Part 9

Besides, these sacrifices are much less than it is commonly imagined they are. I could quote many witnesses, to whom, after just the first days, it no longer cost them any pain to renounce the variety and savoriness of rich viands, for the sake of a simplicity of regimen: which is what nature points out, and is the most pleasing to well constituted organs. A healthy palate, which has all the sensibility that it ought to have, can have no relish but for plain meats; made dishes and high sauces are insupportable to it, while, in the least savory aliments, it finds a relish, and a variety of relish, which escape the depraved, worn out, or furred organs of taste: so that those who return to the simplicity of nature in their aliments, whether it is for their health, or from convinced reason, or from a contracted distaste to high eating, may be assured, that so fast as they shall recover their health, they will find in plain aliments a delight of the palate which they did not suspect in them. A fine ear discerns the slight difference between two notes, which will have escaped a less sensible ear: just so it is with the nerves of the organs of taste; when they are in exquisite order, they perceive the slightest varieties of savors, and are sensible to them; the water-drinkers meet with waters as flattering to their taste as the most exquisite Falernian could be to drinkers of wine, and others as disagreeable to them, as to those the pricked wines of Brie.

But even were there not rational hopes of pleasure in the plain regimen, and I am sure it is not hard to accommodate one’s self to that which I have indicated, the satisfaction one must feel, the consideration that, in submitting to it, one is fulfilling a duty to one’s self, must be a greatly pressing motive, as well as a justly flattering reward, for those who can know all the value of the being well with one’s self.

The liquid part of aliments, or the drink, is an article of the regimen almost as important as the solid, or eating.

All liquids should be forbidden that can augment the weakness or relaxation, that can diminish the little that remains of the digestive powers, that can convey any acridity into the humors, or dispose the nervous system, already too irritable, to a greater mobility. All hot waters have the first defect, of weakening or relaxing. Tea, with that, has also all the others: coffee has the two last; so that one ought rigorously to abstain from them. The author of a work superior to all encomiums, and of which those who interest themselves in the progress of the medical art, wait with the greatest impatience for the continuation, has presented such an account of the danger of these two liquids, as might very well disgust or deter from the use of them those who find the greatest pleasure in them[110].

Spirituous liquors, which, at the first view might appear serviceable, for that they operate precisely the contrary of hot water, of which they really diminish the danger, if added to it in a small quantity, are, however, attended with other inconveniences that authorise their rejection, or at least restrain them to an extremely rare recourse. Their action is too violent, too transient; they irritate more than they strengthen, and if they sometimes strengthen, the weakness which succeeds is greater than before a recourse to them: besides, they give to the _papillæ_ of the stomach a hardness that robs them of that degree of sensibility necessary to the creation of an appetite, and take from the liquids that degree of fluidity which they ought to have in aid of that sensation; and, indeed, the great drinkers of spirituous liquors are strangers to it. “Those (says the illustrious author whom I have just now quoted) who every day drink strong liquors after their meals, by way of remedying the defects of digestion, could hardly find a more likely method for accomplishing just the contrary to what they propose, and to destroy the powers of digestion.”

The best drink is water from the purest spring, mixed, equal parts, with a wine neither too heady nor too acid: the heady kinds sensibly irritate the nervous system, and produce in the humors a transient rarefaction, of which the effect is an extension of the vessels, that leaves them afterwards the laxer for it, and to augment the dissolution of the humors: the acid kinds weaken the digestions, irritate, and procure over-copious urines, which exhaust the patients. The best are those which have the least of spirit and of salt, the most of terrestrial and oily, which constitutes what is called racy, generous wines: such are the red wines of Burgundy, of the Rhône, of Neufchâtel, and a few kinds in this country, (Lausanne,) the old white wines of Grave, the choice ones of Pontac, the wines of Spain, Portugal, the Canaries, and, where procurable, those of Tockay, superior perhaps to those of all the world besides, both for salubrity and deliciousness to the taste. As to common use there are none preferable to those of Neufchâtel.

In places where good water is not to be come at, it may be corrected by filtration, by a hot iron, or an infusion of some agreeable aromatics, such as cinnamon, aniseed, lemon-peel.

Common beer is noxious. Mum which is properly an extract from grain, both nourishing and strengthening, may be of great use: rich of spirit, it enlivens as much as wine, and is more nutritious; it may serve for meat and drink.

