A TREATISE OF Incurable Diseases: CONTAINING
I. An
ESSAY
on the
Proper Means
to reduce the
Number
of INCURABLES.
II. An
ATTEMPT
to settle a just
Notion
of INCURABLE in
Physick.
III. A
SPECIMEN
of a
Rational Method
to discover the Cures of reputed INCURABLE DISEASES.
By
P. SHAW,
M. D.
Neque igitur dubitabo inter
Desiderata
reponere Opus aliquod de Curationibus morborum qui habentur pro Insanabilibus; ut evocentur & excitentur Medici aliique egregii, & magnanimi, qui huic operi quantum largitur natura rerum incumbant; quando hoc ipsum,
Istos morbos pronunciare Insanabiles,
neglectum & incuriam veluti lege sanciat, & ignorantiam ab infamia eximat.
Bac. de Aug. Scient.
L. IV. C. II. p. 310.
LONDON:
Printed for
J. Roberts,
near the
Oxford-Arms
in
Warwick-lane,
1723. (Price One Shilling.)
F Hoffman fecit
TO
THOMAS GUY,
Esq;
SIR,
T HOUGH the Subject of this Treatise, consider'd as a Desideratum in the
Healing-Art,
should chance to have had no great Share in your Studies, yet have you a Right to a Work of this kind, superior to any such Claim.
I will not say, had your benificent Disposition never appeared in favour of the wretched
Incurable,
that I should never have entertained any Thoughts on this Subject: But this I am obliged, in Justice, to acknowledge, that whilst I was committing them to Paper, your excellent Design was so strongly before me, that I found it absolutely impossible to write regardless of it. Upon which Account, it is but Just that I make you a Tender of what was thus written.
I cannot indeed persuade my self, however mean the Performance may appear, that it will prove an unacceptable Present; since it attempts a farther Relief of those deplorable Persons, for whom you have already expressed so tender a Regard.
And if by due Management, any of these shall happily find a Cure, where it might be least expected, in an Hospital set apart for
Incurables,
it will not, I presume, redound more to the Consolation of the Patient, than to the Honour and Delight of him who not only generously founded, but liberally endowed it.
I am, With the highest Esteem, Sir, Your most obedient Servant, PETER SHAW
A TREATISE OF Incurable Diseases, &c.
I.
Of the proper Means to reduce the Number of
Incurables.
A LTHO' several cogent Reasons, to demonstrate the Feasibility of the present Design, may be drawn from the Nature of Distempers, and the known Effects of Medicines; the common Occurrences of daily Practice, and the great Probability there is of bringing many unknown Remedies to Light; yet were it not for what so grave and approv'd an Author, as the great Lord-Chancellor
Bacon,
has recorded about incurable Diseases, it would perhaps seem daring and presumptuous to maintain the Possibility of lessening their Number, after so many Ages appear to have been unsuccessfully spent in attempting it.
FOR, the Cure of Incurables does not only involve a Paradox in the Expression, but in an Age so productive of new Discoveries, and so fertile in Improvements as the present, it generally passes for a desperate Problem; and is apt to be rank'd in the same Class with the Quadrature of the Circle, the Perpetual Motion, and the Philosopher's Stone.
BUT the most celebrated and judicious Author abovementioned, is clear and express, that Physicians
When they enquire into Diseases, find so many which they assert to be
Incurable,
either from their first Appearance, or after they have continu'd some Time, that the Proscriptions of
L. Scylla,
and the
Triumv
rate
were
ing in Comparison of the Proscriptions of Physicians, by which, with the most unjust Sentence imaginable, they deliver Men over to Death▪ many of whom, notwithstanding, escape with less Diffic
y than a
d those formerly under the
Roman
Proseriptions. A Treatise therefore is wanting upon the Cures of repared incurable Diseases, to the
nd that both Physicians and others of Eminence and Resolution may be encouraged and excited to pursue this Matter as far as the Nature of it will permit; since to denounce Dis
es
Incurable▪
is to establish Neg
gence and Carelesness, as it were by a Law, at the same time that it
eens Ignorance from Rep
oach.
"In inquisitione illorum de Morbis, inveniunt Morbos complures quos
Insanabiles
decernunt, alios jam inde à principio Morborum, alios post talem quampiam periodum. Ita ut L. Scyllae & Trium-virorum Proscriptiones, res nihili fuerint prae Medicorum Proscriptionibus, per quas tot homines iniquissimis edictis morti dedunt; quorum tamen plurimi minore cum difficultate evadunt, quam illi olim inter Proscriptiones Romanas. Neque igitur dubitabo
(continues this great Author)
inter Desiderata reponere Opus aliquod de Curationibus Morborum, qui
habentur
pro
Insanabilibus;
ut evocentur & excitentur Medici aliique egregii & magnanimi; qui huic operi, quantum largitur Natura rerum, incumbant; quando hoc ipsum, istos Morbos pronunciare
Insanabiles,
neglectum & incuriam veluti lege sanciat, & ignorantiam ab infamià eximat."
de Aug. Scient.
L. IV. Cap. II. p. 310.
AFTER such a Declaration from so great a Man, it will not, I hope, appear either assuming or ridiculous to attempt a Discovery of the Cures of such desperate or inveterate Diseases as may chance unjustly to pass for Incurable. Such a Design, at least, ought not to be thought assuming, if it be enter'd upon according to his Lordship's Direction,
"To the end that the more able Physicians, and Persons of Eminence and Resolution, may be encouraged and excited to a thorough pursuit of this Matter;"
which is the main View in publishing this Treatise.
And if an Indulgence be granted to any thing that may seem to carry an Air of Presumption or Assurance in such an Undertaking, I am persuaded there are few will think an attempt of this Nature, Ridiculous or Impracticable, after so very grave and discerning an Author has laid it down for just and reasonable.
Some there are, however, who will be apt to say, granting many Diseases were an hundred Years agoe, unwarrantably call'd Incurable; and allowing the Physicians of that time to have, in this Respect, been no less unjust than rigid and severe; yet after so many great Improvements, and useful Discoveries made in Medicine of late, 'tis impossible the Censures of the present Physicians should be equally unjust, or equally severe with those at the time when this great Author wrote. Others will go still farther and cry, can it be imagin'd, when by a grand Increase of Learning, a through Reformation in Philosophy, a prodigious Number of useful Experiments, and happy Discoveries in Mechanicks, Anatomy, Chyrurgery, Chymistry, Pharmacy, and Botany, a noble Addition to the
Materia Medica,
and the Introduction of a Mechanical System of Physic; can it be imagined will some say, when by these large Acquisitions the Art of Healing seems rais'd to its Achme, its Pinnacle of Perfection, that the Censures of Physicians are not extreamly just and utterly Irreversible; and the Number of Incurables already shrunk and contracted within the narrowest Bounds human Means can reduce them?
Indeed, it may very well appear Surprizing, if with these accumulated Advantages the Art of Healing be not vastly improv'd, and the Number of reputed incurable Diseases lessen'd; and yet alas! the thing it self will speak and tell us, that Incurables were never more common, and that they are so far from diminishing, that they rather seem to grow upon us daily, insomuch, that 'tis become necessary to provide for the meaner Sort of them by a new and an extraordinary Kind of Bounty.
Besides, as 'twere folly to endeavour to palliate the Matter, the common Practice of every Place will, at this Day, afford a sufficient Proof both of the great Number of Incurables, and the rash Censures of Physicians. For not to mention that we daily see Persons who were given over by some Physicians, recover'd by others, what Numbers after having been declared Incurable by very eminent Men, and such as were well versed in physical Practice, have not found a Cure by Accident, the Kindness of Nature, the Observation of a Regimen, the Use of slight Medicines, a Course of Physic, or by venturing upon some desperate Means? Instances of all these are every where so Numerous, that 'tis in vain to go about to conceal the Thing, or its pernicious Consequences: Most Persons are now appriz'd, that
Incurable
in Physic has had a like Effect with
Occult Quality
in Philosophy, a Term which manag'd with Address, amus'd the Multitude, and kept up a Veneration for an Appearance of Learning, but at the same time prov'd a very great Obstacle to farther improvement in useful Knowledge.
