's General Practice of Physick (1654)
Transcribed, amended and edited by Adam Tate
Transcribed, amended and edited by Adam Tate
Note that in the following text, ‘Gout’ refers to Arthritic diseases in general, and ‘Meat’ refers to Food in general.
Some general things useful for Gout [Arthritis]
1. Confected Quinces
2. Syrup and Electuary of Quince (without Spices if there is heat)
3. Marmalade
4. Wines of Rosemary, Sage, Wormwood and Clary Sage.
17 Rules to Prevent and Treat Arthritis
1. ‘For as much as the Gout, Arthritis, Podagra, and such like, appear most of all in Harvest [Autumn], by reason of the fruit eaten the whole Summer, therefore must all fruits be eschewed [avoided]’.
Comment:
This clearly demonstrates the idea that damp foods must be avoided to prevent the feeding of Damp diseases. Chinese Medicine likewise places great emphasis on avoiding Damp foods such as sweet, fresh fruit in Damp diseases such as Arthritis and Rheumatism. This agrees 100% with TCM and Ayurveda.
2. ‘Secondly, for as much as venery [sexual intercourse] is so hurtful for this disease, and increases it very much, the same is to be refrained as much as it is possible’.
Comment:
Sex weakens the Kidney energy, and Kidney deficiency is generally a contributing factor in chronic Arthritis and Rheumatism, especially in the aged and those with degenerative changes.
3. ‘Thirdly, a quiet idle life, and sleep by day time do hinder that superfluity cannot be consumed. To the contrary, too great stirring and exercise, whereby the members are over-heated, are also oftentimes the cause of this pain of the members; therefore is the same as much as is possible to be eschewed [avoided]’.
Comment:
Idleness weakens circulation and metabolism, thereby increasing the disease. Likewise over use of the joints causes inflammation and aggravates the disease
4. ‘Fourthly, all Wine, and especially strong wine is very hurtful for all them that be plagued with the Gout’.
5. ‘Fifthly, all rioting and drunkenness make bad digestion, whereby also the pain of the Gout [Arthritis] is augmented’.
6. ‘Sixthly, they that be hot of nature, and addicted to the Gout, are to refrain from all phlegmatic meat which is dressed with sundry things, and also from all meat which does make Choler [Bile] and Blood, for that when these two humors come together, then do they bring gross and undigested defluxions in the Joints, whereof the Gout is caused’.
Comment:
This refers to the breeding of Damp-Heat which feeds arthritic diseases of a hot nature.
7. ‘Seventhly, there be some through purging and letting of Blood that are freed from this disease, which may most commodiously be done in the Spring of the year’.
Comment:
Those with excess conditions, or excess of Heat and Bile can be relieved by purging and bleeding. And this is most effective in Spring because the Dampness that accumulates over Winter is activated and aggravated at this time.
8. ‘Eighthly, the air [wind] hurts them much that be troubled with the Gout’.
Comment:
Arthritic diseases come from Wind and Damp. Avoiding both these factors and aiming to reduce them is essential to relieve the disease. TCM teaches that Wind exposure can aggravate or induce arthritic and rheumatic pain.
9. ‘Ninthly, all great gross fishes, and especially Eels be hurtful for the Gout’.
Comment:
Fish in general, and Eel in particular, breed Damp and Phlegmatic humors.
10. ‘Tenthly, suckling pigs, all water Fowls and old Hens are especially hurtful to the lower members’.
Comment:
These foods are also Damp or hard of digestion.
11. ‘Eleventhly, milk and wine eaten together be very noisome for all members, and very hurtful for the head’.
12. ‘Twelfthly, the drink which is taken without thirst brings much hurt to the body’.
Comment:
Despite the fact that people are regularly told to drink 2 liters of water daily in modern times, drinking water, especially cold water, was usually stated to be unhealthy. This is still seen in Chinese society where cold water is rarely taken, but hot drinks and teas are taken in preference. Here it states that drinking when not thirsty is bad as it will increase cold and damp humors.
13. ‘Thirteenthly, like as great surfeiting with meat [eating excessively] is very hurtful for all the joints, even so does a moderate diet refresh them’.
