An inquiry into the nature, causes, and termination of nervous fevers: together with observations tending to illustrate the method of restoring His Majesty to health, and of preventing relapses of his disease. By Robert Jones, ...

An inquiry into the nature, causes, and termination of nervous fevers: together with observations tending to illustrate the method of restoring His Majesty to health, and of preventing relapses of his disease. By Robert Jones, ...

Table of contents

Title page

TO HIS MAJESTY.

INTRODUCTION.

AN INQUIRY, &c.

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AN INQUIRY, &c.

THERE is not a disease which assumes a greater variety of appearances, nor has given occasion to the loquacity and decided opinions of practitioners of Medicine, than the complaint which has for some time past afflicted our most amiable Sovereign. At one time it is supposed to be the Gout, at other times the Hypochondriasis, and at others a Nervous Fever: nay, it is distinguished by almost every name which is congenial to the medical dogmas of practitioners of physic.

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IT unfortunately happens to mankind, that the method of living which Physicians in general observe, is likely to establish a good state of health; and hence arises their implicit faith in books and systimatical writers. They are therefore seldom harrassed with those complaints, which so constantly fall to the lot of social, and convivial spirits, which are commonly Fevers, the Rheumatism, flatulent Complaints, severe nervous Feelings in the Head, and over every part of the body, and the Gout. But while habits of conviviality produce these effects, the opposite extreme, such as abstinence in wine and animal food, and so forth, are attended with precisely the same consequences, and this state is completely demonstrated in the present deranged condition of his Majesty's health.

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I HAVE long been an enemy to Dr. Cullen's practice in general*; for I have seen it so often attended with the most fatal consequences, and more especially in Fevers†. The natural termination of Fevers is in a state of delirium, and, ultimately, in death, if a deranged condition of the intellectual powers do not intervene to prevent the dissolution of nature. This state is called by the name of Madness: and if human invention was absolutely necessary to operate this effect, the method now in use among practitioners of medicine is compleatly equal to produce it.

LET me ask this question, What is it that produces the disease known by the name of a nervous, or putrid Fever? Every physician, who has a grain of common sense, will answer, that it is produced by [Page]debilitating causes! But in order to refine upon these causes, and to spin a web of their own creation, they will insist upon the addition of contagion, effluvia from putrid substances, exhalations from marshy grounds, &c. &c.

THE penetrating Rousseau wisely says, that "science which instructs, and medicine which cures, are both undoubtedly very good; but science which deceives, and medicine which kills, are bad. Teach us how to discriminate them—there lies the difficulty of the question."

THERE never was an art more full of deception than the practice of physic: and this is completely illustrated, by the fatal termination of most of the diseases which are inflicted by Providence upon mankind. We are, in general, disposed to refer the causes of fevers, and other diseases, to the [Page]influence of physical causes alone, and to overlook the operation of moral causes altogether; whereas it can be proved, that moral causes are chiefly the forerunners of most diseases depending upon debility; and in this state of the body, the application of physical causes, such as cold applied to it, in a debilitated state, heat, contagion, putrid effluvia, and other powers, operating upon similar principles, will more effectually produce diseases of this nature; and the effect of these powers will be the more compleat, if to these are added excess of every kind, immoderate indulgence in the passions, fatigues of the mind, together with the afflictions and pains which are felt in every condition of mortality, from the monarch to the beggar, and which harrow up, and constantly prey upon our minds.

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A MONARCH is perhaps the most exposed to these causes. For when we consider him in the capacity of the first magistrate in the land, it is natural to suppose that he must be burdened with cares and apprehensions, and liable to extreme fatigues, both of body and mind, which are to be always considered as the forboding vouchers of a bad state of health.

‘"If nature, says Rousseau, had decreed that we should be sound in body and mind, I will venture to assert, that a state of reflection is a state contrary to nature; and that a man of meditation is a depraved animal. Our misfortunes originate in ourselves, and that we should have avoided almost all of them, if we had followed the simple, uniform, retired manner prescribed to us by nature*."’

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THESE observations, of this profound observer of nature, apply with much force and propriety to the subject I am about to treat upon. For, as I have observed before, we have, from the most exalted of situations, to the most humble of human conditions, our cares and our calamities to sustain. Yet it is natural to suppose, that the individual who approaches the most to the path prescribed to us by nature, experiences the feelings of tranquillity and pleasure, in a more elevated capacity, than the personage who, from his situation, is constantly immured within the walls of study and reflexion; which is in a continual progression to debilitate the body, and to weaken the soul*. Hence arise nervous complaints of all sorts; such as the hypochondriasis, epilepsy, palsy, apoplexy, gout, and other diseases of this nature.

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I HAVE often been astonished to hear, that his Majesty could sustain, (without being precipitated long before this time into a state of disease,) the weighty, and important business, which, like a millstone, must have hung heavy upon his mind, at the same time that it was reported, that he eat chiefly of vegetable food, and drank nothing but wine and water. To carry on a train of thought with vigour and effect, or to transact business of consequence, which is often very disagreeable to the mind, requires the adventitious aid of stimulating food, and cordial liquors, or the diseases I have taken notice of above will eventually take place. And physicians, as well as their patients, will be woefully deceived, if they suppose that either the Cheltenham waters, or the Bath waters, or even those of Spa, will operate wonders, [Page]when the enemy, I mean disease, has stormed the citadel.

DISEASES, in the commencement of their attacks upon the constitution, are but faint resemblances of what are to happen. But they enliven our sensibilities, and our apprehensions, in proportion to their progress; and our memories are at this time eternally presenting to us scenes in which we have acted a part. Hence philosophers, as well as moralists, are constantly declaiming against those gloomy ideas which hurt their solitary hours, and damp their most aspiring thoughts, by exhibiting things in the most odious colours imaginable.