Among the useful drinks, may be ranked chocolate, which belongs perhaps more properly to the class of solid aliments; the cocoa contains a great deal of nutritious substance, and the mixture with it of sugar and aromatics corrects any detriment from its oiliness. “Chocolate made with milk (says M. LEWIS) in such quantities as to pass easy off the stomach, is an excellent breakfast for a tabid constitution. I knew a child twelve years old who was in the last stage of a consumption, when given over by a Physician, recovered by the mother’s giving her chocolate only, in small quantities, often repeated. Indeed it is an aliment that for weak constitutions cannot be too much recommended[111].” Be it, however, remarked, that there are some to whom it might prove very pernicious.

One general attention to be observed is, that too great a quantity of any drink whatever should be avoided: it weakens the digestions by relaxing the stomach; by drowning the digestive juices, and by precipitating the aliments before they are well digested; it relaxes all the parts, it dissolves the humors; it disposes to urines and to sweats that exhaust the patients. I have seen disorders produced by an atony, considerably lessened, by no other means of assistence, than by a retrenchment of a part of the liquids for drinking.

_SLEEP._

What is to be said of sleep, may be reduced to three points; its duration, the time of taking it, and the precaution necessary for a quiet undisturbed enjoyment of it.

In grown persons seven hours of sleep, or at the most eight, are sufficient for any one: there is even a danger in sleeping longer, and in remaining longer a bed, which throws one into the same disorders as an excess of rest. If any could wish to indulge it longer, it might be those who give themselves a great deal of motion, and of violent motion, during the day time; but it is not those who practise such indulgence; on the contrary, it is those who lead the most sedentary life. Thus that term ought never to be exceeded, unless one should be fallen into such a degree of weakness as not to have the strength necessary left for the being long up; in which case, however, one should try to keep so as long as possible. “The more moderate the quantity of his sleep (says Mr. LEWIS) the sweeter and more invigorating will it be.”

It stands demonstrated, that the air of the night is less healthy than that of the day, and that the weakly sick are more susceptible of its influences in the evening than the morning; as then, during our sleep, we are confined to a small part of the atmosphere, which our bodies also would not fail of corrupting; it is to sleep that that time should be appropriated, in which the air is the least healthy, and in which the being up in it would be the most pernicious; so that it is best to go to bed early, and rise early. This is a precept so commonly known, that it may appear trivial to recall it to mind; but it is actually so much neglected, the consequence of it seems to be so little felt, though infinitely greater than it is believed to be, that it is very allowable to suppose it unknown, and to re-inculcate it by an insistence on its importance, especially to valetudinarians.

Mr. LEWIS gives it for his opinion, “That if a patient lies down at ten o’ clock, which hour he should never exceed, he ought to rise in the summer-time at four or five, in the winter at six or seven, under an absolute prohibition of an indulgence in bed in the morning.” He recommends even the forming a habit of getting up after one’s first sleep, and avers, that uneasy as this custom might be at the first, it would soon become easy and agreeable[112]. A number of examples attest the salutariness of this advice: there are many valetudinarians who feel themselves light and well on waking out of their first sleep, and who experience a laborious restlessness on yielding to the temptation of going to sleep again: they are as sure of passing a good day of it, if, at whatever the hour be of their waking out of their first sleep they immediately get up, as of passing it disagreeably, if they give way to the second.

Sleep is not tranquil but where there are no causes of irritation: which ought therefore to be carefully prevented. Three of the most important attentions are;

_First_, Not to be in a hot air, and to be neither too much nor too little covered.

_Secondly_, Not to have the feet cold at lying down; an accident common to weak persons, and which is, for many reasons, hurtful to them. The rule of HIPPOCRATES should be scrupulously observed, _To sleep in a cool place, taking care to cover one’s self_[113].

_Thirdly_, And what is yet more important, not to lie down upon a full stomach: nothing disturbs more the sleep, nor contributes more to render it disquieting, painful, heavy, or overwhelming, than a laborious digestion in the night. Depression of spirits, weakness, disgust, weariness, incapacity of thought or of application to any thing the next day, are the inevitable consequences.