'Tis well known also, that every Age has had its particular Kind of Practice, which was always adequate to the Discoveries of the Time, and regulated by the prevailing Philosophy of the Place; so that this Practice in the Infancy of the Art, must necessarily have been proportion'd to an infant Knowledge of Diseases and Remedies. 'Tis less to be wonder'd at therefore if the puny Physicians of the earliest Ages shifted the obstinate Cases from one to another, and were pleas'd to denounce all the Diseases incurable which baffled their slender Skill. This Procedure, however we laugh at in them, but are our selves perhaps no less Ridiculous; for we also turn off our desperate Patients, when our Remedies fail us, and term that an incurable Disease which obstinately resists the fashionable Practice of our Age and Country.
But is a Distemper therefore really Incurable, because I, a second, or a third Person cannot cure it? Or can this Term with any Propriety, be applied to a Case which has only eluded the prevailing or current Practice of our Time, without giving any evident Tokens, that 'tis absolutely, and in every respect Incurable? If this be sufficient to denominate a Disease incurable, then numberless Diseases, which have been cured, were incurable.
Doubtless this Term ought to be used with great caution, because when misapplied, it not only abuses the Patient, but disgraces the Profession, and brings a Scandal on its Professors, at the same time that it prevents an Improvement of the Art of Healing. But we of this Age ought more than those of any precedent one, to demur in the Use of the Word, when the Case is not very plain and evident; we who are well acquainted with the Structure of the human Body, and several grand Remedies which were unknown to former Ages; we who are Masters of all the Experience of the Ancients, and have seen their Weakness and Errors, as well as our own, in calling some Diseases incurable; we who cannot but own Posterity may improve in their Knowledge of these Things, and be able to cure Diseases reputed by us Incurable, as we have happily cured some that were so reputed by Antiquity. Are not we also sensible that Physicians generally go in the same beaten Track, and that tho' they differ in Forms, yet usually agree to exhibit the same Medicines in like Cases? Thus all now prescribe Mercury in the Venereal Lues, and Cortex in Intermittents; and if these happen to fail, the modish Practice of our days is suppos'd to be exhausted, and without farther trouble, the Case is adjudg'd Incurable. But as this Sentence is frequently revers'd either by Nature, Accident, or Art, it is, by no means, of it self sufficient to denominate a Person properly Incurable, that his Case has been unsuccessfully prescrib'd to by a few Physicians.
How it comes to pass that Incurables are so numerous at this time, and that whilst other Arts and Sciences appear in a flourishing Condition, and even Medicine it self is greatly improv'd in its Theory, yet the Art of Healing, the practical Part, the most valuable Branch of Physic, and ultimate End which all the other Branches are destin'd to promote and centre in, shou'd not be equally advanced, is a Speculation that wou'd carry us beyond the Bounds of the present Design. And as it is of far greater Consequence to know how to remedy this Defect in the Art of Healing, and thereby diminish, if possible, the Number of Incurables, than to account for the slow Progress of the physical Practice; I shall here confine my self to the former Consideration, and endeavour to shew what is the most proper Method of proceeding in order to discover the Cures of such Distempers as obstinately resist the present Form of Practice, at the same Time that they give no other Signs of their being absolutely and properly Incurable.
The Method that I wou'd offer at in this case, is founded on a proper Use of our natural Faculties. If we will but open our Eyes, allow a freedom of Reasoning, and not be slow in reducing its Dictates to Action, there are good grounds to hope that the Number of reputed Incurables will soon be lessen'd, or at least their increase be prevented; and a more accurate distinction of Diseases for the future be introduced.
As by a reputed incurable Disease, I always mean such an one as proves too strong for ordinary Treatment, without affording any farther reason to persuade us, that the Cure of the same Case is utterly impossible to be effected hereafter, to attempt the Cure of a reputed incurable Disease, is in no wise Wild or Romantick. But the Way to discover such a Cure, is not to stop short where the common Medicines fail, lazily term the Case Incurable, and then sit down contented, and applaud our selves for having got to the extent of our Tether: On the contrary, if we wou'd in carnest endeavour to benefit Mankind, by improving the Art of Healing, from an accurate Observation of the Phaenomena of Diseases, we should proceed to deduce their immediate Causes, and find out what kind of Remedies are wanting to remove them; and then by the proper Experiments obtain these
Desiderata,
or at least in defect of them, contrive to raise the known Remedies to their utmost Power, in order to see whether they will not then reach the more stubborn Cases.
It is such a Kind of Geometrical Method, which appears to me the most proper to be observ'd in this Pursuit; that way of Reasoning from
Data
to
Quaesita,
which has done Wonders in Philosophy, Astronomy, and Mechanicks. But it happens most unfortunately, that instead of encouraging and pursuing this noble Method in Physic, we seem almost entirely to discountenance and contemn it; instead of endeavouring by this means to cultivate the most momentous Art on Earth, we are too often amusing our selves with what is Trifling, when set in Competition with it; and instead of endeavouring to lessen the Number of Incurables, or ease their Tortures, we are either wrapt up in the Clouds, and contemplating the Stars, or groveling on the Ground in quest of Pebbles. Not that I would Reflect on any part of Knowledge, though ever so little useful; but surely those who have attach'd themselves to Physick, and make Profession of its Practice, are inexcusable, if this has no share in their Studies. Some excursions out of this Province are perhaps allowable, but we should not methinks always content ourselves with searching after Things which are utterly foreign to Physic. The Theory of Physic, indeed, no one can deny to be useful, so far as it brings Advantage to the Practice; but who does not see that 'tis Preposterous to spend Time in computing the absolute force of the Muscles, the weight of the Air upon the Lungs, the just Momentum of the FLuids, and a thousand other Things; whilst there remain so many inquiries of infinitely greater Importance to be made, and which might even discover the cure of such Diseases as we now miscall Incurable?
Is it not shocking to see what Pains and Application are bestow'd in promoting other Arts and Sciences, whilst Physick alone is abandon'd, and seems to be almost the only Art that is not cultivated among us? Thus in Astronomy, a glorious Science indeed, and tho' not unworthy of the Esteem it meets with, is yet infinitely less conducive to the Well-being of Mankind than the Practice of Physick; what immense Labour and Assiduity are employ'd? With what diligent attendance and watching is a new Star added to the Catalogue, or another Satellite to the train of a Planet? What Drudgery is not gladly undergone, to determine the Magnitudes, Distances, Periods of Revolution, Gravities and Densities of the remote planetary and cometary World? But if any profess'd Physicians, leaving their own Art to the improvement of others, shall give themselves up to the cultivation of
this,
they may please to consider that such procedure will afford little Consolation to a Man under the raging torture of the Gout or Stone, or to those doom'd to languish under the hard Sentence of Incurable. What will it avail such as these, to be told the exact Minute of an Eclipse, or other Results of numerous Observations, and laborious Calculations? And yet these Things which concern us so little are highly priz'd, at the Expence of Medicine; and the Knowledge of them obtain'd with the most vigorous Resolution and assiduous Application. How we can answer the not taking equal Pains to discover new Remedies, improve the old ones, and advance the Art of Healing, when the Lives of Mankind are immediately concern'd in it, I am at a loss to know. But to return.
The Method I would recommend to find the Cures of reputed incurable Diseases, will be best understood by the Specimen annext; where I aim to proceed intirely upon rational Grounds. I must therefore take leave to observe, that the free use of our Reason is the best Guide we can make choice of to lead us to this Discovery. By the use of Reason I wou'd be understood to mean the exercise of that Faculty upon Subjects relating to Diseases, in order to find a desirable and promising Method of Cure for an inveterate Case, when the current Practice has proved unsuccessful; that is, such a Method as shall, before it be try'd, appear likely to succeed, when consider'd by a rational Physician, and is more eligible to the Patient, than the Distemper 'tis intended to rid him of, or at least to palliate. Such a Method of Cure as this, is, in my Opinion, unexceptionable, in reputed incurable Cases; and ought without scruple to be put in Practice by a reputed incurable Patient; because such a Patient can have no hopes of a Recovery, but either from meer Chance or Empiricism, or else from the tryal of such a rational Means as is here propos'd: But any rational Person will surely rather rely on Reason, than Chance for a Cure. Moreover, true reasoning from the requisite
Data,
brings us to absolute certainty; and is always preferable to Belief, Tradition, casual Experience, or any other Assistance rely'd on in physical Practice: a general and rational Physician therefore, who is never unprovided of
Data
to Reason from, cannot do better than thus to apply this Faculty. And if the result of this Application be the discovery of a desirable and promising Method of Cure, he cannot do better, in the way of his Profession, than to recommend it.