THE cares and anxieties of private individuals, as well as of those who are placed in more elevated capacities, insensibly bring on diseases, and those of a peculiar nature. [Page]And there are sometimes snares, which even wisdom and prudence will not prevent our falling into. Although a warrior is often liable to them, a statesman is infinitely more so, which the history of mankind completely proves. Domestic anxieties, popular tumults, and national disasters, must constantly aggravate his feelings; and these marks of sensibility will, sooner or later, produce nervous diseases. The condition of statesmen in general is by no means applicable to the situation of the first magistrate of his dominions, who has the perpetual call of his people to the exercise of every thing that is wise, just, and benevolent. And when wisdom, virtue, benevolence, and prudence, are disappointed in their intentions, maladies of a most forbidding aspect too often take place. Therefore the only consolation we can enjoy when we are afflicted with disease, is to submit with [Page]patience and philosophy to the fate of men, and to the decrees of fate. Nay, if a straight waistcoat is advised by a grave physician, as a necessary appendage to our misery, we must even submit to this most infernal, and brutal usage. And this act of brutality, I am both free, and bold enough to acknowledge, is the consequence of employing of those, who are profoundly ignorant of the principles, and philosophy of the healing art. I have said before, that what is commonly termed madness, is brought on by the improper treatment of fevers: for this disease is no more hereditary than the Gout, or the scrofula, which I have shewn, in my treatise upon the Gout, to be a disease depending upon the common causes of a relaxed habit. But I need not appeal to a greater authority, than my late learned preceptor, and worthy friend, Dr. Brown, who has had the honour to [Page]explain, with the forcible language of truth, the nature of this disease, as well as almost every other incident to man.

THIS idea leads me to a digression which I did not intend to make. But as I conceive it to be of some importance to mankind, I intend to offer my opinions, at some length, upon the subject, as they may be of utility to mankind. I shall therefore consider the subject, both as a philosopher, as well as a physician; and I hope that a discerning public will not impute blame to an intention, which has the benefit of my fellow creatures before me.

WHEN I visited the Bissetre at Paris, in the year 1785, I could not forbear exhibiting my sensibilities, and my feelings, at seeing such a number of unfortunate persons [Page]chained down to their solitary abodes, without any other cause, from what I could learn, than the peculiarity of their conduct, or excentricity of their behaviour. In the course of my walk, and observations, I came to the cell of an Englishman, who had been a captain of a trading vessel from Dover, and who had been captured by a French privateer in the war before last*. I had two English ladies, a French lady, and a French gentleman in my company; and as soon as he found that there were English in company, he spoke his mind very freely to us, and told us his story with the most perfect distinctness. His mind was perfectly collected, and he was much disposed to express the fervency of it during the time we were in conversation with him; but the police of the place rendered it necessary that [Page]we should saunter on to another abode of misery, and quit the mansion of this son of misfortune. The pleasures of communicating his sorrowful tale to his countrywomen and myself being thus abruptly interrupted, must unquestionably have affected the feelings of the despairing man; and we could hear him, upon our departure, break out into all the wild language of fury and despair.

THIS, as well as many other cases which I could place before my reader, during my stay at this place, is a proof that moral causes have as great, if not a greater influence, in creating and perpetuating of nervous diseases of all kinds, than physical causes; and of that disease, called mania, in particular.

THIS leads me, in a natural direction, to consider the character and important [Page]trust generally reposed by their patients, and the friends and relations of their patients, in practitioners of physic. I have endeavoured to shew, in my Inquiry into the State of Medicine, that the education of physicians in general has a tendency to lead them to engage in disputes of words, while they imagine that they are handling controversies of the deepest importance and concern. It was in order to avoid altercations so frivolous and endless, that the penetrating and learned Dr. John Brown endeavoured to state, with the utmost caution and simplicity, the great desiderata of medicine, and to frame a plan of his own, for the removal of all the obstacles to the improvement of this noble art. This illustrious man saw, almost intuitively, the cobwebs which hung in suspence the fate of mankind: and if he had not united philosophy, and profound learning, together [Page]with much experience, the healing art might languish in its present deplorable condition for ages to come.

"Ab hujus operis scriptore viginti amplius anni discende, docendo, nullas medicinae partes, non diligenter scrutando, consumpti. Quoram annorum quinque primi, aliunde accipiendo, accepta cognoscendo, credendo, quasi pretiosam possessionem occupando; proximum lustrum, singula clarius explanando, subtilius excolendo, poliendo; tertium dubitando, quia nihil ad mentem processerat, algendo, cum multis claris viris, cum ipso vulgo, pro incerta penitus et incomprehensibili salutiferam artem deplorando; sine fructu, sine dulcissima rerum menti, luce veri, praeteriere, tantaque caduce et brevis aevi mortalis pars, tam opima, periit. Solo quarto lustro, [Page]veluti viatori, ignota regione, perditis viae vestigiis, in umbra noctis erranti, per obscura quaedam, quasi prima diurna, lux demum adfulsit."

BRUN. MED. ELEM.

To return, however, to my subject. Diseases and death are the uniform fate of mortals. The infirmities of life, and the pains of disease, will naturally obtrude themselves upon those in exalted situations, as well as upon the most humble of beings; and in this condition of things it is, that reflection takes place. In the gay and pleasing moments of festivity and health, the fleeting moments of mirth and dissipation eraze all thoughts from our minds which are disagreeable to us*; and hence amusements of all sorts are sought after by the more wealthy, to stifle those sentiments of [Page]disappointment, mortification, and chagrin, which must, in a greater or lesser degree, influence all descriptions of individuals; but when the cruel hand of disease renders man a solitary animal, it is then that he begins to think of the past.

THERE are no diseases which assume a greater variety of appearances than Agues, Fevers, and the Gout. When the gout flies to the head, it renders the feelings of the patient exquisitely painful. When the ague visits the head, the feelings are precisely the same. Nay, in what physicians call nervous fevers, there is the same intermission of disagreeable symptoms which prevails in the gout as well as in intermittent fevers. The patient is utterly at a loss to explain certain symptoms which take place in intermittents, such as the severe and dreadful feelings which rack his head, and put him [Page]in momentary expectation of death. The same is precisely the case in the gout. For the same appearances of the body, such as extreme languor, melancholy apprehensions, a state of despair, more or less, tremors, a susceptibility of what is commonly called catching cold, a propensity to think in a disagreeable train of thought, and several other symptoms of the same nature, are observable in this disease also. Putrid, or what are termed nervous fevers, discover a great resemblance in their progress and termination to these foregoing diseases, and are also to be relieved by a similar treatment.

