The CERTAIN METHOD to KNOW the DISEASE.

A LECTURE ADDRESS'D TO STUDENTS IN PHYSIC.

Medicus, si quidem suffecerit ad cognoscendum; suf­ficiet etiam ad sanandum.

HIPPOCRATES de Arte.

LONDON: Printed for J. ROBERTS, near the Oxford-Arms in Warwick-Lane. MDCCXLII.

TO STUDENTS in Physic.

GENTLEMEN,

IT is universally agreed, that among the several other Branches of Learning, ne­cessary to the Accomplish­ment of those, who are Candidates in the Art of Healing; the judicious Instructions of an able, practical Physician, is a Qualifica­tion of the first Moment. The Reason of the present Concession is very evident: Be­cause [Page ij]the Pupil, as the Result of such an happy Institution, according to the Stand­ing of his Professor, may, in a few Years, enter upon Business, with greater Advan­tage, than he could possibly do, in many, without such Assistance. For myself, I own, I am too vain, not to account it a singular Felicity in my Life, that I have been bless'd with an Opportunity of at­tending Sir RICHARD MANNINGHAM'S Lectures in Midwifery and Physic.

I PAY a greater Deference to that GEN­TLEMAN'S good Sense and distinguish'd Modesty, than either to affront the one, or insult the other, by attempting any thing, that might carry the Appearance of an En­comium, tho' religiously confined to his just Praise: Nevertheless, as every gene­rous and honest Mind would be equally careful, neither to offend against the Laws of Gratitude to an ingenious Tutor, for the most instructive Dictates; nor those of Justice and Zeal due to the Public, for whose Service, Gentlemen, you are pre­paring: [Page iij]I expect it be allowed me, on the present Occasion, as a necessary Instance of Duty to Both; that I am at Liberty to de­clare, I want no Veneration for Sir RI­CHARD'S Whole Course.—It is composed, indeed, of Two grand Branches, which are those of Midwifery and Physic. The for­mer of these is by no means destitute of its Beauties: Such as the Improvements in the Apparatus itself; the Chastity of the Insti­tution; and the Exclusion of all Instru­ments.—For the first: The greater Ma­chine is the most finish'd, in its way, that has, as yet, ever appeared, for conduct­ing the different Kinds of Deliveries; while the Glass Machine gives ocular Proof of the Reason and Justness of the Rules to be observed in Operations on the Other; and, consequently, in Genuine Labours.—For the next: It is not possible, by this Manner of Instruction, to give the least Offence to the chastest Mind, the most scrupulous Modesty. — And with respect to the Affair of Instruments: It is evident [Page iv]to a Demonstration, from this Method of Practice, that there is so little Occasion for the present frequent Use of them, that excepting in a Case or two, which but rarely happen; the judicious Management of the Hand, is all that is required in the Art of Midwifery.

GENTLEMEN, I abhor Flattery and Ostentation: And I cannot but persuade myself, you will acquit me of Both, when I assure you, I should, at no rate, have taken upon me to have been either so par­ticular, or positive in the Articles above, if I were not very well acquainted, with the utmost, that has been done Abroad on the Subject of Midwifery. I studied under Two Masters, the late Messieurs GRE­GOIRE and DUSSÉ, at PARIS; and came from thence with no small Freight of Self-sufficiency and Confidence: Nor is it proba­ble to me, I should ever have been dispos­sess'd of my personal Prejudices and dan­gerous Mistakes (especially in the Use of Instruments) had I not fell under Sir RI­CHARD's [Page v]Institution, and formed myself on His Practice.

THESE things notwithstanding: As I always thought the matter of Deliveries the least Branch of the Man-Midwife's Character; and was assured, that He would ever have most Success in Operations, who was best acquainted with the Structure of the Human Body: So I could not help be­ing especially charmed with those Lectures in Sir RICHARD's Course, which proper­ly belong to the latter Branch, the Head of Physic. The superior Utility of the Subject will excuse my passionate Regard on this Part: Since it is plain, that the Science, which leads to a general View of the animal Machine, and to a perfect Know­ledge of all the Diseases to which the whole Nature, in common, is incident; must be vastly preferable to all that is partial and confined, however exalted and worthy in it­self.

WHAT was last observed, Gentlemen, you will please to remember, is designed, [Page vj]not only to account for the extraordinary Pains I was at in securing this Lecture; but is also offered as a Reason, why you are to believe it tolerably correct. For the latter indeed, you have this additional As­surance, that I had not only several Op­portunities of attending the Repetition of it; but was, moreover, allow'd the pecu­liar Indulgence of taking it in short-hand, as delivered.

I CONFESS, it would give me no small Pain, were I the least apprehensive, I was taking any Freedom, that might justly ex­pose me to the Resentment of Sir RI­CHARD MANNINGHAM: But, I flatter myself with less Danger in this Point, so far as concerns the present Publication, however; since, I am only indulging the English Reader with his excellent Method of Investigating Diseases, in the manner he explain'd it to Us, in his first Evening's Lecture in Physic; at the same time, that it is to be observed, he has already com­municated the Method itself to the learned [Page vij]World in his Latin Compendium: Tho' some of the best Judges have acknowledg­ed it's Claim to an higher Title.