This method of Procedure will be readily acquiesc'd in by those who are unacquainted with the general fate of Physick. Such Persons are ant to imagine, that this is the common foot upon which all rational Physicians proceed in their daily Practice, and that no other tolerable Method can be establish'd. But these Persons are not aware how extreamly cautious and sparing Physicians have formerly been in the use of their Reason. That Body of Men have all along had so tender a Regard to their fellow-Creatures, that they thought their utmost care was necessary in the Application of Remedies; and therefore rarely ventured to trust so dangerous a Thing as Reason in the use of 'em. And so Experience, safe Experience, came to be wisely substituted in its stead: this was the Oracle, this alone was extoll'd, and Reason, fallacious Reason was decry'd and contemn'd, as having little to do in the Practice of Physick. Hence they proceeded to settle Rules, and establish Forms from Experience, chusing always to use the Remedies which had been used before, and to prescribe over again what they had already
experienc'd.
To swerve from the establish'd Method, or prevailing Practice of the Age, was commonly thought bold and dangerous; and to try a new Remedy, tho' it might promise ever so fair, was look'd upon as hazardous and presumptuous. The practice of Physick being thus curb'd in, and restrain'd, has advanced by very slow Paces; and all this for want of a sound Philosophy, and a larger stock of
Data.
For certainly there can be no other Pretence, why this best of Faculties should be thrown aside as useless, or disadvantagious in Physick, rather than in Philosophy, or any of the Arts and Sciences. But now as the case is otherwise, as our
Data
are more numerous, and the way of reasoning from them is improv'd; as our present System of Philosophy is solid and extensive, and the Subject of Physick, the animal Structure, is vastly better defin'd and understood; 'twould be highly absurd to pretend, that this grand Talent ought not to be applied to discover the cures of, at least, the reputed incurable Diseases among us. For in these Cases, our present stock of Experience is confessedly of no Service, and new random Trials might be justly deem'd rash and Presumptuous: An attempt therefore to form a method of Cure, by arguing from the nature of the Disease, to the discovery of more powerful Remedies, is here the only rational and promising means we have left.
It will surely be granted, that the present practice of Physick is improveable, if it be consider'd, that the several Branches of which this Art is compos'd, are daily improving; whilst new discoveries are made in Anatomy, and Chirurgery grows more compleat; whilst Chymistry and Pharmacy furnish us with new Preparations, and Mechanicks is more successfully applied to the animal Structure; it cannot be doubted but some use may be made of these Things to the advantage of Physick, and the cure of reputed incurable Diseases. There is no room to question, that many powerful Remedies lye now absconded, or enveloped in their first Principles, if it be consider'd, that the whole Set we are at this time acquainted with, were once in the same state of Darkness and Confusion. Let us but reflect, that
Agues
were reputed incurable till the Cortex was found, and its Uses known, as well as the
Lues Venerea
till Mercury, and the Woods were applied; and consider by
what
means not only these, but numberless other useful Medicines were obtain'd; and then there will be very great Encouragement to expect, that if diligent search were made, and the proper Experiments instituted, many grand Remedies might be disclosed, and such as wou'd be of force sufficient to cure some Diseases which now lye under the unjust Sentence of Incurable.
Nor is this the only reason we have to hope for such a Redress in the Art of Healing, and a considerable Reduction of the present Incurables: great Assistance may in this case be likewise obtain'd from a due management of the Remedies we are already possess'd of. For there are so many Requisites necessary to advance these to their highest Power, that it may very well be questioned, if the utmost force they are capable of affording, was ever exerted on the cause of any Disease.
Chymistry has improv'd the Efficacy of many Medicaments, and shewn them to have such Virtues, as were utterly unknown before that Art became general: And Fire is an Element from which other as great Matters may be justly expected. Besides this, an inverted Order, a well proportion'd Dose, a proper preparation of the Body and Medicine, a right Choice, a select Combination, with many other Things of the like kind, have an immense Power to increase the Virtues of Remedies. Here then is an almost inexhaustible fountain of useful Varieties put into our Hands, which we can manage as we please; and if they were properly employ'd, 'tis not to be said what Effects they might produce in obstinate or reputed incurable Cases. That this may the better be apprehended, let it be consider'd by way of Illustration, that when the
Cortex
has prov'd ineffectual for the cure of an Ague, being given before the Body was rightly dispos'd, it will succeed when exhibited after due Preparation; that Opiates mixed with Purgatives will take effect, which administred single might fail; that Solids will purge when Fluids will not; that lenient Purgatives will open the Body where strong Catharticks wou'd loose their force; that some Medicines succeed when given in small quantities, at long Intervals, which administred otherwise would have a contrary effect; and in short, that all possible Combinations, Doses, Preparations,
&c.
have never yet been try'd, nor perhaps ever can be exhausted.
From all which it appears, that the cures of some reputed incurable Diseases may be justly expected, either from a discovery of new powerful Remedies, or a more apposite use of the old ones. Our Method therefore ought to have regard to both these Desiderata.
In order to acquire new Remedies, let us suppose the true and immediate Cause of a stubborn disorder to be found, which in all bodily Diseases, is commonly material; our Method of proceeding directs us to obtain this material Cause, where-ever it can be come at, and to make the proper Experiments upon that very Matter out of the Body, which being included in it was the Parent of the Disorder. An Example or two will make all plain. The
cretacecus Matter,
or
chalky Stones,
which are often thrown out in a Fit of the Gout, appear to have been the immediate cause of that Fit. A proper quantity of these therefore being obtain'd, and the Nature of them discover'd from the Symptoms of the Distemper,
&c.
we are hence directed to try any Preparation that we know has a power to act upon, and dissolve Matter of the like kind. But in case such a Dissolvent be unknown to us, then are we to contrive some Compositions, after the same manner as if we were prescribing to an inveterate case of a Patient afflicted with the Distemper, and try their Virtues upon these Stones, till at length we arrive at a Preparation that proves a real Dissolvent, at the same time that it may be safely administred, some convenient way, in such a quantity as to be able to effect the like dissolution of that cretaceous Matter, whilst it is circulating in the Fluids of the Body. Such a Composition, 'tis reasonable to expect, wou'd prove a grand Remedy, and perhaps a Specifick, that is, such a Medicine as will effect a Cure without causing any sensible Evacuation. Understand the like Experiments to be made upon the Stones, which are apt to lodge in the Bladder or Kidneys, till a proper Dissolvent be found, which, if it cannot safely effect the desired dissolution in the Body, may at least be so managed, as to prevent the future Generation of a Stone. Again, supposing the case of an Hydrophobia occasion'd by the Bite of a mad Dog, where we know the Fluids are contaminated by an actual Poyson, which being contagious by a Communication of any of those Fluids, a way may very easily be contriv'd to obtain a quantity of the infected Saliva, or any other of the animal Juices, in order to make the proper Experiments upon it, till an Antidote for the Venom were by that means discover'd. This Antidote might thus be known to be found. Supposing two equal Portions of the contaminated Fluid to be procured, and the presumed Antidote to be mix'd in one of them, let both be communicated by Injection, or otherwise to two sound Dogs; and if that wherein the presum'd Antidote was contain'd, proves harmless, and the other noxious, and the same Consequence attends the same Experiment in two or three Repetitions; it would be reasonably to expect that the Cure of this cruel Disease was discover'd, and the Medicine might therefore be try'd occasionally upon Hydrophobous Patients, or rather administred soon after the Bite was receiv'd.
How far this Method of proceeding may be put in Practice, I will not presume to determine; but 'tis very probable that it may be advantageously pursu'd at least in all those Distempers which yield a grosser kind of Matter for their Cause, or else depend upon, a visible alteration in the Consistence, Texture,
&c.
of the Fluids. This is certainly a most desirable and rational way of procuring Specificks or grand Remedies, since the Lives of Mankind are not hereby in the least endanger'd; and it otherwise remains, that we wait for their Discovery till mere chance shall place them before us, open our Eyes, and force us by repeated Importunities and Sollicitations, at once to acknowledge their Virtues, and our own Indolence. If the whole tribe of reputed incurable Diseases, gave such fair Opportunities as these for the discovery of their respective Specificks (and that most of them do not, I would have no one be too positive) we might soon see their number shrink, upon allowing a proper Patronage and Encouragement to this kind of Experiments.