BUT the numerous hypothesis of physicians concerning these three distinct modifications of diseases, form insurmountable barriers to their being treated upon similar principles; and hence the diffusion of error, and unaccountable torpor, which prevail [Page]so universally among practitioners of physic, in their treatment of them.

THERE is no end to the variety of books and dissertations upon medical subjects written by physicians. But the influence of the passions has been, in almost all these verbal disputes and dissertations, too unheededly passed over. ‘"An evil, conceived as barely possible, sometimes produces fear; especially if the evil be very great. A man cannot think on excessive pain and torture without trembling, if he runs the least risque of suffering them. The smallness of the probability is compensated by the greatness of the evil*."’

I HAVE often experienced the truth of this observation in my own person.

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THE regulation of the passions is, therefore, in all nervous diseases, a principal desideratum: and the physician who is not philosopher enough to know how and when to apply with success his penetration in the regulation of the passions, will very seldom relieve a nervous disease, or a disordered state of the intellect. What is the reason that there are so many receptacles for what the ignorant world call mad people? I will answer very frankly, it is because so much ignorance and want of true philosophy prevail among the generality of physicians. It is an abominable disgrace to Britain, to behold such a number of public, as well as private mad-houses, as there are in this island. When an unfortunate man or woman have been mismanaged in a dreadful and alarming disease, it is proposed by some ignorant or interested daemon or other, to send the miserable object of pity and [Page]compassion to some place of security, where he has nothing to console him but cold, hunger, and ill usage. It is impossible to speak too much at large concerning the diseases brought upon mankind by the all-powerful operation of the passion of fear, in its different modifications. Both Mr. Hume, and Rousseau, speak of this passion, as to its causes and effects; and they seem to be in some measure right, so far as it produces diseases of the nervous kind, and what are vulgarly called maniacal diseases among the rest.

‘"A DIBILITATED body," says Rousseau, "weakens the soul. On this is founded the empire of medicine; an art more pernicious to man than all the ills it pretends to cure. For my own part, I know not of what disorders physicians cure us; but I know this, that they give [Page]some which are very fatal, such as cowardice, pusillanimity, and the fear of death. If they cure our body, they kill courage. What is the importance of enabling carcasses to walk? It is man that we want, and we never see any come from under their hands*."’

THIS ingenious philosopher was in a great measure right in his observations. For there is not a doubt, but that the method adopted by physicians in former ages, as well as in those of our own times, is destructive of that principle which upholds us in afflictions, as well as in disease, and that is courage. I do not at all wonder that dramatic writers, such as Moliere, and other authors of sagacity and penetration, were forward in decyphering the hypocrisy and artifice which predominate so much among [Page]some practitioners of medicine. It is quite enough to destroy a man's courage, in a state of disease, to see two, three, or more physicians, dressed in black, with grave countenances, and every affected art which formality itself can invent*.—To depressed spirits and afflicted minds, such symbols of compassion and relief hold out no allurements to please and to gratify a distempered mind, which requires every solacement which virtuous sensibility is ever ready to communicate to the unfortunate. The Scriptures say, ‘"Blessed is the peacemaker;"’ but how much more blessed and happy must that man be, who, by his profound knowledge in his profession, aided by that of deep philosophy, and a knowledge of the passions, knows how to curb them, and when to raise them! he must surely afford the greatest of comforts to the distracted mind, and dibilitated body.

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WHEN I left the university, I flattered myself with the belief, that all diseases were to be cured by medicine and diet. And I have often expressed my surprise, that my attempts in some instances were ineffectual. But when the patient was dead, some unforeseen circumstance then made its appearance, which sufficiently convinced me, that corroding cares had long preyed upon the mind, and that the heart had bled with repeated sorrows; which has often since made me think, that physic and physicians are but imperfect instruments to restore to vigour, constitutions worn out with cares and anxiety.

A POOR man, when reduced in intellectual and bodily vigour by ill usage, and the sophistry and empiricism which prevail in medicine, is sent for the remainder of his days to Bedlam, or some other mansion of [Page]misery. The rich man is confined to his own chambers, without one gleam of hope, either to invigorate his body, or comfort his mind. He is deprived of the society of those he loves and respects. The amusements which he had been accustomed to are never to refreshen his wasted spirits, or his decayed body; and in this solitary and dreadful condition is he to expiate, if he has any, all his errors and his sins. I would rather, if I had my choice, be carried about the country, as Bajazet the Emperor of the Ottomans was, a spectacle for fools, and worse than fools, to look at, than be a prisoner in the predicament I have mentioned.

WERE I possessed of all the eloquence of Demosthenes, Cicero, and Tully, I fear I should be unequal to utter my sentiments at full length upon this important topic; [Page]because I am well aware, that all diseases, where the vigour of the mind is affected, are the result of the passion of fear, which is a most debilitating passion, and is the principal cause of almost all nervous diseases. There is not a doubt but that it frequently produces convulsive, as well as spasmodic diseases; and I have been a witness to its bringing on fits of the gout repeatedly. I have not a doubt in my own mind but that it brings on the hydrophobia, and melancholic diseases, and what physicians term mania, or madness. And I am well convinced, that physic, as it is generally practised, is the most suitable of all professions to produce this nervous disease. If a person, in a debilitated state of the body, is bled, blistered, vomited, and purged, he will, to a certainty, experience some severe nervous disease. But if these dibilitating powers are added to the disease, it is natural [Page]to suppose, that death will be the consequence, unless what physicians call insanity takes place. ‘"But even impossible evils," says Mr. Hume, "cause fear; as when we tremble on the brink of a precipice, though we know ourselves to be in a state of perfect security, and have it in our choice whether we will advance a step farther. The immediate presence of the evil influences the imagination, and produces a species of belief; but being opposed by the reflection on our security, the belief is immediately retracted, and causes the same kind of passion as when, from a contrariety of chances, contrary passions are produced*."’