THERE is one Circumstance, Gentle­men, of great Importance in the present Lecture, I mean: That the whole Argu­ment is built on the most venerable Anti­quity, and not on any precarious, modern Theories. I take the Liberty of inserting this previous Hint; not but your own At­tention in Reading would have excused me the Trouble; because you will from hence immediately argue its intrinsic Va­lue, and give more boldly into its Use.—The Histories of Diseases, originally put together by the most accurate Observations of HIPPOCRATES, and established on the Authority of his Successors, the most celebrated ancient Physicians, is here your Standard. Nature, since her various morbid Phaenomena were, in their manner, first reduced to any regular System, ap­pears to have suffered no Deviation for some thousand Years past; nor can, in­deed, [Page viij]be capable of any, for the future, while the animal Oeconomy, and the Laws, under which the human Species continues to act, remain invariable.

I WISH nothing more ardently, than that, as the Subject, on which the Lecture before you is rais'd, is of general Use in itself; and it is hardly possible, every Stu­dent's Situation should allow him an Op­portunity of attending on the Spot: Those, into whose Hands it may now fall, may find as much Pleasure and Advantage in receiving it from the Press, as the Pub­lisher has perpetually retained, since he first took it from Sir RICHARD's own Mouth. I am,

GENTLEMEN, Your most Obedient, Humble Servant,SAYER RUDD, M.D. and MAN-MIDWIFE.

The CERTAIN METHOD to KNOW the DISEASE.

IN the Course of our LECTURES in Physic, we propose, chiefly to confine ourselves to the Diseases of Children, from Infancy up to ripe Age; and to the Diseases, peculiar to the Female Sex; those especially, belonging to Pregnancy and Childbed: Nevertheless, as Women are liable to all the Di­stempers incident to Men, besides the many pecu­liar to their own Sex, as they are, by Nature, or­dained for the Preservation of Mankind; it will be necessary, in a great measure, to treat of Dis­eases at large; and more particularly of Fevers, which, indeed, make up a very great Part of the Disorders that afflict us, and do also associate themselves, with every other Disease: Febris, maxime communis Morbus, omnium aliorum Morborum, praecipue Inflammationis, comes est. HIPPOCRATES. The Truth of which we daily experience; and, moreover, often observe that, a [Page 2] Fever shall even elude that Method of curing a Disease, which, without a Fever, has been gene­rally found successful; an Observation well wor­thy our particular Notice.

WOMEN with Child, and in Childbed, are often afflicted with Distempers, no ways cognate to Pregnancy or Childbed; especially Fevers of all Kinds, whose Essence and Nature, indeed, differ nothing from other Fevers, and require a like Me­thod of Cure; yet, by reason of their happening at the Times above-mentioned, are attended with greater Difficulties in Curing, and demand our greatest Caution and Prudence, in the Administra­tion of the proper Remedies for the Fever; the Physician at this time, not being at Liberty, so freely to make use of Bleeding, Vomiting, Blistring, Sweating, Purging, and Method of Diet: And during Pregnancy, our chief View must always be to prevent a Miscarriage, or even the bringing on of Labour, whenever the Disease has no Affinity to Pregnancy. For tho' Diseases, which are ow­ing to Pregnancy, either decrease, or go off upon Delivery; yet, those which are no ways cognate, are for the most part found to increase after the Delivery; and as HIPPOCRATES observes: Si mulier, Utero gestans, morbum habuerit non cogna­tum, in Puerperii purgatione, perit.

WHEREFORE, as in all Diseases not cognate to Pregnancy, our chief View, as I observed above, must be, to prevent Abortion and untimely La­bour; so in all Diseases happening in Childbed, [Page 3]our principal Aim, must then be directed, to the due Regulation of the Lochia. Many, and great Dif­ficulties surround us, in this dangerous and com­plicated Situation, which exact our most diligent Care and Attention: And, as it is oftentimes no easy Matter to distinguish between the cognate Di­stemper, and that which has no relation to Preg­nancy or Childbed; and at all times, very difficult rightly and safely to conduct Affairs, in this nice and critical Situation; I shall therefore, in my subsequent Lectures, endeavour, to the best of my Judgment and Knowledge, to inform and direct you in each Particular, from the repeated Obser­vations of the most approved Authors in Physic, both ancient and modern; and also from Experi­ences and Successes, collected from my own Ad­versaria, confirming their Doctrine; besides which, I shall illustrate each Case, by the particular Ap­plication of the Method of Investigating the Na­ture of all Diseases.

IT is a Maxim universally received among Phy­sicians: That Medicine should begin, where Philoso­phy ends. And as it is, undoubtedly, a necessary Qualification in a Physician to be knowing in Phi­losophy; and the Animal Oeconomy is that Part of Philosophy, which is more especially conducive to the Knowledge of the Practice of Physic: I make no doubt, but you, Gentlemen, who have in this City the best Opportunities of being instructed in this Branch of Science; especially by that most accurate, and excellent Anatomist and Physician, Dr. NICHOLLS; who, it must be confessed, is an Ornament [Page 4]of our Profession, and worthy of singular Praise: I say, I make no doubt, but with such Advantages, you have already obtained a competent Knowledge in the Animal Oeconomy; and will, therefore, be enabled to make the best Use of our Lectures, and Method of Investigating the Nature of Dis­eases.