And here I cannot but take notice, how apt we are to plume our selves upon living in an Age when experimental Philosophy flourishes. Experiments, its true, are daily made, but I wou'd fain know to what grand Purposes they serve? Several indeed there are, whose design is highly Commendable; but are there any now on foot, or that can possibly be contriv'd, of greater Moment, than the sort above mentioned; any more Beneficial to Mankind, or Ornamental to a Nation; any so well deserving the Encouragement of the Wealthy, and the Countenance of the Learned? But instead of such useful Essays as these, we generally meet with Attempts so mean and low, so trivial and contemptible, in comparison of them, that one wou'd be tempted to think they came from the ignorant Vulgar, and the Herd of Mankind, rather than from the polite and philosophical Part of the Species. 'Tis a melancholy Reflection, that those Persons from whose open Profession, surprizing Discoveries might be justly expected, should generally amuse us with the
Minutiae
of Things, put us off with the Tith of Mint and Cummin, and leave us to seek the weightier Matters, the advancement of Physic, and the Reduction of Incurables from another Quarter.
But what an Improvement of the Art of Healing may we not expect, what Alleviation of the Miseries of the Incurable may we not hope for, when a spacious Building is now purposely crecting for their Reception and Use? This seems not only a particular Instance of compassionate Bounty, but a Desire express'd for the improvement of Physic, and the universal Benefit of Mankind in an illustrious President of a solid and diffusive Good. Physicians then, we may reasonably presume, will not now be so far wanting to themselves, to their Art, and to human Nature, as to neglect this or the like favourable Opportunities, of raising the Reputation of their Profession, by discovering the Cures for the unjustly suppos'd Incurable, and lessening the Torments of the miserable Objects, to whom such Goodness is shewn.
No longer let us, through Ease and Indolence, give occasion to Empiricks to triumph over us, and boast themselves Masters of Specificks for the Diseases which we inconsiderately pronounce Incurable: No longer let us suffer the People to be deluded with the specious
Arcana
of ignorant Men;
Arcana
the dear and desperate purchace of hazardous Experiments, and random trials on the human Kind: No longer let us leave to Chance, and the slow workings of Nature, the Discovery and Production of those useful Remedies which we are furnish'd with Faculties to search for and obtain. Who does not rather repose his Confidence in Reason, and the due exercise of his own Abilities, than trust to Accident the management of any Affair? And shall we in the Art of Healing alone, put off our inquiries till Chance shall deign to present us with the means of Recovery, when Health is within our own reach? We seem to want no Preparative in this case, but a Resolution to step beyond the slow-paced Practice in vogue, and to be guided by our Reason in the choice of Experiments. We are every way fitted to go immediately upon so useful an Undertaking: We have seen the Effects of a tolerable number of Trials made upon human Blood, and other animal Fluids; which when improv'd and enlarged, may serve to very useful Purposes: We are furnish'd with a large stock of
Data,
and know how to increase it at Discretion: The Causes of Diseases are generally known, and Materials for Experiments are every where at hand; so that if the Work were heartily set about, there is no fear of Success. A Set of
Axioms
also might be laid down to encourage and direct the Undertaking, and serve as Rules in the Prosecution of it. Such as the following for Example.
1. Mathematical Certainty ought not to be expected in Physic.
2. A Chronic Disease allows many Opportunities for the Discovery and Use of Remedies.
3. The success or failure of a single Experiment, is not sufficient to establish or abolish the use of a Remedy.
4. If any undesirable Method of Cure shall, upon repeated trials, either prove intirely unsuccessful, or suffer more to die than recover, it ought not to be acquiesc'd in, before, at least, other more desirable and promising Methods shall have been tried.
5. 'Tis better to try any desirable and promising Method of Cure, than run the hazard of languishing out a Life in Pain and Misery.
6. If any Disease can be transmuted into another, attended with less Danger, and less Pain, every such Transmutation is a Degree of Cure.
7. A Remedy that acts immediately upon the Seat of a Disease, is more likely to effect a Cure, than one that acts only Consequentially upon it.
8. No more causes of a Disease need be inquired after, than will fairly and naturally account for its
Phaenomena.
9. In every inveterate and dangerous Disease, the most powerful Remedies ought to be immediately applied.
10. No Remedy can rationally be directed before it be known what Life is, together with its Cause, State and Effects; and what a Disease is, together with its Cause, State and Effects.
These may suffice for a Specimen of what Rules might be given to forward the discovery of the Cures of reputed incurable Diseases.
But let this business proceed as it may, and that the Success will be proportionable to the Application, cannot be denied; we certainly have it already in our Power, by the Use of known Remedies to make several, whether real or reputed Incurables, pass their Lives with more ease and satisfaction than they would enjoy without, them: Nay, by well adapted Regimen and Remedies, 'tis possible not only to palliate, but to change a stubborn Distemper, so that it may justly pass for a degree of Cure, or really become a partial one. But when a Case is peremptorily adjudg'd absolutely Incurable, the Patient is usually dispirited, and with difficulty brought to follow those Rules which wou'd produce this Effect. For which reason the Sentence of Incurable, be the Case what it will, shou'd never be pass'd with Rigour.
There is another thing still behind, and I am glad to find it insisted upon by, no less a Person than that Ornament to our Nation, the great Lord
Bacon,
whom I have already had occasion to mention; not only because I know it is necessary for the Author of any Doctrine which carries the Air of Novelty, to produce his Voucher; but because the Thing it self seems somewhat contrary to the general Practice of Physicians, and the Sense of some People. 'Tis concerning the proper Means to render Death easy, or less irksom, when its approach can no longer be put off or delay'd by the Use of Remedies: Concerning which, our great Author expresses himself in this manner.
"I am clearly of Opinion. That 'tis the Duty of a Physician to mitigate the Pain and Torture of a Disease, as wel as to restore Heath, and this not only when such a Mitigation tends to a Recovery, as it is the removal of a dangerous Symptom, but also when there being no farther Hopes of a Recovery, it can only serve to make the Passage out of Life more calm and easy. For that Complacency in Death, which
Augustus.
so much desired.
s no small Happiness.—But 'tis a point of Conscience with the Physicians or our Days, to sit by the Sick after they have given them over; when in my Opinion, if they wou'd do an Office of Humanity in their own Profession, they ought to be gaining Skill in their Art, whilst they endeavoured to make the dying Person depart with more Ease and Tranquillity".
"Etiam plane censeo ad officum Medici pertinere, non tantum ut sanitatem restituat, verum etiam ut dolores & cruciatus Morborum mitiget: Neque id ipsum solummodo, cum illa mitigatio Doloris, veluti Symptomatis periculosi, ad convalescentiam faciat & conducat, imo vero cum abjectâ prorsus omni sanitatis spe, Excessum tantum praebeat è vita magis lenem & placidum. Siquidem non parva est felicitatis pars, (quam sibi tantopere precari solebat Augustus Caesar) illa Euthanasia. — At nostris temporibus Medicis quasi Religio est, aegrotis postquam deplorati sint assidere, ubi si officio suo, atque adeo humanitati ipsi de
sse nolint, & artem ediscere, & diligentiam praestare deberent, quâ animam agentes, facilius & mitius è vita demigrent. Hanc autem partem, inquisitionem de Euthanasia exteriori —inter Desiderata reponimus."
de Aug. Scient.
L. IV. C. 2. p. 311. And accordingly his Lordship sets down as a Desideratum,
A Method to cause a Composure in dying,
and does not appear to disapprove even of that course which
Epicurus
took to obtain this end, which was by intoxicating himself.
—Hinc Stygias ebrius hausit Aquas.