Comment:
Eating in excess breeds Dampness, whereas eating moderately helps assure all food taken is properly digested.
14. ‘Fourteenthly, the going too much, or weary walking, and hanging down of the legs, especially presently after meat [food], is very hurtful for the joints’.
Comment:
Walking straight after food liberates Dampness and especially collects in the legs and lower body. And old German saying goes something like ‘Rest after Food, or Walk 1000 paces’. In this case, resting helps proper digestion, but a good walk after food can ensure that circulation is is increase and digestion is enhanced. Nevertheless, in arthritic disease, resting after a light meal is best.
15. ‘Fifteenthly, to lie upon the back is also hurtful’.
16. ‘Sixteenthly, Anger is enemy to this disease’.
17. ‘Seventeenthly, the great sensibility of the joints, and especially of the feet, cannot suffer any pain’.
‘The foresaid 17 rules are only ordained for this purpose, to free one from the Gout [Arthritis]: but as much as does concern the means whereby these joints are to be strengthened and preserved, that the same do not receive those defluxions whereon depends the principal means to free one from it, are in these rules following to be observed’.
18. ‘Eighteenthly, it is very requisite that the feet be often bathed in Alum water’.
19. ‘Nineteenthly, Sage decocted in Beer, and the same drunken oftentimes, is commended, as it were a very secret medicine and receipt which has an ineffable operation in all diseases of the joints’.
20. ‘Twentiethly, Almond flower [meal], Camomile, Meliot and Roses be very commodious for the Joints. Calamus and Ground Ivy have an especial virtue for to strengthen all the Joints; the same does also Indian Nut kernel’.
21. ‘One and twentiethly, Vervain laid fresh upon the feet so worn, is very good for the Podagra’.
Things which strengthen the Sinews
1. Behen root and its oil warms contracted Sinews.
2. Bdellium and Calamus applied with Oils of Citron peel, Camomile, Cypress root, Cassia Wood and Cypress leaf.
3. Oil of Costus.
4. Opopanax
5. Pyrethrum and Pepper ‘above all others’ warm the sinews.
6. Natural Sulphur baths
7. Sage wine
8. After purging, Theriac and Mithridate are very good in all cold joint diseases.
We should also note that Centaury, Frankincense and Tumeric are good to relax tight sinews while strengthening them. Comfrey, Soloman's Seal and Shilajit are good for weak and degenerated sinews.
Treatment of Arthritis in the Summer
1. Purge with Agaric 1 dram, Colchicum 1 ½ drams, Sugar 1 oz.; steep the herbs for 24 hours in 3 oz. of water of Field Cyperus [Cyperus rotundus], strain hard, add the sugar and drink warm in the morning, fasting for 6 hours after. [Note: this seems an excessive dose of Colchicum!]
2. Next this potion is used for at least 8 days to prepare the humor: Honey of Roses 1 oz., Water of White Water Mint, Water of Field Cyperus 1 ½ oz., each; mix together.
It may also be prepared with this: Honey of Roses, Syrup of Stoechas and Water of Field Cyperus.
3. After, take these Pills: Pills of Colchicum, Foetid Pills, of each ½ dram. Form 7 pills with Syrup of Roses and taken early in the morning.
Treatment of Arthritis in the Autumn
Every 14 days take 1 dram of these pills: Aloe 2 oz., Agaric, Colchicum ¼ oz., Colocynth 1 ½ dram, Ginger, Cinnamon, Asarum, Clove and Mace 1 scruple each, Turbith and Dodder of Thyme of each 1 dram, Saffron 1 scruple. Powder them, and cover with water of Field Cyperus and set to dry in the sun. Cover again with the same water, and evaporate enough to form pills.
The defluxions of the Joints are most aggravated in Spring and Autumn; therefore, use one the following:
1. Water of Asarum sugared, 5 oz.
2. Water of Madder (which is better)
3. Troches of Agrimony ½ dram
To consume the Dampness in the Joints
1. Rub the joints, then apply unripe Olive oil 2 oz., and burnt Salt 1 oz. Anoint very warm, the wrap in warm cloth.
2. Pour red wine and vinegar on hot coals and let the fumes bath the joints so they sweat.
3. Anoint on the following: Sagapen 1 oz., Bdellium and Gum Ammoniac ½ oz. each, Sandarac ¼ oz. Dissolve the gums in a little red wine vinegar and with wax form a salve.