NOW, the human Body, we all know, may be properly considered, as a most perfect Machine; whose Parts are extremely well configurated and joined together; whose Symmetry is most beauti­ful; and whose Actions, resulting from this admi­rable Compages, are reciprocally carried on by So­lids and Fluids, of which it is made up. And as many of its Actions and Motions, are easily demon­strated to be the necessary Consequences of it's Stru­cture; so its Diseases, and all their Symptoms, are only the irregular Motions, or Disorders of this very complicated Machine: Nor is the Case the least altered, that we have a Principle within us, not subject, in itself, to the Laws of Motion.

IT is, therefore, highly incumbent on every one, who would attain to the due Knowledge of the Art of Healing, that he make himself very well acquainted with this curious Machine: that know­ing well the Parts, and the natural Actions, and Secretions of the human Body; he may be enabled to judge, when, and how, these natural Actions are perverted: all the Symptoms of Diseases, being the necessary Consequences of the Alteration of the Animal Oeconomy. It's Actions therefore being per­formed [Page 5]by Fluids secerned from the Blood; without the Knowledge of Secretions, we cannot under­stand the Nature of Diseases: Secretion being the Spring of all animal Functions. Wherefore, the greater our Knowledge is of the Animal Oecono­my, the more likely we shall be, to discover the Seat and Nature of its Diseases; and of course be better enabled to rectify all its Disorders.

EXPERIENCE is, no doubt, of great and necessary Use, in promoting the Art of curing Diseases, if directed by a Knowledge in the Animal Oeconomy; forasmuch as it is only by a just reason­ing on our Experiences, that we can come at the Knowledge of any Phaenomenon of Nature. So that Experience, or the Knowledge of the Histories of Diseases, added to that of the Animal Oeconomy, is what can only make a Physician; and, where­ever the History of a Disease is exactly known, if the right Method of curing it cannot be deduced, it must be, because the Animal Oeconomy is not suffi­ciently understood: For our Skill in curing Diseases, whose Histories are exactly known, is, for the most part, proportional to our Knowledge of the Ani­mal Oeconomy. For in order to find out the Seat and Nature of a Distemper, and from them to de­duce a right Method of Cure, it will be absolutely necessary to reason on those Histories; which we cannot do, as we ought, if we are ignorant of the Structure of the Machine, we are about to rectify.

DESCRIPTIONS and Diagnostic Signs of Diseases, are the proper Business of Observation [Page 6]and Experience; but, Indications of Cure arise from our reasoning upon those Observations. Di­agnostics are properly a Collection of particular Symptoms only; but Indications are those Conclusi­ons, which our Knowledge of the Animal Oecono­my enables us to make on these Observations, and Descriptions: So that the Histories of Diseases, and the Knowledge of the Animal Oeconomy, must al­ways go hand in hand, in order to the obtaining the due Knowledge of the Practice of Physic. He therefore, who is sufficiently knowing in Philoso­phy and the Animal Oeconomy, and makes a proper Use of this Knowledge, by reasoning on real Facts, grounded on repeated Experience and Observation, may justly be said to use his Philosophy aright; and may then reasonably hope for Success, in finding out the genuine Indications of Cure, in which, the Practice of Physic chiefly consists: And without this Caution our Reasonings will certainly be to ve­ry little purpose.

THE great HIPPOCRATES has this Assertion: That Nature cures Diseases. The Truth of it we, of this Day, may experience, if we will carefully keep up to his excellent Directions, and Method: It being his only Aim to relieve Nature when op­pressed, in the very Way, and Manner he observed her endeavouring to expel Diseases. And it was by a constant Diligence of this Kind, joined with his wonderful Sagacity, that he arrived to that great Degree of Perfection in the Knowledge of Physic: Hence he perceived that, Nature herself judges Diseases; and, indeed, does all, being properly as­sisted; [Page 7]nay, and, sometimes, without any Assist­ance.

HIPPOCRATES also informs us, and our own Experience cannot but confirm it: That those People who have Fevers, and are left to themselves, and take no Medicines; if they do recover, get rid of their Fevers by Sweating, a Looseness, an Haemor­rhage, Diabetes, or the like: From whence HIP­POCRATES, and the ancient Practitioners in Phy­sic, took their first Intimation to provoke Sweat and the other Evacuations. And from their re­peated Observations and Successes, they have form­ed for us, a most rational Method of Cure. And if we duly consider, and attend to the different Ways by which Nature extricates herself from Dis­eases, when left to herself; we shall soon be con­vinced, that they are not the confused and disordered Effects of Nature, ill defending herself; but, in fact, the gradual, steady, and measured Operati­ons of that exquisite Mechanism, and innate, inces­sant Principle of Self-preservation, with which Pro­vidence has been pleased to endow our Bodies: A very strong Confirmation of the Necessity of a care­ful and diligent Observance of the Tendencies of Na­ture, in all her Disorders; and the Method she takes to get rid of Diseases, when left to herself: And also, a very good Caution to us all, not to be over hasty, or too busy in the Administration of our Remedies; lest we should be found to ruffle and disturb, rather than assist Nature, with the untime­ly Use, or Multitude of our Medicines. And re­ally, the Ne quid nimis, in the Practice of Physic, [Page 8]is a Matter of no small Consequence. He there­fore, in my Opinion, is most likely to prove the best, most prudent, and rational Physician, who most diligently observes, and constantly follows, the Motions, and Dictates of Nature herself.