But tho' the Physicians of our Time are acquainted with better ways than this, to cause such a Composure, yet I don't know how it happens that few are careful to put them in Practice; unless it be for fear of bringing Death the sooner upon the Patient, instead of rendring the passage out of Life more easy. For I believe there are not many who apprehend such a Procedure to be unnatural, and who would chuse to feel that Pain and Torture which some weak Minds may fancy Nature intended they shou'd; and so be willing to dye by the regular workings of Providence, rather than be thrown out of the ordinary way by human Art. 'Tis therefore methinks a proper enquiry, by what means this composure in Death may be obtain'd, and whether it cou'd not be effected by a Remedy which should rather promote than prevent a Recovery. And since there may be frequent occasions for such an Assistant; since it would be inhuman to deny it, when requested; and since the Art in it self is doubtless very desirable, and highly beneficial, 'tis pity that any opportunity of improving it should be neglected.
An Attempt to settle a just Notion of
Incurable
in Physic.
NO proper meaning being generally convey'd by the word
Incurable,
'tis necessary to appropriate one to so important a Term.
That the bad tendency of a Distemper, from its first Existence to its latest continuance in the Body, cannot in the least be prevented; or that, after a stated Period, the cure of a case can by human Means, be advanced no farther, is what this Term in propriety of Speech shou'd constantly signify.
But, a loose and abusive Sense of the Word has so universally obtain'd, and is so apt on several occasions to be run into, that 'twill be difficult to make it always carry this more restrain'd and correct Signification. Nor is it an easy matter in some Cases, to obtain such a distinct and positive Idea as ought to be rais'd by this Sound, when we talk of Diseases in a Philosophical manner; which perhaps is one reason why so many Distempers commonly pass under this Denomination; and that when a certain form of Remedies has for a determin'd space of Time, been used without the desired Effect, the case is merely upon this account pronounc'd Incurable. But 'tis apparent that there may happen a wide difference between a real and such a reputed incurable Distemper; since to constitute the former, tis necessary that it will utterly elude the force of what the most perfect Physicians can rationally prescribe for its Cure; when to make the latter, 'tis enough that it has eluded the Prescriptions of one or two Practitioners. To confirm a Disease really Incurable, the utmost powers of Remedies must prove ineffectual: To cause it to pass for Incurable, that it has baffled the fashionable Practice will suffice. Some Reason drawn from the Nature of the Thing, is requisite to shew a Case to be absolutely Incurable; to denominate a Patient so, a groundless Conjecture will serve.
'Tis likewise evident, that reputed Incurable may chance, at the same time, to prove real incurable Diseases; so that to introduce a more accurate Distinction, and to shew the true difference betwixt them, is of great Importance.
'Tis not necessary however, in an Essay which rather proposes what ought to be done, before we make so free with a Term, upon whose use the Lives and Health of Mankind depend, than undertakes to do it; 'tis not necessary, I say, in such an Essay as this, to descend so far as to inquire what Life and Health are, what their Causes and Effects, wherein they consist, by what various Means, and how far they may be impair'd or diminish'd before Death necessarily ensues; all which it wou'd be absolutely requisite to know in the respective Distempers, if we were willing to see whether any, and which of the Catalogue of Diseases are in their own Nature absolutely, and in every Stage properly Incurable; or if we would fix the Point in other Cases, to which when Diseases arrive, they will never admit of farther Alleviation. These Things are here suppos'd to be in great measure known already, altho' they highly deserve the most exact and careful Inquiry.
But not to let this weighty Matter pass intirely unregarded, it shou'd be observed, that if a Distemper be absolutely Incurable, the reason why it is so, must arise either from the Nature of the Disorder, or the natural Imperfection of Medicine; and consequently where the Properties and immediate Cause of a Disease are well known, and yet from them no Reason can be deduced to manifest the case Incurable; that it passes for such, ought to be attributed to the natural Imperfection of the Art of Healing. But the Art of Healing cannot be said to be naturally Imperfect, till its utmost extent be known, that is, till the animal Oeconomy, and the immediate Causes of its Disorders are throughly understood, and the utmost Powers of the known Remedies have been fully obtain'd; if not also, till all the discoverable ones have after the best Manner been experienc'd. Now if all these Advantages have not been acquir'd in our Days, as no considerate Person will say they have, it follows, that no Distemper can properly by us be called Incurable, but where some evident Cause of its being so, appears from the Nature of the Thing it self. For unless this Cause be manifest, to pretend a Disease is not to be alleviated in any of its Stages, or that a Cure can be carry'd no farther, when we don't know why, is a bold Guess; and to pronounce the Case Incurable, even after we have done our utmost, will mean no more than that the Remedies hitherto used in it, have fail'd of the defir'd Effect. But wou'd not such a Censure be equally Ridiculous, as to say, ten or an hundred unsuccessful Experiments have been made to transmute Metals, and therefore their Transmutation is undiscoverable? Here then is a Foundation for a just Distinction between real and reputed incurable Diseases.
Thus we see in Chirurgery, those Wounds are properly adjudg'd Mortal or Incurable, which happen in such Parts of the Body whose Union was of absolute necessity to the continuance of Life; as for Example, a transverse Section of the
Larynx,
which intirely stops Respiration; a disunion of the
Cerebellum,
which prevents the Influx of the Fluid there secreted into the Heart;
&c.
These and the like Cases are justly deem'd Incurable, from the very Instant when the Wounds were first inflicted; because here the vital Functions are evidently destroyed, without any opportunity being allow'd for the Use of Remedies. This is the most determin'd and genuine Sense of the Word, and therefore the Use of it in other Cases ought to be judg'd of, by its Approach to, or Recess from this original Meaning. And accordingly where the Fatality of Wounds is less sudden, and less certain, as in Obstructions of the animal Faculties, suppose by a transverse Section of the
Oesophagus,
the Term Incurable cannot with equal Certainty be apply'd at the Instant the Wound was receiv'd, because there may be other Ways contriv'd of conveying Nutriment to the Body, besides by the Mouth; and in the mean Time, Opportunities may be afforded, of applying the proper Remedies. But if the Body could be supply'd with Nutriment only by the Mouth, and there were no Opportunities allow'd for the Use of Means for Recovery, then such a Case might, with equal Certainty, be pronounc'd Incurable, or mortal, as one of the former Kind; though the Prediction would not be so soon fulfilled. In all such Cases as these, 'tis evident when and why the Term incurable is applicable, which is always governed by the Nature of the Thing, and the Opportunities there are for the Use of Remedies, or else by the natural Imperfection of the Art of Chirurgery: Whereas on the contrary, in several Diseases, both Acute and Chronic, this Term is apply'd, where no such Reasons appear. Thus when certain equivocal Symptoms come on in acute Distempers, without having any Regard to the immediate or material Cause of the Disorders of the animal Oeconomy; they consist in without so much as any positive Idea in our Minds, obtain'd from reflecting on the Nature of the Distemper; and without considering the State of the Art of Healing, we at present make no Scruple to adjudge them mortal, or Incurable, though neither the vital, natural, or animal Faculties are wanting. Thus for Instance, we proceed in the Plague, malignant Fever, Goal-Distemper, and the confluent Species of the Small-Pox,
&c.
when perhaps if the Matter were carefully examin'd into, such Diseases ought never to be call'd Incurable, till they arrive at the very Point of Death. But if there be any Reason to suspend this final Judgment in acute Cases, is there not vastly more to be cautious, how we pass such a Censure in chronic Diseases, where no Opportunities are wanting to make the necessary Inquiries to find out the Cause, and to apply the proper Remedies? And what reason can possibly be assigned, that the respective Specificks for the Gout and Stone, shall never be discover'd; or that no means can be contriv'd to alleviate the Pain of those Diseases, farther than is effected by the present Practice? Who can pretend, that an Antidote for the Bite of a mad Dog is undiscoverable, when he considers we are Masters of the Specifick for that of the Viper? But to call these, and several other Diseases Incurable, is the Way to make them so, as being apt to put a Stop to farther Inquiries into the Nature of them, and retard the Discovery of any Thing that has a Relation to their Cure. At least then, let no one pretend to call any Case Incurable, till he is well acquainted with the Subject of Diseases; till he knows their true and immediate Cause, and the utmost Virtues of the several Remedies we are at present possess'd of.
An animated human Body, we are certain, is a pure mechanical Structure, wholly compos'd of Solids and Fluids; and consequently the immediate Cause of every bodily Disease, can be only Matter and Motion.