4. Oil of Roses, Oil of Camomile of each 1 oz., Egg yolks 3, Saffron 3 grains, mix and apply warm. After applying, sprinkle on powder of Earthworms, and cover with Sheep wool.
5. Oil of Earthworms 1 oz., Oil of St. Johns wort ½ oz., and Oil of Juniper 1 ½ oz., Mastic and Frankincense of each ¼ oz., Sulphur viv [living Sulphur], Pyrethrum of each 2 ½ drams; apply warm.
Oil of Earthworms
‘Oil of Earthworms is especially good for all pain of the Joints, and for all frozen sinews’.
Earthworms 3 oz.
Olive oil 12 oz.
Wine 6 oz.
Wash the Earthworms in wine, boil together until the wine evaporates, then strain through a cloth.
Treatment of Arthritis in the Winter
Half way through Autumn, the following pills can be used:
1. Pills of Agaric, Pills of Colchicum of each half a dram, Indian salt 2 grains; make 7 pills with Confections of Roses. Take 1 pill each day for 7 days.
2. After these are finished: Syrup of Wormwood, Syrup of Agrimony of each three quarters of an ounce, Water of Hops, Water of Cyperus rotundus of each half an ounce; mix together, and take.
3. Confection Benedicta 3 drams, Indian Confection 2 and a half drams, Water of Blue Flower-de-Luce 2 oz.; mix together, make it warm and drink.
After this, the above pills that are to be taken in Autumn (beginning with Aloes) can be taken.
What is to be Done once health has returned to prevent recurrence
One of the following may be used:
1. Aloeswood half a scruple taken with Water of Cyperus rotundus
2. Take Mithridate twice a week
3. Chebulic Myrobalan chewed and eaten
4. Or alternate Mithridate and Chebulic Myrobalan
The above passage taken from Wirtzung is a good introduction to the treatment of Arthritic disorders in the Western Tradition. Most of the 21 Rules comply with the principles of TCM and Ayurveda. In addition, many of the remedies listed contain medicines which have proven effects against Arthritic disease.
Some general things useful for Gout [Arthritis]
1. Confected Quinces
2. Syrup and Electuary of Quince (without Spices if there is heat)
3. Marmalade
4. Wines of Rosemary, Sage, Wormwood and Clary Sage.
17 Rules to Prevent and Treat Arthritis
1. ‘For as much as the Gout, Arthritis, Podagra, and such like, appear most of all in Harvest [Autumn], by reason of the fruit eaten the whole Summer, therefore must all fruits be eschewed [avoided]’.
Comment:
This clearly demonstrates the idea that damp foods must be avoided to prevent the feeding of Damp diseases. Chinese Medicine likewise places great emphasis on avoiding Damp foods such as sweet, fresh fruit in Damp diseases such as Arthritis and Rheumatism. This agrees 100% with TCM and Ayurveda.
2. ‘Secondly, for as much as venery [sexual intercourse] is so hurtful for this disease, and increases it very much, the same is to be refrained as much as it is possible’.
Comment:
Sex weakens the Kidney energy, and Kidney deficiency is generally a contributing factor in chronic Arthritis and Rheumatism, especially in the aged and those with degenerative changes.
3. ‘Thirdly, a quiet idle life, and sleep by day time do hinder that superfluity cannot be consumed. To the contrary, too great stirring and exercise, whereby the members are over-heated, are also oftentimes the cause of this pain of the members; therefore is the same as much as is possible to be eschewed [avoided]’.
Comment:
Idleness weakens circulation and metabolism, thereby increasing the disease. Likewise over use of the joints causes inflammation and aggravates the disease
4. ‘Fourthly, all Wine, and especially strong wine is very hurtful for all them that be plagued with the Gout’.
5. ‘Fifthly, all rioting and drunkenness make bad digestion, whereby also the pain of the Gout [Arthritis] is augmented’.