IF an altogether new Distemper should at any time arise among us, the only Way of getting into the Nature of such new Disease, would be to copy HIPPOCRATES's Example; I mean, his Me­thod of observing, joined to the Rule of finding out the Nature of Diseases: For we must, first, be led by Symptoms to find a Disease; after that it's Nature, and from thence the Method of Cure. And here it may be proper to observe, that there are several Seasons, which have Diseases peculiar to themselves; and may, in some measure, indeed, be called new Diseases: It will therefore be necessary to know, and carefully observe the Seasons, as HIPPOCRATES, and, our renowned Countryman, SYDENHAM advise; wherein such Diseases are wont to appear; otherwise we shall be unsuccessful in curing the Diseases peculiar to those different Seasons. It must also be observed, that these Dis­eases are generally stated, and regular in each Con­stitution, and have an Affinity to each other: He therefore, who is able to come at the Nature and Cure of one Epidemical Distemper, in any Constitu­tion, hath an Advantage in the Cure of all the other. For tho' they may differ in several respects, yet they require something common in their Cure, as proceeding from a common Cause. And a few Cases diligently enquired into, by recollecting and [Page 9]carefully examining their Symptoms, as directed by our Method of discovering the Nature of Diseases; will be sufficient to give us the Nature, Causes, and Method of Cure, of the Disease of every Constitu­tion whatever. Here we can by no means omit a pertinent Observation of CELSUS: Quod si jam incidat Mali genus aliquod ignotum, non ideo ta­men fore Medico de rebus cogitandum obscuris; sed eum protinus visurum, cui morbo id proximum sit; tentaturum (que) remedia fimilia illis, quae vicino malo saepe succurrerint, & per ejus similitudinem opem reperturum.

THE many accurate and charming Descriptions of Distempers, delivered down to us by HIPPO­CRATES in his Histories of Diseases; wherein the Phaenomena of each Distemper, even in its minu­test Circumstances, are observed; present us with a most exquisite Delineation of Nature: and if duly attended, will always be found, of the great­est Service for advancing our Progress in the Art of Healing. Because, from his Diagnostics in particu­lar, and others of the Antients, and such among the Moderns, who have closely copied after His manner; we readily discover the Nature of the Disease. And as, whenever we arrive at the true and exact History of any Distemper, whether from Books, or our own careful Observations; we may, at all times, by the right and diligent Application of the Method of Investigation, most assuredly dis­cover the immediate and conjunct Cause; so may we likewise, on those Principles, easily come at the Nature of the Disease; when, having that [Page 10]given, it will be no difficult matter to find out Re­medies to Cure, in all curable Cases; and to admi­nister Relief, even in those, which are incurable.

THIS unwearied Diligence in Observation, and close Attendance on Nature in that sagacious, great Man HIPPOCARTES, and others of the Antients; might probably be heightened in them, from the Scantiness of their Materia Medica, and the ex­ceeding Harshness of the then known Remedies; however, much to our Benefit: since the excellent Descriptions of Diseases they have given us, can not only never be exceeded, but will always remain invariably true, while Human Nature continues the same. And had those of later Ages, who have been so happily provided with a more copious and salutary Materia Medica; and who, it must be allowed, have been greatly improved in the Know­ledge of the Animal Oeconomy: had these, I say, constantly persevered in the Use of HIPPOCRA­TES'S great Diligence and Manner of observing; they might, doubtless, long ago, have brought the Practice of Physic to a considerable Degree of Per­fection; tho' they had not been bless'd with his extraordinary Sagacity: For that, indeed, is a pe­culiar Happiness, and the Lot of a very few; in which Particular, I believe, we may say of the Physician, as is commonly done of the Poet: Na­scitur, non fit.

Now, should we of this Age, flushed with our superior Knowledge in the Animal Oeconomy, and the Variety of our Materia Medica; neglect to [Page 11]make use of that Prudence and Diligence, which is necessary in attending the Motions and Intentions of Nature; and, instead of endeavouring to assist her on these Principles, when oppress'd, become too precipitate and officious, in the Administration of our Medicines; the Consequence will inevitably be, that we shall only obscure the Disease, by mul­tiplying, rather than taking off the Symptoms; and this to our own personal Confusion, the manifest Injury of our Patients, and the great Disrepute of our Profession. Whereas, would we consult the true and proper Use of the many happy Improve­ments of our own Age, I think, it cannot be done more effectually, than by keeping close to our most skilful Leader, HIPPOCRATES; together with the ancient Practitioners in Physick, in their Manner of observing, and in their Method of heal­ing; founded upon the Knowledge of the conjunct Causes of Distempers, from whence alone, the cu­rative Indications are to be taken: agreeable to the Method here mentioned, and HIPPOCRATES'S Manner of observing. And by a careful Perseve­rance in these Methods, I imagine, we may rea­sonably hope for the greatest Success; and may, perhaps, in a few Ages, arrive at the highest Per­fection in the Practice of Physic, that human Na­ture is capable of attaining.

FROM what I have already advanced, you will naturally conclude, that it is no easy Matter to be­come a prudent and skilful Physician: Much Read­ing, much Thought and Pains will really be re­quired; many Things are necessary to be learnt▪ [Page 12]much Diligence in Inquiry, much Assiduity in Observation is to be used, before we can be duly qualified, either with Peace of Mind to ourselves, or Relief to our Patients, to undertake a Trust, in which the Lives of our Fellow-creatures are so nearly concerned.

