Where the gout affects the head with obstinate pain, and appears to be seated in the muscles, cupping and leeches give great relief. This mode of bleeding should be trusted in those cases only in which the morbid action is confined chiefly to the head, and appears in a feeble state in the rest of the arterial system. The advantages of bleeding in the gout, when performed under all the circumstances that have been mentioned, are as follow: 1. It removes or lessens pain. 2. It prevents those congestions and effusions which produce apoplexy, palsy, pneumonia notha, calculi in the kidneys and bladder, and chalk-stones in the hands and feet. The gravel and stone are nine times in ten, I believe, the effects of an effusion of lymph or blood from previous morbid action in the kidneys. If this disease were narrowly watched, and cured as often as it occurs, by the loss of blood, we should have but little gravel or stone among gouty people. A citizen of Philadelphia died a few years ago, in the 96th year of his age, who had been subject to the strangury the greatest part of his life. His only remedy for it was bleeding. He lived free from the gravel and stone; and died, or rather appeared to fall asleep in death, from old age. Dr. Haller mentions a similar case in his Bibliotheca Medicinæ, in which bleeding had the same happy effects. 3. It prevents the system from wearing itself down by fruitless pain and sickness, and thereby inducing a predisposition to frequent returns of the disease. 4. It shortens the duration of a fit of gout, by throwing it, not into the feet, but out of the system, and thus prevents a patient's lying upon his back for two or three months with a writhing face, scolding a wife and family of children, and sometimes cursing every servant that comes near enough to endanger the touch of an inflamed limb. Besides preventing all this parade of pain and peevishness, it frequently, when assisted with other remedies to be mentioned presently, restores a man to his business and society in two or three days: a circumstance this of great importance in the public as well as private pursuits of men; for who has not read of the most interesting affairs of nations being neglected or protracted, by the principal agents in them being suddenly confined to their beds, or chairs, for weeks or months, by a fit of the gout? 2. A second remedy in the state of the gout which has been mentioned, is _purging_. Sulphur is generally preferred for this purpose, but castor oil, cream of tartar, sena, jalap, rhubarb, and calomel, may all be used with equal safety and advantage. The stomach and habits of the patient should determine the choice of a suitable purge in every case. Salts are generally offensive to the stomach. They once brought on a fit of the gout in Dr. Brown.