The utmost Virtues of Remedies cannot be known, till the Remedies have been most artificially prepar'd and combin'd, most seasonably and properly apply'd, exhibited in the most just Quantity, at the most proper Intervals, and lastly, continu'd in exact Proportion to the Demand of the Distemper. All which Requisites, there is little Reason to believe, have been hitherto strictly observ'd in their Exhibition. And besides the Improvement which may be made in the present Set of Remedies, 'tis not to be doubted, as was before observ'd, that many others, of equal Virtue, may be discover'd by proper Application; upon all which Accounts, it were greatly to be wish'd, that Physicians would never apply the Term Incurable to any Cases, but such alone where that Matter and Motion are wanting, which Life, even in its lowest and weakest State requires, or when all means, by which they used to be supply'd, are intirely cut off. For if a Distemper be curable only in Part, 'tis improperly call'd incurable, till that partial Cure, can by human Means, be carry'd no farther.
We daily observe so many unexpected and surprizing Turns in the Disorders of a human Body; Nature here acts by so many secret Springs, and makes so many unforeseen Sallies and Excursions, as if she took Delight to mock our Toil, baffle our best concerted Measures, and reverse our best form'd Judgments, that it is presumptuous, where the Case is not manifest, to pretend to fix and determine the Point she shall just come up to, and not exceed; to say, hitherto shalt thou come, and no farther; here the Disease is Incurable, and here the Art of Healing fails. No one less than an absolute Master of this Art, will surely ever go so far. If indeed we could always obtain from an exact observation of the Properties of Diseases, their true and immediate Causes, and had a previous Knowledge of the utmost Effects, the best adapted Regimen and Remedies would have upon them, then we might presume to determine what Cases either were, or were not incurable, by the present known Remedies; and no one, without this Qualification, can pass a valid Judgment. Let us then endeavour to increase our Knowledge of Distempers and Remedies, by all possible Means, and not venture to pronounce the Sentence of incurable upon Diseases, at least till we have acquir'd such a Definition of them, as will bring us acquainted with their real Causes; and till we are Masters of the best Way of managing and improving the Remedies we enjoy.
To discover whether a reputed incurable be also a real incurable Distemper, I apprehend the best Course to be taken, is first to set down the several Properties of every Case distinctly; next, to draw as many Consequences from these Properties, as may give Light into the Nature of the Case, and assist in discovering its immediate Cause: And when this is obtain'd, we are naturally directed to search for the Remedy; so that at length, by this Method of Proceeding, we shall see how far our present Stock of Remedies will reach, after they have been duly improv'd; and what we are farther directed to seek for, to advance the Art of Healing to a greater Perfection. To usher in this Method, I will here set down a few short Examples, by way of Specimen, of what may be expected from it, upon a proper application. The Cases I shall chuse to instance in, are
reputed Incurable,
either from their first appearance, to their ultimate Stage, or after a set Time; the Sequel will shew whether they really deserve the Appellation of incurable, or ought to be rescu'd, and set free from the tyrannical Imposition of a misemploy'd Term.
A Specimen of a rational Method, to discover the Cures of reputed
Incurable Diseases.
Of
MADNESS.
1. THERE are two Species of this Distemper,
viz.
Melancholia and Mania.
2. The Properties of the Melancholia are; to proceed from some Disorder in the Mind.
3. To be preceded by Anxiety, Want of Sleep, intense Thought, frequent Anger, or any violent Passion; profuse Venery, Pain in the Head, Suppression of the natural Evacuations, burning and lasting Fevers, violent Exercise long continu'd, hot and dry Weather.
4. To manifest it self by Fear and Sadness, and the Colour of the Skin, which grows pale, yellow, brown, livid; by Spots of the same Colour, a slow Pulse, hard Respiration, Secretion and Excretion lessen'd, Loss of Appetite, Loss of Flesh, Love of Solitude, lasting Passions, Fixedness on some Thought, a Pressure, Coarctation or Repletion about the Viscera or Hypochondria.
5. When 'tis of long continuance, it causes the Apoplexy, Epilepsy, Mania, Convulsions,
&c.
6. 'Tis sometimes naturally cured by a cuticular Eruption, large Vatices, great Swelling and consequent Flux of the Haemorrhoids, and an Excretion black Bile by the Mouth or Anus.
7. The Properties of the Mania are generally the same, but differ in a few Particulars; for Instance,
8. Boldness and Anger here attend instead of Fear and Sadness in the former.
9. Immense muscular Strength.
10. Very great Watchfulness.
11. A surprizing Endurance of Cold and Hunger.
12. Most dreadful and outragious Ideas.
13. All Secretions in a manner stopt.
14. Anatomy shews in both Species, that the Brain and its Meninges are dry, hard and crisp; its Cortex yellow, and that its Vessels abound in Varices, and are distended with a black viscid Gore.
15. The Mania, after an obstinate resistance of the common Practice, has been cured by spontaneous Varices or Haemorrhoids, by a Dropsy, Dysentery, a tertian or quartan Ague, and large Haemorrhages.
16. Does it not follow, that the immediate Cause of both Species is an Evaporation of the more subtile Parts of the Fluids? 1. 2. 3. 7. 10. 13. 14.
17. That the Mania differs from the Hypochondria only in degree, 4. 5. 6. 14. 15. Since they both have the same Causes, and exhibit the same Appearance upon Dissection?
18. That this Disease unjustly passes for incurable 6. 15. even altho' a Year or two may have been unsuccessfully spent in attempting its Cure?
19. And lastly, that the Specific wanting in both Species, is such a Remedy, as will prevent this Evaporation 16. which remains to be discover'd by proper Experiments.
20. In the mean time, perhaps no known Remedy will more forcibly contract the Pores, and prevent this Evaporation, than the Cold Bath, when used so as to exert its proper force.
21. Now the Cold Bath can only act upon the Body by its Gravity or Pressure, the Insinuation of the Parts whereof it is compos'd, and its Coldness; but its Gravity or Pressure will be proportionably increased by a deeper Immersion, and this will consequently render the Insinuation of the Water proportionably greater. Its Coldness also may be immensely increas'd by the addition of
Sal Armoniac, &c.
Here therefore is a Remedy of an unlimited Force, which seems to be exceedingly well adapted to the Cure of this Disease: And accordingly, 'tis found in Fact to answer, the best of any known Remedy in this Distemper, tho' made use of under very great Disadvantages.
Of the Rabies Canina, or Hydrophobia, consequent upon the Bite of a mad-Dog.
THE Properties of this Disease are as follow.
1. 'Tis spontaneous in many Animals, especially in Dogs, Foxes, and Wolves, which communicate it not only to one another, but to Men, by Contagion.
2. The slightest Bite of an Animal thus infected is often fatal, as it is also to touch their Saliva with the Tongue, or to handle such Instruments much, as have been used about them.
3. The Contagion in a human Body, manifests itself at various Intervals in various Subjects; in some it will lurk for several Years.
4. The Place where the Bite happen'd first becomes painful, the Pain spreads to the adjacent Parts, a Weariness and Heaviness is felt in the Flesh, the Sleep is broken, discompos'd, frightful, and attended with Convulsions. The Patient is uneasy when awake, he sighs, is sad, and seeks Solitude. These Symptoms gradually increase, and a Difficulty of Respiration comes on, which is now frequently interrupted with Sighs; an unusual Dread and Terror upon beholding any Liquid, loss of Appetite; to taste any Liquor causes very great Anxiety, Tremors and Convulsions; vomiting of a viscid bilious or green Matter, Heat, Fever, Watching, Priapismus, strange disorderly Ideas. The Tongue is dry, and extended out of the Mouth, there is a Hoarseness and very great Drought; the Patient at length now becomes outragious upon attempting to drink; he endeavours to bite whoever he meets with; he foams at the Mouth, and gnashes with his Teeth; a cold Sweat comes on; he grows most outragiously mad, and, with the utmost Difficulty of Respiration, dies convulsive.
5. From Dissection it appears, That the Organs of Deglutition are inflam'd, that a viscid bilious matter is lodg'd in the Stomach, that the Gall-Bladeer is full of black Bile, that the Pericardium is dry, that the Lungs are greatly overcharg'd with Blood, that the Arteries are full of a very liquid Blood, but the Veins empty. Tis remarkable, that this Blood will scarce coagulate, when extravasated and exposed to the Air. All the Muscles, Viscera, Brain, and Spinal Marrow appear too dry.
