Part 8

such, I say, will easily be sensible of the importance it is of to the sick, their breathing one air preferable to another. Such as may have once entered into a room inhabited without being aired; such as may have kept walking on the side of a marsh in the heats; or have resided in low places, surrounded, on all sides, with eminences; such as have made a transition from a populous town to the country; who have breathed the air at sun-rise or at mid-day, before or after a shower of rain; all these, I say, will conceive how great an influence the air has over health.

_Temperie cœli corpusque, animusque juvatur._ OVID.

The sick or weakly have, more than others, need of a good air; it is a remedy that acts, and perhaps the only one that does so, without the concurrence of our nature’s vital forces, to which it gives no trouble, and is no draught upon them: and for that very reason, it is of the greatest importance not to neglect it. That air which is the properest for a general atony or relaxation, is a dry, temperate air: too moist, or too hot an air are pernicious. I know one labouring under a disorder of this kind, whom great heats throw into a total faintness or exhaustion of strength, and whose state of health varies in summer, according to the vicissitudes of days less hot or less cold. A cold air is much less to be dreaded; and it is necessarily, and according to Nature, that it should be so. Heat relaxes still more the fibres which are already but too relaxed, and dissolves still more the humors already too much dissolved: Cold, on the contrary, is a remedy against these two evils. When the Caribes are attacked with the palsy, after, and in consequence of those dreadful convulsions of the cholic, to which they are subject, when they cannot be sent to the warm-baths in the north of Jamaica, the other expedient is to send them to some place of a colder air than that of their country; and this bare change of air has always manifestly a favorable effect.

Another essential quality of the air, is, that it should not be impregnated with noxious particles: that it should not have lost, by its stay or stagnation in inhabited places, that kind of reviving quality which constitutes all its efficacy, and which might be called its vital spirit as necessary to plants as to animals; and such is the air one breathes in a country, open, airy, interspersed with the verdure of herbs, bushes, and trees.

“Let the sick, says ARETÆUS[104], live near meadows, fountains, rivulets; the freshness they exhale, and the gaiety which those objects inspire, fortify the mind, restore strength to the body, and give new life.”

The air of the town, continually sucked in and let out again, continually crouded with foul vapors or infected exhalations, combines at once the two inconveniences of possessing less of that vital spirit, and of being big with noxious particles.

On the other hand, the air of the country is enriched with the two opposite qualities. It is a pure virgin air, an air impregnated with all that is the most volatile, the most agreeable, the most cordial, in the effluvia of the plants, and in the vapor of the earth, which is itself very salubrious.

But it would be of no use to fix on a place with a good air to live in, if one does not chuse to breathe it. The air of rooms, or chambers, if it is not continually renewed, is nearly the same in all. It can hardly be called a change of air, from a close room in town to a close room in the country. There is no enjoying the benefits of a healthy atmosphere but in the open fields. If infirmities, or weakness, hinder the procurement of that benefit, by the going or the being carried thither, at least the air of the room, or chamber, should be renewed several times in a day; not simply by opening a door or a window, which renews it only a little, but in letting into the chamber a torrent of fresh air, by opening, all at once, two or three different and opposite inlets. There is no disorder that does not require this precaution; but it is requisite not to expose the sick person to the force of the current of air, and it is always very easy to place him out of the power of it.

It is also extremely important to breathe the morning air. Those who deprive themselves of it, for the sake of remaining in a stifling atmosphere between four curtains, voluntarily renounce the most agreeable, and perhaps the most strengthening of all remedies. The freshness of the night will, by morning, have restored to the air all its vivifying principle; and the dew which evaporates, by degrees, after having loaded itself with all the balm of the flowers on which it will have dwelt, renders the air truly medicinal; you solace yourself in a vaporous bath of the essence of plants, the air of which you continually draw in, and of which nothing can be equivalently substituted to the good effect. The ease, the refreshment, the strength, the appetite, which we may feel procured by it, for the rest of the day, are a proof in every one’s power, and a stronger one than all that I could add.

I have, very recently, seen the most sensible effects of it on some valetudinarians, and especially on such as were hypochondriacs: these experienced, in the clearest manner, that if they indulged themselves in breathing the morning air, they were always the more chearful, the more lively, for the rest of the day; and those who passed that rest of the day with them, could not, by that mark, be mistaken as to the hour of their rising.

It is easy then to conceive, how important this effect is for those who are affected, in any degree, with the _Tabes dorsalis_, who are so often hypochondriacal; and in whom a return of chearfulness is alone sufficient to furnish an unquestionable sign of a general amendment of health.

_ALIMENTS._

In the choice of Aliments I would recommend the two following rules:

_First_, To take no aliments, but what, under a small volume, contain a great deal of nourishment, and are of easy digestion. This is an aphorism of SANCTORIUS: _Coïtus immoderatus postulat cibos paucos et boni nutrimenti_[105].