IF this be a just State of the Case, what shall we say of those Persons, who boldly take upon them the Practice of Physic, without the least pre­vious Knowledge of the Requisites absolutely neces­sary for the regular Discharge of this important Office? Certainly it can be no other than the great­est Folly, and the highest Presumption, for Those to expect Success, or hope for a Blessing on their En­deavours; who are altogether ignorant of the Pro­vince in which they engage: And would such Persons but give themselves Time to reflect, and seriously consider, the great Consequence of Physic, in the practical Part of it; where Life itself is so immediately at stake: I am persuaded, they would not thus rashly venture to administer Medi­cines, before they had acquired the proper and ne­cessary Qualifications.

IT is a mighty Mistake, that has seized some of our young Candidates in Physic, who are not much addicted to Study or Pains-taking, to ima­gine: That, if they are but well furnished with Books of Recipes, they have every Qualification suf­ficient to commence Doctor upon; because in those Books, as they think, agreeable to the com­mon Saying, they are sure to find a Salve for every [Page 13]Sore. But, alas! these base, empirical Books, the Pest of the present Age, will greatly deceive them. They are by no means to be confided in; but, on the contrary, are rather to be looked upon as very injurious: Forasmuch as they only furnish all Sorts of People, with great Opportunities of destroy­ing each other's Health. And should any Person pretend to set up to practise Physic on this deceitful Foundation, He would soon find himself miserably misled; to the great and manifest Injury of Him­self, as well as his Patients. For it is most cer­tain, that every Medicine, be it never so good, must always be administer'd in the most proper Dose, and at the most proper Times of the Disease, to make it of any Advantage to the Patient; but the Chance of the Mischief arising from the con­trary Practice, no one, I think, would covet: Yet this Knowledge can no otherwise be come at, than in the arduous and diligent Manner of study­ing above-mention'd; join'd with the Method of In­vestigating the Nature of Diseases. Not that this is the only Advantage, which follows on our Do­ctrine of Investigation; fince it not only leads us into the true Nature of the Disease, and the cer­tain Method of Cure; but also, at the same time, into the very Nature and Power of Medicines them­selves, if rightly attended to and applied. And were it possible, even to find out an Universal Re­medy for all Distempers; it must still be subject to the due Timeing and Dosing; the accurate Know­ledge of which, can no otherwise be obtained, than by the Manner and Method already laid down. And this, indeed, is the only real and true Arca­num, [Page 14]in the Practice of Physic. All your Pana­ceas, Nostrums, Specifics, and the like; without this perfect Knowledge of administring them, in the most proper Dose, and at the most proper Times of the Disease, will, for the most part, prove very mischievous. And here the Opinion of the late learned Professor BOERHAAVE concurs with us: Nec speciosos Medicamentorum titulos Morbis addidi. Cur? Nihil Arti exitiale magis novi; neque verò ipse ullum cognosco, quin solo tempestivo Usu tale fiat. * And these Remedies can only, by the greatest Hazard and Chance imaginable, ever prove of good Effect, in any Disease of Consequence: Tho' we all know, indeed, that, in many Cases, let the Medicine given be ever so improper in itself, or ever so unseasonably administer'd; the Strength of Nature may sometimes get the better of both. But this is by no means Curing; nor can it be any Excuse for our Ignorance.

HAVING thus prepared you for the Method to be observed in finding out the Distemper; I shall now proceed to give it you, in the plainest, and most methodical Manner, I am able.

I CANNOT introduce, what I have to offer on this Head, with greater Advantage, than by laying before you, the following practical Observation of SCHEFFLER: Ut Rationalis Medicus curativis Sco­pis satisfacere, Materias Medicas invenire, inventis rectè uti valeat: non satis erit, Vires custodire, & morbificas Causas amovere; sed & Morbi Speciem, [Page 15]& Locum affectum exquisitè cognitum habeat, necessè est.

AGREEABLE with this, you will observe that, in order to Cure any Disease, it is necessary to have a thorough Knowledge of the Disease itself, and of the Remedy peculiarly adapted to it; it being im­possible to cure a Disease according to Art, if the Nature of the Disease be hid from the Artist: And for want of this Knowledge, the Care and Pains of many Physicians have proved ineffectual. For these Physicians, for the most part, making little other Use of the Diagnostic Symptoms, than the mere naming the Distemper only; have, very inju­diciously, taken their Indications of Cure, from se­condary and casual Symptoms: Whereas the true Nature of a Disease is ever best found out, from the Diagnostic Signs or Marks alone; and from thence also, the true Indications of Cure, must always be drawn, in order to the best and most effectual Me­thod of curing the Disease. And as these Indicati­ons wholly arise from our Reasoning upon the Ob­servations of the Phaenomena of Nature; therefore, the greater our Knowledge of the Animal Oecono­my is, the better we shall be enabled to find out the Nature of the Disease. For 'tis the Animal Oeconomy alone, which must enable us, by reason­ing upon the Causes, Signs, and Symptoms of Dis­eases, to find out their Natures, and to deduce true and just Indications of Cure.