THE passions produce infinitely greater effects upon the mind when the body is [Page]in a debilitated state, than when it enjoys a healthy and vigorous state, whether this condition of the body arises from a too spare diet, or from a too voluptuous one. The imagination is infinitely more lively with apprehension in relaxed habits, than in vigorous constitutions. And hence arises the great necessity of caution, presence of mind, and minute circumspection in those who are commissioned to attend the sick. For an error at this time is often irretrievable, but more especially when gentlemen of the faculty attend patients in exalted situations. Their empiricism, instead of assuming the bold and decided practice of Van Helmont, or Paracelsus, now puts on an air of timidity, for fear of what are termed the consequences.

To contribute, by want of foresight, or a profound and discriminating knowledge [Page]of diseases, to the death of any department of society, is generally a prelude to their want of business as physicians; and therefore it is natural to presume, that they will exercise more than common caution, and indulge in more than usual timidity, when they are to prescribe for their Sovereign. As fevers are the result of debilitating powers, and consist of debility over every part of the body, but more especially in the head, it is to be presumed, that the King's physicians abstained from bleeding, blistering, &c. in their late treatment of him.

AN unusual fatality is generally the lot of kings, when they are subjected, by either accident or disease, to the fate prescribed by nature for man. In his healthy and vigorous state, both of body and mind, he is, as it were, elevated by the excessive obeisance [Page]of his courtiers, to a rank infinitely superior to the rest of mankind.—But observe the reverse! When all-prying disease commits its havock upon his body, and his mind, then he is reduced to a level with the rest of mankind, if not to a greater state of mortification, and even humiliation. That nature, in a great measure, points to relief, is a rule of infinite importance in the healing art, but never attended to as it ought, by those who have the management of the sick.

To regulate the mind in all diseases, but more especially in all nervous complaints, is an object of fundamental importance*.

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TAKE from a man the pleasures that he has been accustomed to, you hurt his peace of mind, and destroy for ever his sweet-repose. Deprive him of his usual comforts, and you make him a miserable and melancholy being. If a man is fond of the pleasures of a country life, such as farming, gardening, the sports of the field, and amusements of this nature, which are conducive to his propensities as a moral agent, you deprive him of the principal comforts [Page]which this world is capable of affording him. If he is fond of the subject of moral philosophy, natural philosophy, or the subject of mechanical knowledge, it naturally implies, that a deprivation of these pleasures, which are the accompanyments of his solitary hours, are equivalent to the deprivation of his happiness. And without this celestial enjoyment, life, I will venture to say, is not worth enjoying.

PHILOSOPHERS have endeavoured to explain the causes of suicide, but their attempts have been ineffectual; because no remedy has hitherto been applied to the disease. Like the laws of the Romans, which were, before the reign of the Emperor Justinian, an endless subject of municipal ordinances, so also have been the maxims and speculations of men, to put a stop to this unfortunate failure of courage in [Page]man. It would be an endless subject to multiply examples of the cruelties exercised upon men in one form or the other. Moralists and philosophers may preach to eternity upon this subject, and never reach at the cause. They are as widely at variance with the origin of this unfortunate propensity, as the greatest number of physicians are in the proper treatment of nervous diseases. Even the elegant admonitions of Rousseau make me smile when he pretends to speak upon the subject, and are to be considered as neither more nor less than Job's comforters.

EVERY good and benevolent man is of use to society during the period of his existence: but deprive this virtuous character, by human ordinances, of that pre-eminence which his goodness, his charitable inclinations, and his universal sentiments [Page]of benevolence prompt him to exercise; nay, go a step further, say that he is insane, and then you complete, in some measure, the catastrophe*

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IN order to carry folly and ignorance still further, deny the same individual the pleasures of seeing and conversing with those that are dear to him; if he is fond of music, deprive him of that; if he is desirous of seeing and of conversing with any person more than another, be sure that he is deprived of this consolation; if his family, which are dear to him, and most amiable in his eyes, are requested to afford him comfort, they are by the same authority denied access; if the same individual should long for wine, and other cordials, to raise [Page]his drooping spirits, this, forsooth, is supposed to be pernicious; and all this for no other reason, but from the mere ipse dixit of a set of men, who presume to hang in suspence the fate of men, as well as the fate of kingdoms. This complication of evils is sufficient to destroy the mind, as well as the body, of any human being. The body may be cured by medicine and diet, but a distempered mind requires some other consolations besides those which are derived from an apothecary's shop. Boluses, and pills, and draughts, &c. will heal the wound which want of discernment and skill has opened;—it requires some additional assistance to cure severe nervous diseases.

THE examination of Dr. Adington before the Privy Council, concerning the state of our most worthy and amiable monarch's health, is now before the public, [Page]and I shall not therefore hesitate to speak my sentiments upon the occasion. As I have not a doubt but that his Majesty has been treated injudiciously, from the beginning of his complaint to the present time; and it will be a duty incumbent upon his physicians to state at full length the condition they found him in when they were consulted first of all, and to publish a journal of their proceedings. It is full time that the whole of this dismal story should be held out to public notice. The public have a right to be acquainted with the whole mystery of their proceedings. Their reputations as physicians ought either to stand or fall by their method of treating the King in his late and present state of health. It is to be presumed that they can write, and defend, by their learning and ingenuity, their practice.

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DR. ADINGTON, it appears, makes a distinction in what the vulgar call insanity. He confidently asserts, that it is an hereditary disease. I beg leave to enter the list as an advocate for the contrary doctrine. And I contend, that this disease is no more hereditary than a common fever, or the small-pox, but that it is brought on by the common causes of all other diseases. In my Inquiry into the State of Medicine, I have endeavoured to shew, that physicians are too often the unthinking copyists of each other. No man is allowed to think for himself; and if he does, he is hooted at as a common disturber. Therefore, whatever Dr. Boerhaave, or Dr. Cullen say, is a law with their disciples.

"As man," says the immortal Lord Bacon, "is but the servant and interpreter of nature, he can work and understand [Page]stand no further than he shall, either in action or contemplation, observe of the proceedings of nature, to whose laws he remains subject."

As truth is but one simple thing, so likewise is the interpretation of nature. But the senses are fallacious, the mind unstable, and the cause pressing, yet the business of interpretation is rather uncommon than difficult.

NOV. ORGAN.