_Secondly_, To avoid all that have any acridity.

It is of great importance to restore to the stomach all its strength; and nothing is more destructive of the forces of the animal fibres than an over-stretch; so that the dilatation of the stomach by an over-abundance of aliments would daily weaken it: besides, if it is too full, weak persons feel a state of uneasiness, of anguish, of debility, and melancholy, that augments all their disorders. Both these inconveniences are prevented by the choice of aliments, such as I have recommended, by taking of them a little at a time, and frequently. It is essential that they should afford an easy nutrition: the stomach is in no condition with persons in their state, to conquer any thing hard of digestion: its action, which is extremely faint and languid, would be totally destroyed by aliments too indigest, or of a nature to diminish its strength.

Upon these principles may be formed a catalogue of such as are proper in this case, and of those which should be excluded. In this last class are all flesh-meats naturally hard and indigestible; such as pork; all flesh of old animals; all that has been hardened by salt or smoak, a preparation which, at the same time, renders them acrid: all that are too fat, or greasy; a quality which, in any other subject of aliment whatever, relaxes the fibres of the stomach, diminishes the action, already too weak, of the digestive juices; they remain indigested, dispose to obstructions, and acquire, by their stay in the stomach, an acridity, which, breeding a continual irritation, gives inquietude, pains, want of rest, anguish, feverishness. In short, there is nothing which persons of a weak digestion ought more carefully to avoid, than fat or greasy food. Unfermented pastry-ware, especially when kneaded up with fat, is another sort of aliment much above the strength of a weak stomach. Flatulent garden-stuff is also very noxious, by producing a turgescence that distends it, and at the same time cramps the circulation in the neighbouring parts; such, in general, are all forts of cabbage, of leguminous pulse, and such plants as have a taste and smell remarkably acrid, which last quality renders them noxious, independently of their flatulency.

Fruits, which are so salutary in acute and inflammatory distempers, in obstructions, especially those of the liver, and in several other disorders, are never proper in this case; they weaken, relax, and enervate the strength of the stomach; they augment the attenuation of the blood, already too aqueous; and ill digested, they ferment in the stomach and intestines, and this fermentation sets free an astonishing quantity of air, which produces enormous distensions, that absolutely disturb the course of the circulation. I have, in a woman, seen this effect: so considerable, for her having eaten too many cherries and currants, four and twenty hours after a very easy delivery, that her belly was stretched to such a degree as to become livid; she appeared lethargically dozing, and her pulse was almost imperceptible. Fruits also leave, in the first passages, a principle of acidity, apt to occasion several dangerous symptoms, so that it is necessary to abstain almost totally from them. Crude garden-stuff, vinegar, verjuice, have the like inconveniences, and deserve the like exclusion.

But though the catalogue of prohibited articles of food be a long one, that of the allowable ones is still longer. It comprehends the flesh of all young animals, fed in healthy places, and wholesomely fed; such especially is that of veal, lamb, or young mutton, young beef, fowl, pigeon, turkey, partridge. Lark, thrushes, quails, and other wild fowl, without being absolutely forbidden, are, however, attended with such inconveniences, as not to allow of their entering into daily food. Fish is under the same restriction.

But it is not enough only to chuse your flesh-meats with due discernment, but they must also be properly prepared. The best way is to roast them by a gentle fire, so as to preserve their gravy, and not dry them up too much; or to stew them slowly in their own juices. The flesh-meats that are boiled in too much water, give out to it all that they have of juiciness, and remain incapable of nourishing: thus they often become nothing but fleshy fibres deprived of their nutritious juice, and equally insipid to the taste, and indigestible to the stomach. It is common for weak persons, and even for such of them as are above all suspicions of being too nice, not to be able to eat of them without their stomach being disordered by them. The more tender flesh meats are, the less they can bear this preparation, which, in the case of sick people, ought to be reserved for extracting by it from hard or tough meats whatever nourishment they may contain.

Yet whatever preparation may be carefully employed upon the flesh meats, there are persons who cannot digest them: and to them it becomes as necessary to give them the broth, extracted by a gentle boiling; but as that has too great a tendency to putrefaction, it must be accompanied with some bread, and a dash of lemon juice, or a little wine: such a mixture is of the most desirable, in that case, for nourishment. Some lobsters boiled, and crushed in the broth, heighten its relish, and make it perhaps more strengthening; but they have the double inconvenience, of being somewhat heating, and of rendering the broth more susceptible of a quick corruption; so that on these two accounts it is good to be on one’s guard.