THIS, however, in general; more expressly: To come at the true Method of investigating all Dis­eases, [Page 16]incident to the Human Body; and from thence proceed to the most effectual Methods of treating and curing them; the solid Knowledge of the following Particulars is absolutely required, viz.

  • 1. The next, and ever-concomitant Cause of the Disease.
  • 2. The Seat and Part affected.
  • 3. The Ways and Passages, thro' which the Evil takes its Course.
  • 4. The inseparable Signs of the Distemper.
  • 5. The Symptoms, which commonly accompany the Disease; and
  • 6. That we be careful the Symptoms of the Dis­ease are rightly distinguished.

IF we err not in these main Points, we are in the right Way of arriving to an happy Cure of the Dis­ease.

IT is very necessary at all times, carefully to distinguish between the Disease itself, and the Sym­ptom; the want of which has been the Stumbling­stone of some, even very learned Men, in all Ages: Since it is to be imputed to the want of this Distin­ction, as a principal, if not the only Obstacle; that Physicians have been so much at a Loss, for the true Cause of the Disease, and have therefore so often taken the Symptom for the Disease itself; not rightly distinguishing the next, and immediate con­junct Cause, from its Symptoms or Accidents; which [Page 17]may not be occasion'd by the next, and always ac­companying Cause of the Disease, but by some other Symptom; and what is so far from being the Mark of the Disease, that it is a Symptom of a Symptom only.

IN the Tooth-ach, for Example, when it does not proceed from a Caries; the genuine Essence of this Disease, is the violent Distension or Stretching of the Periostium, by some sort of Humour; by which means this Membrane, being forc'd out of its natural Form and Situation, excites a most ex­quisite Pain; which Pain is not the Disease, but the true Mark of the Disease; and the Humour occasioning this Pain, the Cause of the Disease. The Inflammation, Fever, swelled Face, &c. which may succeed, are neither of them the true Mark; but proceed from the Pain, which is the true Di­agnostic Sign or Mark of the Disease; each of the above-mentioned being the Symptom of a Symptom only.

Of the DIAGNOSTICS or SIGNS of a Disease.

THE true Marks or Signs of a Disease are such, which are present from the Beginning, and, as it were, born with the Disease; they grow up with the Distemper to it's height; abate also, and va­nish with the Disease. These are the only sure Marks or Signs: other Signs or Symptoms, which do not immediately follow the Disease, nor any proper Ef­fects [Page 18]of it; and which do not always appear in the Disease, are therefore deceitful Signs, and not to be trusted to; tho' such as have, inadvertently, mis­led some, even sagacious Men.

NOW, these deceitful Signs are not to be reckon­ed among the proper Symptoms of the Disease; be­ing only such as proceed from some proper Sym­ptom of the Disease; and are, indeed, Symptoms of Symptoms only. For the true, and proper Diag­nostic Marks or Signs of the Disease, must always begin, grow up, decline and vanish with the Disease itself; and, from such Marks only, we must ever draw our Indications of Cure.

Of the SYMPTOMS of a Disease.

AS to the Symptoms of any Disease, the first Bu­siness is to distinguish the Symptoms in general, from the Disease itself; and then to make a Distinction between the Symptoms themselves: That is, the Sym­ptoms which arise and vanish with the Disease, are to be distinguish'd from those, which are bred, not from the Disease itself, but from the Symptoms of the Disease: And the Symptoms, as we before obser­ved, which immediately accompany the Disease, and are born and die with it; are the only sure Marks or Signs of the Disease.

TO illustrate this by our former familiar Instance of the Tooth-ach: Here the Pain is the chief and most grievous Symptom, but is neither the Disease it­self, [Page 19]nor the Cause of the Disease; nor, yet, is it a simple Symptom only, forasmuch as it is the Cause of other Symptoms, which succeed; as the Fever, In­flammation, swelled Face, &c. especially when the Pain is violent. Those several Accidents, now mentioned, are caused only by the raging Pain of the Tooth-ach (the true Mark of the Disease) and are Symptoms of a Symptom only. And farther, these Accidents of Fever, Inflammation, swelled Face, &c. are neither in whole, nor in part, the Cause of the Tooth-ach; neither are they insepara­ble Companions of the Tooth-ach; for the Tooth-ach may be, and often is, without them. And the swelled Face, in particular, does not begin, nor end with the Disease; nor does it always accompany it; nor is it of the same Nature with the Humour, oc­casioning that violent Pain, but is a Symptom only of the Tooth-ach; being raised by the Pain, and bred by Consent of Parts from an Afflux of Hu­mours.

THUS you see plainly the Method of investiga­ting the Nature and Causes of a Disease; it's Seat and Part affected; it's Diagnostic Symptoms; and the Necessity of distinguishing these latter, not only from the Disease itself, but also from one another: All which will make way to judge the better of a fit Remedy to cure the Disease; for we cannot rea­sonably hope for a Cure, before the Disease be tho­roughly understood. And in this manner we must come at the Nature, Cause, and Cure of all Dis­eases whatever. — And, indeed, Diseases have that surprizing Analogy to one another, that we [Page 20]cannot find the Nature of any one Disease; but the Nature of several other will, by the same means, become manifest to us. So that a general Know­ledge arises from a particular Inquiry; and we are instructed from the Discovery of any one, into the Nature of many other Diseases, and the most perfect Practice in Curing them.