THESE aphorisms of this illustrious philosopher apply to my subject. For I am ready to prove, to the satisfaction of mankind, that the disease under which our most excellent Sovereign labours, is, from all accounts upon record, nothing else than a common nervovs fever. At the same time, I am forward enough to assert, and my assertion shall not be destitute of proof, if [Page]called upon, that it is more uncommon in its appearance than difficult to cure. And I hesitate not to say, that I would, at the risque of my life, and every thing that is dear and valuable to man, undertake to restore him soon to the full exercise of every bodily and mental enjoyment, upon a plan of diet alone, with proper exercise, together with the management of the passions of the mind. And there is nothing more easy than to uphold his Majesty in a state of good health, when once it is established.

"HE who has not, in the first place, and above every thing else, thoroughly examined the motions of the human mind, and with the utmost accuracy noted, and made a kind of map of the paths of science, and the seats of error therein, will find all things under a mask, or, as it [Page]were, inchanted; and unless he breaks the charm, can never interpret it."

NOV. ORGAN.

IT is impossible that a private individual like myself can alter, remove, improve, or redress the prejudices, opinions, and errors of men, who have the sanction of mankind to tread in the paths of delusion and error, and have the inveterate and general prejudices of ages to uphold them in their career of desolation. It may be said of them as it was said of Caesar, ‘"Caesar gladium cito condidit, nunquam posuit."’ Cicero also, when he speaks of this great man, says, ‘"Caesar, si ab eo quaereretur, quid egissit in toga, leges respondisset multas et praeclaras tulisse."’

WHEN a practice of physic destructive to our natures is pointed out by a man [Page]of discernment and science, it is natural to presume, that when the system of a popular assailant of these pernicious doctrines becomes general, that the opponents of a rational system of medical knowledge will, like Caesar, soon sheath their swords, but never lay them aside. Death, one would suppose they consider, as some moralists do, is a cure for all the evils we bring upon ourselves; and that nature is tired of suffering us to be for ever miserable.

FASHION, it must be granted, flourishes too much in human affairs; and fashion prevails to an extreme in the healing art. If a duke, a lord, or any man of fashion employs a physician, his tradesmen must ape their manners, and do the same. If a physician, let his ignorance of his profession be ever so great, can afford to keep up the formality of an equipage, and suitable decorations, [Page]he is sought after, and feed, while men of the greatest abilities and learning are suffered to walk the streets unheededly. And if a title is conferred upon them, they arrive at the summit of the hill, from whence they can survey the folly and vanity of mankind. They are then in a too elevated situation to be opposed or questioned by itinerant physicians. They arrive at the ne plus ultra, and must be obeyed; and can, with the language of a dictator, say, like Caesar, ‘"Leges respondesset, multas et praeclaras tulesse."’

WE need not wonder that diseases assume a variety of appearances in different persons, no more than we wonder at seeing different conformations of the body and the face in men and women. We might as well wonder, that in habits of severe exercise, that the sweat appears first of all [Page]on the forehead. If two young men, who live precisely alike, either in abstinence, or in hard drinking, or in debauchery of all kinds, entail upon themselves diseases, one would suppose that their respective complaints might resemble, in appearance, each other; but it is a hundred to one if they do; for the more athletic may experience severe nervous feelings, while the more feeble is hurried off in a putrid fever. The same is the case with the fair sex; and the parallel holds good. The one is precipitated into convulsions, when the other is labouring under a disease diametrically opposite in appearance. Appearances of diseases are nothing, the causes of diseases are the only requisites in the hands of a skilful and discerning physician; and when the causes are before him, if he unites philosophy with experience, the cure is near at hand in all human diseases.

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THE method of restoring the King to his accustomed mental and bodily vigour, is, in my humble opinion, obvious. He ought to be indulged in every rational propensity which is agreeable to his mind. His illustrious consort and family ought to have access to him at all times. He should never be contradicted, nor thwarted in any thing that he can request, either in food or drink, unless he calls for vegetable food, and what are called diluting liquors. He should now indulge in animal food, and a proper quantity of wine. Music, provided it is not too loud, will be of great service in the re-establishment of his health. He should refrain from all kind of study and business, unless it is of an agreeable nature. He should avoid going out into the air, until the complaint leaves him entirely, otherwise the smallest chilliness in the air [Page]will convey it into the head.* His body ought therefore to be kept very warm with flannel cloaths. Soups are very proper. The soups he takes ought to be made very rich of animal food, but much condiment [Page]is not necessary in these preparations. His requests ought to be implicitly observed. ‘"FOR the requests of kings," says Grotius, "have the same power as commands; and a denial, how just soever, shall be by them as ill digested as an injury."’ It was therefore a most cruel act in those who attended his Majesty, when he saw through his window some of the princesses walk in the garden, to deprive him of the pleasure and satisfaction of speaking to his beloved children. I have often, in this work, endeavoured to impress upon the minds of my readers, the extreme cruelty of depriving of mankind of their usual comforts and consolations in some [Page]nervous complaints. And what pleasure in nature is there equal to the seeing, even in a state of health, much more in a state of disease, of those we are by nature, as well as by habits of mutual love and intercourse, to cherish and to admire.

ANOTHER solacement to the mind of the King, is to be derived from reading to him, at proper seasons, those books which used to afford him pleasure when he was in a state of health.

DR. WILLIS appears, from his examination before the House of Commons, to be a very sensible and discerning physician, and speaks of the causes which produce his Majesty's illness with perfect distinctness; such as weighty business, severe exercise, extreme abstemiousness, little rest, &c. These causes, of themselves, are sufficient [Page]to produce a nervous fever, without the co-operation of other powers, tending to produce the same effect; such as bleeding, blistering, the debilitating operation of James's powders, and other medical prescriptions of the same nature. It appears, however, that the medicines given to his Majesty since Dr. Willis has been called in, have been attended with beneficial consequences: And I am naturally led to suppose, from the advantages which have hitherto resulted from them, that they must have partaken of opium, which, if administered with judgment and caution, and supported in their efficacy by invigorating food, and proper vinous cordials, are qualified to produce the most happy consequences. The very reverse is the case with this medicine when injudiciously made use of, which very often happens.

