If the pain is not removed by this method neither, or a swelling comes on, the skin must be cut and cucurbitals applied; urine must be promoted; and if the belly be bound a clyster must be given. The last remedy, which is also of great efficacy in disorders of the womb, is to make ulcers in the skin with hot irons in three or four places above the hip. To make use of friction too, chiefly in the sun, and several times in one day: that this hurtful collection of humours may be more easily discussed. The hips themselves may be rubbed, if there be no ulcer; if there is, the other parts of the body. Now since an ulcer is frequently to be made with hot iron, that noxious matter may be evacuated, this is always to be observed, that ulcers of this kind be not healed, as soon as may be; but kept open, till the distemper, which we propose to cure by them ceases. CHAP. XXIII. OF A PAIN IN THE KNEES, AND ITS CURE. The knees are next to the hips, in which there sometimes happens to be a pain. The cure consists in the same cataplasms and cupping: which are the remedies also when any pain arises in the shoulders, or the other joints. It is most hurtful of all things for one, whose knees are pained, to ride on horseback. Now all pains of this kind, when they have continued long, are scarcely cured without the use of the actual cautery. CHAP. XXIV. OF THE DISEASES IN THE JOINTS OF THE HANDS AND FEET, AND THEIR CURE. In the hands and feet the diseases of the joints are more frequent, and continue longer. Such as happen to gouty people in these places, seldom disturb either eunuchs, or boys before coition, or women unless their menses be suppressed. When they begin to feel them, blood must be let. For this done immediately at the beginning often procures good health for a whole year, sometimes for life. Some too by cleansing themselves thoroughly by drinking asses milk, have prevented its ever returning; Others by abstaining from wine, mulse and venery for a year, have rendered themselves secure from it for their whole life. And this method is to be pursued after the first attack of the pain, although it has ceased. But if the fits of it are grown customary, one may indeed be more secure at such times as the pain has remitted: but more care ought to be taken at such seasons, as it returns(34), which happens commonly in the spring or autumn. Now when the pain is not violent, the patient ought to use gestation in the morning; then to be carried, or to exercise himself by walking gently, and if the gout be in the foot, at small intervals alternately sometimes to sit, sometimes to walk; next before he takes food, without bathing to be rubbed gently in a warm place, to sweat, and have egelid water poured over him; after that to take food of the middle kind, making use at times of diuretics; and whenever he turns plethoric to vomit.