FROM this Method also of finding out the Di­stemper, is discovered, at the same time, the only Way of making a right and true Prognostic; which is only a Declaration of a Physician's Expectation in curing a sick Person. And this Expectation can no otherwise be truly framed, than from the Na­ture of the Disease; the Quantity and Intenseness of it; the natural Strength of the Sick; and the Power of Medicines conjunctly. The Knowledge therefore of Prognostics is not otherwise to be acqui­red, than by rightly investigating the Diagnostic Marks of a Disease, whereby it's Nature is disco­vered; with that the Quantity of the Disease, and the Strength of the Sick, at the same time. And as by this Method, we are also led into the Nature, and Power of Medicines themselves; so here again, the very Medicine reflects Light, and, in some measure, confirms the Knowledge of the Disease; as HIPPO­CRATES well observes: The Medicine declares the Disease.

THIS then is the Method, by which the Nature of all Diseases, to which human Bodies are, or may be liable, is discovered. And should ever any alto­gether new, and unheard of Disease, at any time, [Page 21]appear amongst us; this will be found the sure way of coming at it's Nature: by only thus carefully re­collecting, and examining its Symptoms. Again, this will of Consequence direct to the most proper Method of Curing; the Knowledge of a Disease be­ing the first Step towards its Cure.

‘"ALL the Difficulty of Philosophy," says the great Sir ISAAC NEWTON, "seems to consist in this: From the Phaenomena of Motions to investi­gate the Forces of Nature; and then, from these Forces, to demonstrate the other Phaenomena."

AGREEABLE to which, we observe: That the Symptoms of any Disease being given, it's Nature may readily be discovered.

NOW the Method of curing Diseases, by draw­ing Indications from the evident and conjunct Cau­ses, has been most approved of by the best and Generality of Physicians. To this purpose CEL­SUS: Rationalem quidem puto Medicinam esse de­bere: instrui vero ab evidentibus Causis; obscuris omnibus, non à Cogitatione Artificis, sed ab ipsa Ar­te rejectis. As to the Knowledge of these Causes, it is allowed, they can only be attained by a close and assiduous Observation of all the Appearances in the se­veral Stages of the Distemper: Whoever therefore is Master of an exact Knowledge in the Histories of Diseases, having also due Regard to the Diag­nostics, as by our Method directed; may readily investigate their Nature. Natural Philosophy and the History of Diseases, as we observed before, must [Page 22]ever go hand in hand in improving the Art of Healing; it not being possible to make any great Use of the latter, without some Degree of Know­ledge in the former: and the greater our Knowledge is in the Animal Oeconomy, the better the Nature of Diseases will be known.

I HAVE always found, the keeping close to this Method of investigating the Nature of Diseases, of the greatest Use to me in the Course of my Pra­ctice. For having long since drawn up our Method from the most approved Authors in Physic, Anci­ent and Modern; I have constantly apply'd it, not only to all those Histories of Diseases, which I read in Authors, whose Descriptions of evident Causes, Signs, and Symptoms are just; where the several Species of the same Disease are judiciously distinguish­ed; but also to all those Diseases, together with their several Appearances, I have at any time met with among my Patients. And I am verily persuaded, that you, Gentlemen, will likewise reap the same Advantage, by the Use and Application of our Method, if duly attended, in your future Practice; as well to the great Relief of your Patients, as the abundant Satisfaction of your own Minds.

NOW, in order the more strongly to inculcate on your Minds this most necessary and useful Method of investigating, we will here again give it you in a closer Manner, and in a somewhat different Light; setting out with an Observation of LOMMIUS: Noscere Morbum proximus est ad Sanitatem Gra­dus: Nemo sane hanc aut praesagire, aut reddere [Page 23]affectis rectè potest, qui non animadvertere Genus Aegritudinis, quod sit; non ejus Eventum omnem praenunciare, certis Indiciis norit.

WE said before, that the Symptoms of any Dis­ease being given, it's Nature may be discovered.

NOW, the Symptoms of every Disease are no other than the Effects of some Cause, or some Number of Causes, which pervert and overturn the natural Actions of one or more Parts; for which reason by explaining these Symptoms, we become apprised of the perverted Action, or discover the Dis­ease: for nothing can be the Cause of a Disease, that does not produce the Symptoms, in which the Nature of the Disease consists.

WHEREFORE, the Symptoms of any Disease be­ing given, it's Nature may thence be discovered: And the Nature of a Disease being assigned, we have also the Methods of curing it. Farther, having the Nature and Causes of any Disease, we shall be able to determine how far the Disease is curable or incurable; the Probabilities of curing any Distem­per; and the most proper Methods of attempting it.

NOW the Ancients, as we have already obser­ved, having accurately describ'd the Diagnostic Signs or Marks of Diseases, together with their most natural and simple Appearances; whoever is thoroughly acquainted with the Histories, as deli­vered down to us by them, and is accurate, or well [Page 24]versed in the Structure and Nature of the Fluids and Solids of the Human Body; may, from their Diagnostic Signs, in particular, be able to discover the Nature and Seat of the Disease, and the Way it is produced. By the same means also, he will have it in his Power to shew in what manner, the Symptoms attending the Disease do flow from it's Nature, thus found out from it's Symptoms; and likewise be capable of perceiving how those Sym­ptoms give way, or are cured, by changing the di­stempered Condition of the Parts affected.