[Page]

I BEG leave to submit one more thought upon this subject. It appears that his Majesty had experienced considerable relief, during the progress of his illness, in using the warm bath; and I can venture to speak with certainty, that the effects of the warm bath are prodigiously increased, by being impregnated with the Peruvian bark, and aromatic herbs of all sorts. The only indication of cure is therefore to invigorate, by all possible means, the body, and to afford every consolation to the mind. This plan ought to be studied with much assiduity by those who attend his Majesty. For whatever produces an encrease of bodily relaxation, will, to a certainty, bring on a renewal of his disease.

FINIS.

Notes

*

See Appendix, Note A.

↵

†

See Appendix to an Inquiry into the State of Medicine.

↵

*

Miss Colbrooke's translation of Rousseau's thoughts.

↵

*

See Note B.

↵

*

He said that he had been 30 years in consinement at the Bissetre.

↵

*

See Appendix, Note D.

↵

*

Hume's Essays.

↵

*

See Miss Colebrook's translation.

↵

*

See Appendix, Note E.

↵

*

Hume's Essays.

↵

*

The bite of the Tarantula, they affirm, is to be cured by music; and I do not deny the possibility of it in some cases. The bite of the rattle-snake, by the snake-root; the ague, by the Peruvian bark; the bite of a mad dog, by immersion in sea-water, nearly approaching to drowning the patient; the syphibilic disease, by mercury; schirrous and cancerated parts, by preparations of hemlock, and so forth, ad infinitum. The efficacy of these medicines, and applications, in these particular diseases, depend as much in the expectation of relief they afford, as in any specific virtues they are endowed with. I have not a doubt, but that the greatest number of these diseases are brought on through fear, and its effects upon the imagination, and are cured more by exciting of hope, than from any specific virtue of medicine. The death of Dr. Walsh, and that of Dr. Purnel, is to be explained upon the same principles. They were no doubt brought up in the belief, that dangerous consequences must result from inoculating themselves with matter from putrid bodies; and I have not a doubt, but the fear arising from this belief precipitated them into fevers, and mismanagement after this into their graves. I have often experienced the effects of contagion in my own person; but being regardless of the consequences, and being confident in my own plan of managing of these diseases, I never experienced any bad effects from contagion.

↵

*

It is said that Dr. Warren, when examined before the Privy Council, made use of the word insanity, as applying to his Majesty's disease, and that he was reprimanded by Lord Camden for such an expression. If the Doctor had made use of such language, it is impossible for any words to be sufficiently severe for the noble earl to make use of, to curb such a wanton and unbounded expression of speech. In the inferior conditions of life, the expression alluded to is equivalent to die destruction of a man's credit and happiness for ever. But in the more exalted situation of a monarch, it not only affects the credit and importance of the nation he governs, but must fall upon his offspring; and the more especially, as this disease is supposed, without any ground for such a supposition, to be hereditary.

Dr. Reynolds, upon his examination, says, that his Majesty's complaint may last for weeks, months, and years. And I am willing to admit of this prophecy, unless a different plan is pursued than that which has been adopted by the learned Doctor's friends and himself, which, from all accounts that I have yet been able to learn, must encrease the malady rather than remove it.

When the King went to Cheltenham, I mentioned to my friends, who are ready to prove what I said, that his disease would be encreased, rather than be diminished, by his drinking of the waters of that place. They were by no means suitable to remove his disease, but to encrease it. I suspected that a dropsy, instead of a fever, would be the result of his drinking the Cheltenham waters. If Sir George Baker, or any other physician whose advice had been called for at that time, had recommended a proper quantity of Madeira, indulgence in animal food, &c. instead of ice creams, and vegetable preparations, he might have the gout in his feet, which would be of infinite service to him, instead of a fever, which unfortunately has affected the most tender part of the nervous system. For my own part, I fee nothing difficult in restoring the King to his usual state of health; and I should experience infinite pleasure in being instrumental in rendering of the smallest service to so virtuous a monarch.

↵

*

The evidence of Sir George Baker, before a Committee of the House of Lords, is a compleat illustration of the principles and importance of the late Dr. Brown's doctrines in fevers, and all other nervous diseases, the causes of which consist in universal relaxation. Physicians have been too negligent in observing the effects of cold applied to the human body in a state of debility; and there is not an evil of greater magnitude. Marsh Miasmata, as physicians call it, is nothing but cold and moisture applied to relaxed habits. But neither the essluvia arising from putrid bodies, nor from bales of goods impregnated with the plague, nor the effects of the Grotto Del Cane, are by any means more dangerous, than the effects which are produced by cold upon relaxed habits. I have experienced, in my own person, repeatedly, the effects of what is called contagion; and I have also experienced, to a great degree, the effects of cold applied to the body in a relaxed state. But, if I had my choice in a state of debility, I would rather chuse to be exposed to the opening of goods from the Levant, impregnated with the contagion of the plague, than be exposed to moisture and cold in the same situation.

His Majesty's physician says, that his royal patient had wetted his feet at Windsor, and that he went to St. James's without changing his stockings. This circumstance alone, in the King's state of health, was sufficient to produce alarming consequences, admitting that no eruption took place, which, from the evidence of this physician, was the case at the time. The eruption which took place upon the body, was of peculiar utility in tending to remove the disease. A warm room would have been a proper prescription at this time. And I am not averse to the belief, that palsies, apoplexies, and sudden death, are often the consequences of going out into the air when the mind is unusually melancholy, and the body is greatly relaxed.

↵

§

§

[Page]

AN INQUIRY INTO THE NATURE, CAUSES, AND TERMINATION OF NERVOUS FEVERS; TOGETHER WITH OBSERVATIONS TENDING TO ILLUSTRATE THE METHOD OF RESTORING HIS MAJESTY TO HEALTH, AND OF PREVENTING RELAPSES OF HIS DISEASE.

BY ROBERT JONES, M. D. AND MEMBER OF THE ROYAL SOCIETY OF ANTIQUARIANS AT EDINBURGH.

SALISBURY: PRINTED AND SOLD BY B. C. COLLINS: SOLD ALSO BY S. CROWDER, PATER-NOSTER-ROW, LONDON.

M.DCC.LXXXIX.

TO HIS MAJESTY.