6. ‘Sixthly, they that be hot of nature, and addicted to the Gout, are to refrain from all phlegmatic meat which is dressed with sundry things, and also from all meat which does make Choler [Bile] and Blood, for that when these two humors come together, then do they bring gross and undigested defluxions in the Joints, whereof the Gout is caused’.
Comment:
This refers to the breeding of Damp-Heat which feeds arthritic diseases of a hot nature.
7. ‘Seventhly, there be some through purging and letting of Blood that are freed from this disease, which may most commodiously be done in the Spring of the year’.
Comment:
Those with excess conditions, or excess of Heat and Bile can be relieved by purging and bleeding. And this is most effective in Spring because the Dampness that accumulates over Winter is activated and aggravated at this time.
8. ‘Eighthly, the air [wind] hurts them much that be troubled with the Gout’.
Comment:
Arthritic diseases come from Wind and Damp. Avoiding both these factors and aiming to reduce them is essential to relieve the disease. TCM teaches that Wind exposure can aggravate or induce arthritic and rheumatic pain.
9. ‘Ninthly, all great gross fishes, and especially Eels be hurtful for the Gout’.
Comment:
Fish in general, and Eel in particular, breed Damp and Phlegmatic humors.
10. ‘Tenthly, suckling pigs, all water Fowls and old Hens are especially hurtful to the lower members’.
Comment:
These foods are also Damp or hard of digestion.
11. ‘Eleventhly, milk and wine eaten together be very noisome for all members, and very hurtful for the head’.
12. ‘Twelfthly, the drink which is taken without thirst brings much hurt to the body’.
Comment:
Despite the fact that people are regularly told to drink 2 liters of water daily in modern times, drinking water, especially cold water, was usually stated to be unhealthy. This is still seen in Chinese society where cold water is rarely taken, but hot drinks and teas are taken in preference. Here it states that drinking when not thirsty is bad as it will increase cold and damp humors.
13. ‘Thirteenthly, like as great surfeiting with meat [eating excessively] is very hurtful for all the joints, even so does a moderate diet refresh them’.
Comment:
Eating in excess breeds Dampness, whereas eating moderately helps assure all food taken is properly digested.
14. ‘Fourteenthly, the going too much, or weary walking, and hanging down of the legs, especially presently after meat [food], is very hurtful for the joints’.
Comment:
Walking straight after food liberates Dampness and especially collects in the legs and lower body. And old German saying goes something like ‘Rest after Food, or Walk 1000 paces’. In this case, resting helps proper digestion, but a good walk after food can ensure that circulation is is increase and digestion is enhanced. Nevertheless, in arthritic disease, resting after a light meal is best.
15. ‘Fifteenthly, to lie upon the back is also hurtful’.
16. ‘Sixteenthly, Anger is enemy to this disease’.
17. ‘Seventeenthly, the great sensibility of the joints, and especially of the feet, cannot suffer any pain’.
‘The foresaid 17 rules are only ordained for this purpose, to free one from the Gout [Arthritis]: but as much as does concern the means whereby these joints are to be strengthened and preserved, that the same do not receive those defluxions whereon depends the principal means to free one from it, are in these rules following to be observed’.
18. ‘Eighteenthly, it is very requisite that the feet be often bathed in Alum water’.
19. ‘Nineteenthly, Sage decocted in Beer, and the same drunken oftentimes, is commended, as it were a very secret medicine and receipt which has an ineffable operation in all diseases of the joints’.
20. ‘Twentiethly, Almond flower [meal], Camomile, Meliot and Roses be very commodious for the Joints. Calamus and Ground Ivy have an especial virtue for to strengthen all the Joints; the same does also Indian Nut kernel’.
21. ‘One and twentiethly, Vervain laid fresh upon the feet so worn, is very good for the Podagra’.
Things which strengthen the Sinews
1. Behen root and its oil warms contracted Sinews.
2. Bdellium and Calamus applied with Oils of Citron peel, Camomile, Cypress root, Cassia Wood and Cypress leaf.
3. Oil of Costus.
4. Opopanax
5. Pyrethrum and Pepper ‘above all others’ warm the sinews.
6. Natural Sulphur baths
7. Sage wine
8. After purging, Theriac and Mithridate are very good in all cold joint diseases.
We should also note that Centaury, Frankincense and Tumeric are good to relax tight sinews while strengthening them. Comfrey, Soloman's Seal and Shilajit are good for weak and degenerated sinews.