Bread and garden-stuff have not the advantage of containing at once a great deal of nourishment in a small quantity; but the use of them, especially of bread, is indispensably necessary, to prevent, not only the distaste which the use of a regimen consisting totally of animal meats would not fail of producing, but also that putridity which would be the consequence of them, if not mixed with vegetables. Without this precaution, there would soon a spontaneous alkali disclose itself in the first passages, with all the disorders consequential thereto. I have seen terrible accidents produced by this regimen, in weak persons, to whom it had been prescribed. One of the commonest symptoms is, thirst; they are obliged to drink, and drink weakens them: besides, the liquid they drink does not easily mix with the humors of the body, as that mixture depends on the action of the vessels, which is very languid; and if, unfortunately, as is not unfrequent with those who do not use much motion, the action of the kidneys diminishes, the liquids pass into the cellular membrane, and immediately form œdematous swellings there, and, at length, dropsies of all kinds.

These dangers are prevented by a due alliance of the vegetable regimen with the animal. The best garden-ware are, the tender roots, herbs of the endive kind, artichoaks, asparagus. There are some others, which, though tender, are of disservice; being too cooling, they deaden the strength of the stomach.

Farinaceous grains, prepared and boiled in cream, with flesh broth, are an aliment not to be slighted, as it combines every thing that is nourishing in the two kingdoms animal and vegetable, while their mixture prevents the danger from each aliment given single; the broth hinders the meal from turning sour, the meat the broth from putrefying. By reading, with a little reflexion, observant Naturalists, it may easily be perceived, that distempers are more malignant in the north of Europe than in its middle regions: may not that be owing to more flesh meats being eaten in proportion than vegetables?

What I have above said of fruits, need not, however, hinder, where the stomach still preserves something of its strength, one’s indulging one’s self, now and then, with a small quantity of the best chosen for the sort, and for ripeness; the most watery are those which are the least proper.

Eggs are an aliment of the animal kind, and an aliment extremely useful; they strengthen greatly, and are easy of digestion, provided that they have but little or even no preparation by fire, for if the white is once hardened it does not dissolve again; it becomes heavy, indigest, and unnutritious: it might then be the aliment of those who digest too quickly, and not of those who have rather no digestion. The best way of eating them, is just as they are new laid from the fowl, without any preparation, or in the shell, after only three or four dips in boiling water, or stirred into warm, and not boiling broth.

Conclusively; there remains to mention the aliment from milk; which unites all the qualities that can be desired, without having any of the inconveniences that are to be dreaded. It is the most simple, the most easily assimilable, and the quickest restorative: all prepared as it is by nature, it needs no risk of spoiling it by an artificial preparation: like the broth of flesh meats it nourishes, but is not susceptible of putridity; it prevents thirst, it supplies the place of meat and drink; it keeps up all the secretions; it disposes for tranquil sleep; in short, it fulfils all the indications that present themselves in this case. M. LEWIS attests its having produced the best effects[106]. Why then is not it always employed, always substituted to the other aliments? Answer. For a reason which is peculiar to it, which unnaturalises its effect, and which makes it sometimes produce a very different one, from that which might be hoped from it, or reasonably expected.

This reason is, that sort of decomposition to which it is subject. If the digestion of it is not very quick, if it stays too long in the stomach, or if, without too long a stay there, it meets in it with matters of a nature to hasten that decomposition, it undergoes in the stomach all the changes, which fall under our observation, out of it. The butyrous, the caseous, the serous parts separate; the whey sometimes occasions a quick diarrhœa; sometimes it passes off by the urinary passages, or by perspiration without nourishing; the other parts, if they stay in the stomach, are not long before they trouble it, cause uneasy sensations, bloatedness, loathings, cholics; and if one is not immediately affected by them, it is because they will have passed into the intestines, where they may, it is true, remain some time without a sensible prejudice, but they acquire there a singular acridity, and after a certain time they produce mischiefs which the delay will not have rendered the less dangerous; and, indeed, it may be established for a law, that should render one extremely circumspect in the prescription of it in dangerous cases, that if it is an aliment of which the digestion is the easiest, it is also that of which the indigestion is the most noxious. We have already mentioned the difficulties that BOERHAAVE found in the use of it; but however great they may be, the advantages to be drawn from it are so considerable, that it is worth while to study all possible means for surmounting them, and happily such means there are. They may be ranged under two classes; attentions to the regimen, and the medicines. Of these last I shall refer the discussion to one of the following articles.

The attentions to the regimen are, first, the choice of the milk. From whatever species it may be determined to procure it, the female that furnishes it should be healthy, and live regular: Secondly, during the time of taking it, all aliments should be avoided that can turn it sour; such are all fruits, raw or prepared, and in general every thing that is acid: Thirdly, it must be taken at times very distant from other aliments; it not taking kindly any mixture: Fourthly to take only a little of it at a time: Fifthly, all the while to take care of keeping the breast, the abdominal region, and the legs extremely warm: and, above all, Sixthly, (for without this precaution all the others would be useless,) to be very moderate as to the quantity of even the best chosen aliments. During this recourse to milk, there should be no trouble given to the stomach; the smallest over-load, the slightest indigestion, leaves in it a principle of corruption, which presently turns the milk, and may, of the most wholesome of aliments, make a poison sometimes very violent, and, at least, almost always infallibly one, in a greater or less degree.