6. Is not therefore the immediate Cause of this Disease a subtile Poison in the Fluids, whose Specific Antidote is unknown to us?
7. And till this Antidote can be found, is it not clear, that all manner of Evacuations, especially Phlebotomy or rather Arteriotomy, are to be used in every Stage of the Disease; and all other Measures to be pursu'd, which tend to introduce new Fluids, in the Room of the contaminated Set; or at least to discharge so much of the Virus, as to lessen its pernicious Consequences?
8. The Effects of this Virus in the Body, being so very dreadful and fatal, may justify the Use even of severe and hazardous Means to prevent 'em, so that at least Phlebotomy
ad Animi Deliquium us
que
may be occasionally repeated; not only upon that Account, but also by reason of the very great Inflammation that attends it. And because Fear is known to have been serviceable in this Case; may it not be very proper to contrive some extraordinary Ways to raise this Passion to a very great Degree, if not before Immersion in the cold Bath, at least by means thereof, being us'd in almost its utmost force?
Of the Palsy.
1. THERE are three Species of this Disease. 1. Where Motion alone is wanting. 2. Where Sensation alone is wanting. 3. Where both Motion and Sensation are wanting.
2. 'Tis often preceded by the Apoplexy, Epilepsy, or Convulsions, a Retention of the natural Evacuations, a Translation of the Matter of an acute or chronic Disease; Wounds, Contusions, Luxations, Compressions, Erosions,
&c.
intense Cold or Heat, too free an Use of hot Water, Exhalations of poisonous Minerals admitted into the Body.
3. The paralytic Parts grow cold, soft, flaccid and waste gradually.
4. 'Tis often critically cur'd, or by the Force of Nature, either by a spontaneous and lasting Diarrhaea, a Fever, an insensible Dissipation of the morbific Cause, or lastly, by a convulsive Motion of the Part.
5. From hence it follows, that the immediate Cause of the Palsy is a Want of the Influx of the Blood, or nervous Fluid, or both, into the Part, 1, 2, 3.
6. That the Parts lose their natural Elasticity. 2, 3.
7. That when both the nervous and arterial Fluid is wanting to the Part, and the Canals are depriv'd of their natural Elasticity, the Case is most inveterate.
8. That its Cause may be either external or internal. 2.
9. That the Want of the nervous and arterial Fluid, is either owing to a Fault in their respective Canals, or to the Fluids themselves. 2.
10. That it may be cured either by a Specific or an Evacuant, 4. and consequently is not justly reputed incurable.
11. That the Cure depends upon removing the Obstruction to the Influx of the Fluids, and deriving them in their natural State, into their respective Canals.
12. That the Cure must be adapted to the Cause.
13. Supposing then, both Canals and Fluids to be affected; the Canals to have become cold and flaccid, and the Fluids gross and tenacious; 'tis plain, that a powerful Dissolvent, which at the same time that it liquifies and purifies the Blood, promotes a free Circulation in the disorder'd Parts, and restores the Elasticity to the Canals, will prove a Specific in this Case: And why the Cortex Peruvianus, when rais'd to its utmost or proportionable Power, may not prove this Specific, perhaps nothing but the proper Experiments will shew.
14. The very great Effects of a due Use of the Cortex, not only in intermitting Fevers, but in many other Disorders, both of the Solids and Fluids, are too well known to stand in need of a particular Enumeration; and this Medicament is now so universally allow'd to be safe as well as efficacious, when properly apply'd, that I know of no Objection that can lie against the Use of it in the Palsy. Those who think it not of Force sufficient in such an obstinate Distemper as this, when, after some Months have to no Purpose been spent upon it, 'tis reputed Incurable, will please to consider its surprizing Effects on the Solids and Fluids in a rebellious Quartan Ague, in what very large Doses 'tis capable of being exhibited, and how much a prudent Mixture of
Sal Absinth: &c.
will add to its Virtue; especially if so grand a Remedy as the cold Bath, when duly improv'd, may be call'd in to its Assistance, as in the Distemper we are speaking of, it frequently may.
Of the Lues Venerea.
1. WHEN this Disease is hereditary, or become universal, it appears under various Forms, but may be distinguish'd by these Properties.
It generally begins with an Itching, Heat, and Inflammation in some Part of the Body. Whitish Pustules appear, which drying, scale off, and leave a Cavity; or else break, grow deep, afford a yellow Mucus, or corrosive Sanies, and form Ulcers incurable by common Medicines. These afterwards increase in Number both externally and internally. The inguinal Glands swell, collect Matter, break of themselves, and discharge. Shankers, Verrucae, Porri, Mariscae, Condylomata, Caruncles, Strangury, Erosion of the Urethra, and Parts adjacent. Stiffness in the Joints, and Pain of the Limbs. Erosion of the Cartilages. The Bones grow carious, and rise in stubborn Apostems, corrupting the adjacent Parts. The Viscera mortify, and the Flesh corrupts.
2. This Distemper is found to be communicated by Lactation, Sweat, Saliva, and Exhalation.
3. From hence, it's Cause is a corrosive Taint admitted into the Body, which gradually assimilates the Fluids to it self, corrupts the Solids, and becomes contagious by a Communication of the Fluids.
4. The Specific wanting here is therefore such an one as will destroy the force of this Corrosive, or put a stop to the Contagion in the animal Fluids; which there is an opportunity of discovering by the proper Experiments.
5. In the mean time, if we expect this specific Virtue from any known Medicament, 'tis necessary it shou'd be used as a Specific, that is, by suffering it to be detain'd in the Body as long as possible, to let it have it's utmost Effects upon the Solids and Fluids: And who can say that Mercury, thus properly manag'd, will not have such a specific Virtue?
This is a matter of no small moment, and certainly deserves to be well examin'd; for if this reasoning will hold good, it follows, that much Pain and Fatigue, very great Danger and Loathsomness, the necessary attendants of a Salivation, are often undergone to no purpose, or else to a bad one; whilst such a hazardous Method frequently failing to Cure the Disease, occasions it afterwards to pass for Incurable. In which Case, this specific Use of Mercury, may bid very fair for a Cure.
There is but one Objection, that I know of, can be made against this way of turning Mercury into a Specific, for the Cure of the Lues Venerea,
viz.
That the Venereal Taint or Virus, being plentifully evacuated by Salivation, as appears from the quantity and stench of the Saliva, a contrary way of proceeding will have a contrary Effect, and consequently detain and lock up the Virus in the Body.
That some Portion of the Venereal Taint is evacuated with the Saliva in a Salivation, cannot be deny'd, any more than that some is likewise evacuated with the Urine, and other Excretions, since in both Cases the Virus will evidently manifest it self by propagating the Contagion. 2. But that it is more plentifully evacuated by the Salivary Glands in the former Case, than it wou'd be by the Renal in the latter, were proper Diureticks exhibited, may be justly question'd, if the stench of the Saliva be no proof of it. But 'tis well known that the Saliva evacuated in the Salivation of a Person who is entirely free from any Venereal Taint, is equally fetid with that of a Venereal Patient.
Again, successive Salivations have been oftentimes regularly rais'd, and prudently carried on, so as to cause a very plentiful Excretion of fetid Saliva; but notwithstanding this, the Lues has been left uncured: from whence it shou'd appear that the Cure does not depend upon an evacuation of ferid Saliva. Nor will this perhaps admit of a doubt, if it be remember'd that many, on the contrary, have been cured of the Lues, by Mercury, who cou'd never be brought to Salivate at all; and that others, whom upon account of some Disease of the Breast, or the like, it has not been thought prudent to venture under so dangerous a Flux by the Mouth, have happily recover'd by this specific Use of the same.
And agreeable to this Doctrine is that Practice of the best Physicians, who even after the most profuse Flux by the Mouth, either exhibit proper Doses of Mercury, during the space of several weeks after the Salivation is drop'd, without any Design to bring it on again; or else put the Patient into a Course of specific Diet-Drink; as well knowing that unless somewhat of this kind be done, the Patient is not secure, but runs the hazard of a relapse.
'Tis evident that Mercury exhibited so as to Purge or Salivate, cannot exert its full Force upon the Body; because by those very Excretions it is soon thrown out, as appears, in that it may be reviv'd from the Excrements and reinstated in Possession of its former Properties: If therefore we wou'd obtain the utmost Effects of this grand Medicament, ought it not by a prudent management to be detain'd, in a large quantity, as long as possible in the Body? This Method alone, methinks, can determine whether Mercury will prove a true Specific for the Lues Venerea.