[Page]

Most Gracious Sovereign,

THE object of the following sheets is to explain to your Majesty the nature of your late illness. I have been anxious in my inquiries concerning its origin and progress. All diseases of a similar nature admit of a speedy cure, when properly treated. I have therefore been desirous, as a loyal and affectionate subject, to offer my sentiments upon your Majesty's deranged state of health.

[Page]

THE thoughts which are inserted in the following sheets may perhaps be of some utility to your Majesty. And my intentions will be quite accomplished, if they contribute, in the smallest degree, to the restoration of your health, and to the prevention of relapses.

I am, Your MAJESTY'S Most loyal and devoted Subject and servant, ROBERT JONES.

SALISBURY, Jan. 1, 1789.

INTRODUCTION.

[Page]

THE pathology and practice of medicine are (of all the arts and sciences) the least which approach to certainty and to truth; and the practitioners of physic are therefore too often disposed to appeal to conjecture, analogy, and probability, in their judgment and treatment of most diseases, rather than to reason, philosophy, and a scientific discernment of causes and effects.

EVEN from the infancy of this art, we find reasoning from false principles prevail, [Page]instead of observing, with accuracy, the uniform course of nature. The symptoms of diseases are, therefore, more carefully noticed than their causes; and the practice of physic is, consequently, more influenced by effects than by causes, which should be the solid basis upon which all reasoning concerning diseases ought to be established.

THE innovation which was introduced in the practice of physic by the celebrated Dr. Sydenham, was of essential importance, so far as it was calculated to establish a proper and rational method of practice in all diseases of a phlogistic or inflammatory nature; such as the pleurisy, small-pox, measles, and diseases of this description. [Page]But it is very evident, that in those of an opposite nature, such as nervous fevers, palsies, apoplexies, epilepsies, and all diseases of this nature, it must produce a different effect: and this is completely proved, by its bringing on, in these modifications of disease, the very worst of consequences, and even death.

THE principles and practice of this distinguished physician have therefore had a bad effect, so far as they have been the means of introducing a dangerous practice in nine tenths of the diseases of mankind. For they have found their way into all the principal schools of physic in Europe, and prevail, to a great extent in the practice of medicine, all over the world at this present time.

[Page]

ALL nervous diseases, and fevers in particular, arise more frequently from domestic anxieties, and passions of the mind, such as grief, disappointment, and despair, than from any other causes whatsoever. And in order to remove them, it is evident, that to increase the cause is not the method to remove the disease. But the idea that plethora, or too great a quantity of blood exists in the body, and is therefore the cause of these diseases, is a most pernicious doctrine; consequently bleeding, cupping, a spare diet, purging, and applications of this nature, are supposed to be efficacious in removing of these several diseases; and more especially when they affect athletic and robust people. This supposed cause, therefore, [Page]points out to a most dangerous method of cure.

IT has been the study of a great part of my life to inquire into the defects which prevail so universally in the practice of physic; and I hope that the observations I have made, and the improvements I have in future to suggest, may be of some utility. The bulk of mankind are averse to the study of physic, from the technical terms, the endless multiplication of causes, and the numerous uncouth names for diseases and their remedies, which prevail so universally; therefore private gentlemen were never remarkable for their knowledge of this art, although they have distinguished themselves often by their deep [Page]inquiries into law, antiquities, &c. A Selden and a Spelman were private gentlemen; and no men have been more keen in their researches concerning points of law and constitutional topics.

IT is therefore much to be lamented, that men of fortune, rank, and learning, do not bend their minds to inquiries into subjects of so much importance to mankind as the healing art. The healing art is surely the most interesting to our natures of any whatsoever; and yet men of distinction and consequence in general treat it as a department of knowledge beneath their notice*. The practice of physic in [Page]Great Britain is, at this present time, to be considered as the result of applying Dr. Boerhaave's and Dr. Cullen's principles to practice. These systems have been most compleatly exploded, both as false in their principles, and most pernicious in their practice*. And yet the advocates for these systems of medicine are suffered to domineer, as it were, over the sufferings of mankind.

THE method of treating of nervous fevers, of every description, is in a lamentable condition indeed. We hear of those that survive; and the newspapers inform us of some that are dead. We cease to inquire into causes, and we sit down contented [Page]with viewing of effects. It is, I am forward to say, owing to the mismanagement of the fair sex after laying in, that we hear of the death of so many. It is very likely that they may experience a little fever at this time; but ignorance and mismanagement at this period is likely to convert it into a nervous, or putrid fever, and death. All mankind experience a pre-disposition to diseases, before they announce themselves with all their formality and terrors*. [Page]When the disease takes place, we are not in a condition to help ourselves, and we therefore are obliged to send for the advice of those who are supposed to be qualified to [Page]understand it. The patient, at this time, is perhaps restless * , with a severe and heavy feeling in the head, cold chills, with great lassitude, and full of melancholy apprehensions. Or he may labour under a delirium, and raging fever. An error at this time is irretrievable; and hence the necessity of great judgment, and a nice discernment of causes, in the physician. Bleeding, blistering, vomiting, and purging, will at this [Page]time encrease the malady, and, eventually, bring on death. The delirium arises from a weakened condition of the nervous and vascular system in general, but more especially in the brain. Sudorifics and opiates produce a temporary relief; and it behoves those who administer these medicines, to take particular care that the patient is not exposed to the smallest degree of cold during their operation, or the delirium will be encreased, and all the symptoms of the disease aggravated to an alarming degree.

I HAVE had the management of a great number of patients labouring under nervous or putrid fevers, and have uniformly been successful in the treatment of this [Page]dangerous disease. But I have observed, and I have abundance of proofs to establish my observation, that it sometimes happens, that what is called a state of insanity, is the consequence of these fevers.

A CONTINUAL state of delirium will either bring on death, or a considerable relaxation in the blood vessels of the brain, which will sine vi a tergo, admit of more blood within them, than they were, in their vigorous and healthy state, capable of receiving; just in the same manner that severe study, hard drinking, severe vomiting, and the application of leeches to eyes which are inflamed through weakness, will produce a greater degree of inflammation [Page]in them, by weakening still more these parts*.