Another question occurs: What is the milk that merits preference? In answer to this, I will not enter into an examination of the various sorts of milk; this would be over-lengthening my work by an adventitious subject; for satisfaction in which there are many recourses extant, and perhaps none better than a dissertation, now indeed out of print, of the late Mons. d’APPLES, M. D. and Professor of Greek and Morality in this College[107].

Now-a-days there are hardly any kinds of milk used but of the female breast, or of asses milk, the goat’s, or the cow’s. Each has its different qualities: it is the comparison of these qualities, and of the indication presented by the disorder, that should determine the choice from among them. There are few cases in which milk from the cow may not be succedaneously used for all the others. That from the female breast is generally believed the most strengthening: it is the notion of the greatest masters in the art, and yet this opinion bears upon a ruinous foundation, which is, the women’s making use of animal food, without considering at the same time that the preference is constantly given to the milk of a hale robust nurse from the country, who eats no flesh-meats, or, at least, very little, and who lives only upon bread and vegetables. I believe, however, that there are cases in which it may be tried with success. The noble cures operated by the use of it, leave no doubt of its efficacy; but there is one inconvenience which is peculiar to it, which is, that it must be taken immediately from the breast that furnishes it: this is a precaution, of which GALEN has already taken notice of the necessity, and, in ridicule of those who would not care to confine themselves to it, he refers them “_like asses, to asses milk_.” But in the case of recourse to the female breast for lactation, might not the vessel of conveyance excite those desires which the main point is to keep under? Might it not expose the patient to the temptation of renewing the adventure of that Prince, the story of whom CAPIVACCIO has preserved to us? He had two nurses given him, whose milk produced so good an effect, that he put them both into a condition of supplying him, at the end of some months, with new milk on a fresh account, if he should happen to need it.

It is thought that asses milk has the nearest analogy to that of the female breast; but, if I may be allowed to say it, this assertion is rather matter of opinion than of experience. It is the most serous, and, from that very quality, the most laxative. It is a most pernicious error the imagining it the most strengthening. Daily observations demonstrate the contrary, and prove not only that it is not the most efficacious, but that it is, perhaps, the least so. I have rarely seen any good effects from it; sometimes I have seen bad ones, and am not the only one that has seen them. M. DE HALLER, writing to me, says, “It appears to me, that this same asses milk rarely does what it is desired to do.” Now, the inutility of a pretended remedy, in disorders where the hopes of a cure are founded on it, is one of the most grievous defects. M. HOFFMAN advised it in cases where there were at once an exhaustion and a desire[108].

Before I quit this subject of Aliments, I ought to conclude with the counsel of HORACE, to avoid mixtures.

——_nam variæ res_ _Ut noceant homini credas, memor illius escæ_ _Quæ simplex olim sederit, at, simul assis_ _Miscueris elixa: simul conchylia turdis;_ _Dulcia se in bilem vertent; stomachoque tumultum_ _Lenta feret pituita._

To sense it is obvious enough, without any need to insist on this advice, how impossible it is for very different aliments to undergo, within the same time, a perfect digestion: this mixture it is which is one of the causes that ruin the healthiest constitutions, and is mortal to weak ones: it cannot be too carefully avoided.

Another attention equally necessary, and almost equally neglected, is, a thorough mastication. This is a help to digestion, of which even the most vigorous stomachs cannot be long deprived, without a notable decline or diminution; and without which the digestion in weak ones is extremely imperfect. Nothing but a long and attentive observation could satisfy one of the infinite importance to health of a careful mastication. I have seen the most stubborn diseases of the stomach, and the most inveterate languors, dissipated singly by this attention. On the other hand, I have seen persons in good health fall into infirmities, when their teeth, being damaged, no longer suffered them to employ any but an imperfect mastication; nor recovered they their health, till, after a total loss of their teeth, their gums acquired such a hardness as to enable them to supply their function.

So many particulars, so many precautions, so many self-denying privations, will seem very fit to verify this line of M. PROCOPE,

_Vivre selon nos loix c’est vivre miserable._

_By physic’s laws to live ’s a wretched life._

But is there any paying too dear for health? How amply are you satisfied for the sacrifices you make, by the enjoyment of it, and by the pleasures it throws into all the moments of your life? “Without health (says HIPPOCRATES) there can be no enjoyment of any earthly good; honors, riches, and all other advantages are of no avail[109].”