Moreover, such an Use of Mercury is not only directed by the nature of the Disease, but by the similar Effects of other Remedies. The Lues Venerea is a very stubborn and obstinate Distemper, and where it once seises, is with great difficulty removed; it seems strongly to adhere to the body, or rather it entangles it self so as to become one with it, as appears particularly by its lasting Effects after a partial Cure; (for Mercury as 'tis generally exhibited, only palliates, but seldom eradicates this Disease, as is well known to the more curious observers:) ought not then the Remedy also to be entangled and united with the Body, in order to exert its full Force, and be upon equal Terms with its Adversary? Thus we see every Day when the Cortex, exhibited in an Intermittent, is evacuated by Stool, 'tis of no Effect towards curing the Disease, tho' administred in a very large Quantity; but stop this Evacuation, let the Medicine remain in the Body, circulate with the Fluids, and exert it's full Force, it becomes a very different and vastly more powerful Remedy than before, and justly deserves to be call'd a Specific.
Of the Gout.
1. THE chief Properties of the Gout are, to return generally in the Spring and Autumn. 2. Seldom to affect any but Men of a gross and corpulent Habit. 3. To succeed high Living, hard Study, violent Exercise, the free Use of Acids, and taking Cold on the Feet.
2. A Fit is usually preceeded by Crudity, or rawness felt in the Stomach, heaviness, Costiveness, a stoppage of Sweat in the Feet, and by Varices.
3. When regular, it seizes the internal Parts of the Foot, its Periosteum, Nerves, Membranes, Ligaments, and Tendons about the Joynts: And when irregular, that is, when it moves about or disperses it self, it always falls on the like membranous and nervous Parts.
4. A Fit comes on with a tensive, burning, gnawing Pain, which increases gradually to it's height, then decreases, as the Part grows moist, red, and tumid.
5. The Pain goes off in a Diaphoresis, leaving an Itching behind it.
6. It scales the Part, or bursting the Vessels, throws off a solid cretaceous Matter.
7. 'Tis more violent, as the Swelling is less, and
vice versâ.
8. The more severe the Fit, the greater the Interval of its return, and
vice versâ.
9. Does it not follow that the immediate Cause of the Gout, both in its knotty and smooth Species, is a cretaceous Matter lodg'd in some nervous and membranous Part? For a Fit never ceases 'till this Matter is thrown off in the former Species, and to suppose a like Expulsion in the latter, tho' made in a less sensible manner, fairly and naturally accounts for the other Phaenomena, which are the same in both. It should follow therefore, that these two Cases differ only as the Cause happens to be more or less perspirable, 3.4.5.6.
10. Does not the Cause of this Disease lurk in the Body in the Absence of a Fit? 1.7.8. If the Gout be ever properly hereditary, this is still more evident.
11. It appears that this Cause is deposited upon various Parts by the Fluids; 2. For the Solids never exchange Places; and consequently the Fluids alone, in the Absence of a Fit, are the Seat or Vehicle of this Cause.
12. This Cause upon many Occasions 1. is apt to stagnate, or be deposited in the smallest Canals, and such as are most remote from the Brain and Heart, where the Circulation is languid, and the Parts are naturally pressed, contracted and less yielding, 3.
13. This Matter is corrosive 4.6.
14. As the Vessels are more stiff and rigid, 12. and the Matter more corrosive and tenacious, 11.13. the Disease will be more severe.
15. Both the Solids and Fluids being concerned in the Fit, the Cure ought at that Time to regard them both: But in the Absence of a Fit, the Cure need only regard the Alteration of the Fluids 11.
16. The Cure then in the Absence of a Fit, is to be effected, either by a proper Dissolvent of a cretaceous Matter in the Fluids, or by proper Evacuation.
17. Till the Specific can be found for this Case, perhaps Evacuations might be contriv'd, to carry off the Semina of the Disease, during that large Interval (1.) which is usually interpos'd between two Fits; and by that Means a new Set of Fluids be procur'd, and a proper Regimen and Remedies used to prevent the future Generation of this Cause. For if the Cause of the Disease, in the Absence of the Fit, exits in the Fluids, 11. and be equally dispersed in them, as there appears Reason, from the suppos'd present State of Health, to believe; 'tis certain, that an Evacuation of Blood, at a large Orifice, would lessen the Quantity of this Cause in the Body: and could not Phlebotomy be so manag'd, as to detract as much of it as would otherwise be thrown out by the ensuing Fit; and if so, would not this prevent a Fit as effectually as the having undergone one? In the absence of the Fit, the Body is sound, and the Effects of moderate Phlebotomy on a sound Body, we know are to lessen the Quantity of the Blood, and rarify the remaining Part; to take off from the Resistance of the Fluids, allow a more free Contraction of the Canals, and a Recovery of their Elasticity; to dissolve Coagulations, to open Obstructions, and promote a free Circulation; and lastly, to forward both Secretions and Excretions, and to allow of a Renovation of the Fluids or Mass of Blood. Now there are none of these Effects, taken separately or conjointly, but seem of themselves to have a direct Tendency to forward the Cure, provided the first Digestion can be well secur'd, and Crudities in the others prevented; which greatly depending upon a prudent Choice of the Subject, and a proper Management during the Use of the Remedy, no greater Objections will perhaps lie against this Method, where a Person is willing to pursue it, than are to be produc'd against other approv'd and establish'd Forms of Procedure in other Diseases.
Phlebotomy, after the manner propos'd, has never that I know of, been try'd by Way of Prevention or Cure of the Gout, though in the Rheumatism, an acknowledg'd similar Case, it frequently has with very good Success; and is one of the best known Methods of Cure, for that Distemper. And the same Operation, when perform'd in the common Manner, or used as an Assistant in the Cure of the Gout, has sometimes been found of Service. But as this Case has seldom been prescrib'd to by Physicians of Judgment, it being always look'd upon as Incurable, or such a Disease as was render'd worse by the Use of Physic, it has fallen almost entirely to the Management of Empiricks, from whose Practice I will not, in a Case of so great Nicety, venture to draw a Conclusion.
As these few Examples are propos'd by Way of Specimen, it must be observ'd, that it did not suit with the Nature of the Design, to enumerate all the Properties and Phonomena of every Disease, under its respective Title, tho' there may perhaps be commonly enow from whence to deduce their immediate Cause, and a suitable Method of Cure. Nor are all the possible Advantages taken of what Properties are set down, upon account of the design'd Brevity of this Discourse. It ought not therefore to be attributed to neglect, that under
Madness,
no Notice was taken, of what Service a prudent Exhibition of the Cortex, Sal, Absinth.
&c.
might be, during the Use of the particular Remedy, there recommended; nor any Mention made of the proper Ways of endeavouring to reduce the Mind to its natural State: Nor again how advantagious, deep Incisions, frequent Scarifications, strong Attractives, actual Cauteries, powerful Digestives, sharp Corrosives, proper Lotions,
&c.
in the Bite of a
mad-Dog:
How useful strong stimulating Remedies in the
Palsy;
or what better Methods than the common, there are of treating the inveterate or confirm'd
Lues Venerea:
Nor lastly, of what Service a Course of Relaxatives, Perspiratives, Sudorificks, Corroboratives, Stomachicks, or a Salivation in the
Gout;
or the most proper Method of treating that Disease during the Fit, though the Properties mention'd will lead to it.
Much less could it be expected, that the Diet, Regimen, and Medicines requisite, or useful in each Process, should be there insisted on, which would be to have swell'd a Volume upon each Distemper.
Thus then have I done what I at first props'd; which was only to offer at some probable Means to improve the Physical Practice with Regard to inveterate Cases, or such as are undeservedly stil'd Incurable; in hopes, at the same Time, to wipe off some Part of that Reproach, which has fallen on the Art of Healing, through a Remissness to cultivate so necessary and beneficial a Part of it. I am sensible how little I have contributed to so great a Work, yet if this imperfect Sketch may happen to give Occasion to a due Prosecution of the Design, I shall not repent that I ventured to communicate so slender a Performance to the Public.
FINIS.