[Page]

THERE is no affliction more painful to man than the gout; and yet important discoveries have been made of late, in order to shew that it admits of a speedy cure and easy management. And I am well convinced, from my own experience, that the fear and apprehensions of what takes place in fits of this disease, often produces what is called a relapse. The apprehension of the past feelings, and pains, generally brings on a renewal of the disease. And physicians ought to be particularly careful to prevent their patients from going [Page]out into the cold in a state of convalescence. Cold applied to the body in this state, and especially at this time of the year, will generally produce a relapse; and I suspect that his Majesty has experienced, from this cause alone, disagreeable consequences, and that very lately. In a state of convalescence, the mind is always melancholy and dejected; and whatever weakens the body at this time, will, to a certainty, bring on a return of the disease. Excessive heat in sultry weather produces nearly the same effects.

IN this treatise I have endeavoured to be as short and as concise as possible. But in a future publication, which I have in contemplation, I intend to offer my opinions [Page]at some length, concerning some diseases which are known by the name of Opprobria Medicorum. *

Notes

*

There is an exception to this remark in an illustrious foreigner, His Serene Highness the Prince and Duke de Bouillon, who is not only a profound philosopher, but a most discerning physician.

↵

*

See Dr. Brown's works, and an Inquiry into the State of Medicine, upon the principles of inductive philosophy.

↵

*

The doctrine of pre-disposition to disease is perhaps the most important and useful department of physic. Every man feels the approach of disease before it comes on, by a variety of different symptoms, which are peculiar to every description of men. The Gout is known before it makes its appearance, to those who have been accustomed to it, by flatulent complaints in the stomach and bowels, accompanied with acid eructations, and apprehensions and fear of the disease. The same is precisely the case with fevers, and with great numbers of nervous complaints. This is the time that a physician has it in his power to exert his skill and judgment, and before the disease makes its formal appearance; therefore a proper knowledge of the doctrine of pre-disposition to diseases, as it is called, is of the greatest utility in preventing the accession of them. Therefore Dr. Willis, with all deference to this physician, was perfectly erroneous in asserting, that diseases of the same nature with that complaint under which his Majesty has laboured are liable to relapses; for the knowledge of a state of pre-disposition to disease will qualify a discerning physician to observe the malady at a distance, and to prevent the tumult which it creates—relapses, in these cases, are therefore accounted for. It is natural to suppose, that his Majesty will be an invalid for some time to come, and that he will be liable to trifling attacks of his disease. During this period, it would be very advisable that there should be a physician in constant attendance, who ought to have nothing else to do but to wait on his royal patient, and to obviate every little attack, by proper medicines, diet, &c. This plan will constantly ensure his Majesty a good state of health, and enable him, in a short space of time, to be, from experience alone, his own physician.

↵

*

From the reports of his Majesty's physicians of the 7th, 8th, and 9th of December, I am still more strengthened in my opinion, that his disease is neither more nor less than a nervous fever. Every man, in all descriptions of nervous fevers, is rather incoherent, unless they are refreshed by sleep. For a want of rest debilitates the mind and body to a great degree. This is proved by the invigorating effects of sleep which his Majesty experienced on the 8th and 9th.

The report is, His Majesty has had more than seven hours undisturbed sleep in the night, and is quiet this morning.

(Signed)

R. WARREN.

J. R. REYNOLDS.

↵

*

There are no diseases more obstinate in their cure than some inflammatory conditions of the eyes. A great number of people lose their sight by tampering with their eyes in this situation. The great object of surgery is to prevent the amputation of legs and arms, by curing of the disease, which, however, in some cases, is absolutely necessary. But surgeons, as well as oculists, are too fond of using of instruments. Oculists are not in general sufficiently qualified to reason concerning the causes of diseases of the eyes, much less of obstinate opthalmias, or inflammations affecting these organs; hence arises the inveteracy of this disease. It is therefore probable, that a noble Lord, once high in office, will lose the use of his eyes from mismanagement. For the method of treating these inflammations of the eyes, is diametrically opposite to the indication of cure. They are, from the inflammatory appearance of the blood vessels, conceived to be real inflammatory diseases, when the contrary, I am ready and willing to prove, is the fact, in nineteen times out of twenty. I have had the management of a great number of patients labouring under this obstinate complaint, and have been successful in curing every individual that has been under my care.

My motive in introducing of this subject is only to shew, that in cases of mental derangement, the blood vessels within the brain are in the precise situation of debility and relaxation which takes place in the blood vessels which occupy the anterior parts of the eyes in obstinate Opthalmias; and that to invigorate, by all possible means, the whole system, and the vascular system in particular of the parts affected, is the only cure.

↵

*

The Appendix and Notes, which it was my original intention to make a part of this treatise, are to be inserted in a subsequent performance, which is to comprehend in it a great variety of proofs, which are not taken notice of in this publication.

↵

Information about this book

Title statement

An inquiry into the nature, causes, and termination of nervous fevers: together with observations tending to illustrate the method of restoring His Majesty to health, and of preventing relapses of his disease. By Robert Jones, ...

Jones, Robert, M.D.

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Publisher

University of Michigan Library

Place of publication

Ann Arbor, Michigan

Date

2012 November

ID [DLPS]

004876617

ID [ESTC]

T116073

ID [DOCNO]

CW108868707

ID [TCP]

K092929.000

ID [GALEDOCNO]

CW3308868707

ID [CONTENTSET]

ECMS

ID [IMAGESETID]

0920100900

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— An inquiry into the nature, causes, and termination of nervous fevers: together with observations tending to illustrate the method of restoring His Majesty to health, and of preventing relapses of his disease. By Robert Jones, ..., Jones, Robert, M.D..

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[2],xviii,51,[1]p. ; 8⁰.

printed and sold by B.C. Collins: sold also by S. Crowder, London,. Salisbury :: 1789.. (Reproduction of original from the British Library.) (English Short Title Catalog, ESTCT116073.) (Electronic data. Farmington Hills, Mich. : Thomson Gale, 2003. Page image (PNG). Digitized image of the microfilm version produced in Woodbridge, CT by Research Publications, 1982-2002 (later known as Primary Source Microfilm, an imprint of the Gale Group).)

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