Treatment of Arthritis in the Summer
1. Purge with Agaric 1 dram, Colchicum 1 ½ drams, Sugar 1 oz.; steep the herbs for 24 hours in 3 oz. of water of Field Cyperus [Cyperus rotundus], strain hard, add the sugar and drink warm in the morning, fasting for 6 hours after. [Note: this seems an excessive dose of Colchicum!]
2. Next this potion is used for at least 8 days to prepare the humor: Honey of Roses 1 oz., Water of White Water Mint, Water of Field Cyperus 1 ½ oz., each; mix together.
It may also be prepared with this: Honey of Roses, Syrup of Stoechas and Water of Field Cyperus.
3. After, take these Pills: Pills of Colchicum, Foetid Pills, of each ½ dram. Form 7 pills with Syrup of Roses and taken early in the morning.
Treatment of Arthritis in the Autumn
Every 14 days take 1 dram of these pills: Aloe 2 oz., Agaric, Colchicum ¼ oz., Colocynth 1 ½ dram, Ginger, Cinnamon, Asarum, Clove and Mace 1 scruple each, Turbith and Dodder of Thyme of each 1 dram, Saffron 1 scruple. Powder them, and cover with water of Field Cyperus and set to dry in the sun. Cover again with the same water, and evaporate enough to form pills.
The defluxions of the Joints are most aggravated in Spring and Autumn; therefore, use one the following:
1. Water of Asarum sugared, 5 oz.
2. Water of Madder (which is better)
3. Troches of Agrimony ½ dram
To consume the Dampness in the Joints
1. Rub the joints, then apply unripe Olive oil 2 oz., and burnt Salt 1 oz. Anoint very warm, the wrap in warm cloth.
2. Pour red wine and vinegar on hot coals and let the fumes bath the joints so they sweat.
3. Anoint on the following: Sagapen 1 oz., Bdellium and Gum Ammoniac ½ oz. each, Sandarac ¼ oz. Dissolve the gums in a little red wine vinegar and with wax form a salve.
4. Oil of Roses, Oil of Camomile of each 1 oz., Egg yolks 3, Saffron 3 grains, mix and apply warm. After applying, sprinkle on powder of Earthworms, and cover with Sheep wool.
5. Oil of Earthworms 1 oz., Oil of St. Johns wort ½ oz., and Oil of Juniper 1 ½ oz., Mastic and Frankincense of each ¼ oz., Sulphur viv [living Sulphur], Pyrethrum of each 2 ½ drams; apply warm.
Oil of Earthworms
‘Oil of Earthworms is especially good for all pain of the Joints, and for all frozen sinews’.
Earthworms 3 oz.
Olive oil 12 oz.
Wine 6 oz.
Wash the Earthworms in wine, boil together until the wine evaporates, then strain through a cloth.
Treatment of Arthritis in the Winter
Half way through Autumn, the following pills can be used:
1. Pills of Agaric, Pills of Colchicum of each half a dram, Indian salt 2 grains; make 7 pills with Confections of Roses. Take 1 pill each day for 7 days.
2. After these are finished: Syrup of Wormwood, Syrup of Agrimony of each three quarters of an ounce, Water of Hops, Water of Cyperus rotundus of each half an ounce; mix together, and take.
3. Confection Benedicta 3 drams, Indian Confection 2 and a half drams, Water of Blue Flower-de-Luce 2 oz.; mix together, make it warm and drink.
After this, the above pills that are to be taken in Autumn (beginning with Aloes) can be taken.
What is to be Done once health has returned to prevent recurrence
One of the following may be used:
1. Aloeswood half a scruple taken with Water of Cyperus rotundus
2. Take Mithridate twice a week
3. Chebulic Myrobalan chewed and eaten
4. Or alternate Mithridate and Chebulic Myrobalan
The above passage taken from Wirtzung is a good introduction to the treatment of Arthritic disorders in the Western Tradition. Most of the 21 Rules comply with the principles of TCM and Ayurveda. In addition, many of the remedies listed contain medicines which have proven effects against Arthritic disease.