IN this Examination of the Nature of the Dis­ease from it's Symptoms, we must be most careful, that every casual and foreign Symptom be separated from the constant and permanent, in the manner the Method, more at large, directs; it being easy by observing the Rule there laid down, to distin­guish the constant and inseparable Symptoms from those, which are merely casual and secondary.

THE principal Symptoms are, for the most part, casy to be explained; the false Symptoms are most commonly found among the secondary Sort, and are the Symptoms of Symptoms only; for which rea­son they ought to be rejected from the Number of Symptoms properly belonging to the Disease.

INDICATIONS of Cure must be drawn from the Nature of the Disease, and not from their pre­carious and supposed Causes; nor from their adven­titious and casual Symptoms: And there must run an uninterrupted Chain, from the Diagnostic Signs [Page 25]of the Disease, through it's Nature and Causes, 'till it ends in a rational and evident Method of Cure.

THUS we see that, in order to cure any Disease, the most natural, easy, and practical Way, is first, to collect the most constant Symptoms and Effects of the Disease. But in doing this, we must always remember; that our utmost Diligence will be abso­lutely necessary, rightly to distinguish the Symptoms: That in our collecting the genuine Diagnostic Signs of any Disease, we never suffer the secondary Signs, or Symptoms of Symptoms, to creep into the Num­ber of the genuine Diagnostic Signs. For, if we do, we shall certainly render our Inquiries into the true Nature of the Disease, almost fruitless and impra­cticable. But, by strictly observing this Caution, we shall readily discover the Disease, and it's Sym­ptoms; together with the Causes of Both. And if we can come at the Nature of the Disease, we are about to Cure; there remains no Difficulty as to the Way of curing, be the Appearances of the Symptoms ever so various or complicated.

THE direct Method of Cure being thus obvious, the Probabilities of Success must be, as the Nature of the Distemper we come to Cure, and the Force and Efficacy of the Medicines we administer, respe­ctively: And if we already know, or can discover by Practice, the peculiar Ways, in which the Me­dicines, we make use of, will act; we shall be thereby instructed, when one Method, or any one [Page 26]Medicine, is most properly administered; and why it must be continued, or laid aside: which is the Sum and Substance of Physic.

THE MATERIALS, which compose the Me­thod of Investigating, and finding out the Nature of Diseases, having been only dispersed in several Parts of the Works of HIPPOCRATES, CELSUS, and other most approved Authors in Physic, both ancient and modern; and having never yet, as I know of, been thoroughly collected and digested into a regular Form: As it may, to this Day, be justly supposed one great Reason, why those excellent Hints and Admonitions have not, always, been so duly re­garded and attended to, as they certainly deserve; so was it, long ago, an Incentive to me to throw them together, with some Care and Pains, in the Method, in which I have now delivered them. And I have, for many Years, with much Satis­faction and Success, experienced the great Benefit and Usefulness of so good a Monitor in my own Pra­ctice; and I flatter myself, it may become equally serviceable to others of my Profession, if rightly made use of: It being the whole Business of the Phy­sician to find out the Distemper, and from that to draw the Method of Cure; and to know the Power and Efficacy of his Medicines, together with the true and exact Manner of Timeing and Dosing them, in each particular Disease, and its Variations.

THIS METHOD, therefore, of investigating the Nature of all Diseases, being the most natural, most rational, and certain Way of attaining that [Page 27] compleat Knowledge; I think, it may not improper­ly be esteemed the very Master-Key to the Know­ledge of the Practice of Physic: And I imagine, if thoroughly understood, and then properly apply'd, it will most safely conduct us, from the very Threshold of Physic even to its Consummation; and that, with much greater Expedition and Success, than any other, hitherto known, Method. And, as it will be of very great Service to the Beginner; so likewise, will it continue to be the most useful and necessary Companion, we can associate withal, through the whole Course of our Practice. Where­fore, that I might make this Method familiar to you, I have gradually opened it in the Beginning of this Lecture, and have through the whole variously represented it: More particularly, I have given it you in two different Views; that I might the more strongly inculcate, and impress it on your Minds. And, that nothing may be wanting to it's compleat Use; I shall endeavour, in my subsequent Lectures, not only to make it still more familiar, but also as serviceable as possibly may be, both to yourselves and Patients; by illustrating it with frequent Ex­amples, and the constant Application of it to the se­veral Disorders, we shall hereafter be obliged to treat of. By this means, Gentlemen, I hope, you will be altogether Masters of the right Use of our Method of Investigation, and the Application of it in all the Diseases, and the Varieties of them, you may either meet with in Authors, or observe in your own future Practice.

FOR the rest: I shall take care to direct you, how to judge of the Efficacy and Powers of Medi­cines, with their peculiar Way of acting: How to administer each Medicine in the most proper Dose, and most proper Time of the Disease: When it may be necessary to alter, entirely change, or continue the Methods and Medicines: When, and how, pro­perly to Bleed, and apply Blisters, in the several Stages and Complications of a Distemper. I shall, besides, furnish you with a select Materia Medica, and Methodus Praescribendi, suitable to each Dis­ease. This introductory Knowledge, joined to your own necessary Diligence and constant Attention; will, I apprehend, most effectually qualify you, to pra­ctise with Success, in every Disorder, we shall have occasion to lay before you in this Part of our Course.

FINIS.

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