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.
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.
I HAVE long been an enemy to Dr. Cullen's practice in generalSee Appendix, Note A.; for I have ſeen it ſo often attended with the moſt fatal conſequences, and more eſpecially in FeversSee Appendix to an Inquiry into the State of Medicine.. 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
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
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.
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 natureMiſs Colbrooke's tranſlation of Rouſſeau's thoughts.."
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 ſoulSee Note B.. Hence ariſe nervous complaints of all ſorts; ſuch as the hypochondriaſis, epilepſy, palſy, apoplexy, gout, and other diſeaſes of this nature.
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,
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.
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
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
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
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 laſtHe ſaid that he had been 30 years in conſinement at the Biſſetre.
. 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
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
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
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,
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 usSee Appendix, Note D.; and hence amuſements of all ſorts are ſought after by the more wealthy, to ſtifle thoſe ſentiments of
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
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
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 evilHume's Eſſays.."
I HAVE often experienced the truth of this obſervation in my own perſon.
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
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
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 handsSee Miſs Colebrook's tranſlation.."
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
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 inventSee Appendix, Note E..—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.
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
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;
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
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 producedHume's Eſſays.."
THE paſſions produce infinitely greater effects upon the mind when the body is
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
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
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 importanceThe 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..
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
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
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
of benevolence prompt him to exerciſe; nay, go a ſtep further, ſay that he is inſane, and then you complete, in ſome meaſure, the cataſtropheIt 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.
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
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,
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.
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
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
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
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
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,
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
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.
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
will convey it into the head.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.
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
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
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
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.
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.