——_vides ut pallidus omnis_ _Cœna desurgat dubia? Quin corpus onustum,_ _Hesternis vitiis animum quoque prægravat una_ _Atque affligit humo divinæ particulam auræ._ HOR.

On the contrary, nothing is more efficacious toward procuring a sweet, calm, uninterrupted, refreshing sleep, than a light supper. Freshness, agility, gaiety, are, the ensuing day, its necessary consequences.

_Alter, ubi dicto citius curata sopori_ _Membra dedit, vegetus præscripta ad munia surgit._ Ibid.

“The time of sleep (says Mr. LEWIS, with great reason) is that of nutrition, and not of digestion.” Accordingly he requires of his patients the greatest severity as to their supper: he prohibits to them, and never was a juster prohibition, all flesh-meats at that meal; he allows them nothing but a little milk, and some bread sippets, and that two hours before they go to bed that the first digestion may be over before they lie down to sleep. The Atlantics, who were strangers to an animal diet, and who never ate any thing that had life, were famous for the tranquillity of their sleep, and hardly so much as knew what dreams were.

_MOTION._

Exercise is a point of absolute necessity. To the weak it is a pain to take it; and if they have any inclination to melancholy or dejection of spirit, it is not easy to determine them to motion; and yet nothing is more apt to augment all the evils that proceed from weakness, than inactivity; the fibres of the stomach, of the intestines, of the vessels, are lax; the humors every where stagnate, because the solids have no longer the strength to impress on them the necessary motion: thence are generated lodgments of matter, choaked up passages, obstructions, extravasations; coction, nutrition, the secretions, do not proceed; the blood remains aqueous, the strength diminishes, and all the symptoms of the disorder increase. Exercise prevents all these evils, by augmenting the force of the circulation; all the functions execute themselves as if there existed in the body a real strength for it, and this regularity of the functions does not fail soon to give it, so that the effect of motion is to supplement the vital forces, and to restore them. Another of its advantages, independent of the augmentation of circulation, is its enabling one to enjoy an air always new. A person that does not stir, soon corrupts the air which surrounds him, and becomes noxious to him: whereas a person in action is continually changing it. Motion may often supply the place of remedies, but all the remedies in the world cannot supply the place of motion.

The fatigue of the first days of attempting it, is a rock against which the faint heart of many of the sick is apt to split; but if they had the courage to conquer this first obstacle, they would soon be experimentally sensible, that to this case especially it is that that proverbial saying is truly applicable, _Il n’y a que les premiers pas qui coûtent_: “It is only the first steps that are hard to take.” I have been myself astonished at seeing to what a degree those who had not been disheartened at the first, acquired strength by exercise. I have seen persons fatigued with one turn in a garden, arrive, in a few weeks, at being able to take a walk two leagues, and be the better after it.

The exercise of walking on foot is not the only favorable one. For persons extremely weak, for such as have a complaint of their bowels or breast, riding on horseback is even better: but in a still greater weakness, the motion of a carriage, if not too easy an one, is preferable. When the weather does not allow of going out, some means of motions should be contrived, in the house, some not too laborious occupation, or some exercise of play; such, for example, as the battledore and shuttle-cock, which diffuses through the whole body an equable motion.

A return of appetite, of sleep, of chearfulness, are the necessary consequences of motion; but the precaution should be observed, of not taking any thing of a violent motion immediately after a meal, and not to eat while warm from exercise; which should be taken before a meal, with allowance of some moments of rest before the sitting down to it.

_EVACUATIONS._

The evacuations are apt to be disordered along with the other functions, and their disorder increases that of the whole machine; it is then of importance to give attention thereto, in order to the earliest remedy. The evacuations which principally require observation are, the stools, the urines, the perspiration, and the saliva. The best way to keep them in due order, or to bring them to the point at which they ought to be at, is to govern one’s self by those precepts which I have laid down on the other objects of regimen: when those are heedfully attended to in practice, the evacuations, whose greater or the less regularity is the barometer of the better or worse state of digestions, proceed regularly enough. That evacuation which it is of the most importance to favor, as being the most considerable, is perspiration, which very easily goes out of order, in weak persons. It may be aided by having the skin very regularly rubbed with a flesh-brush, or a flannel; but when it is very languishing indeed, there is not a surer way to restore it, than to put the whole body immediately into woollen covering. And yet care should be taken to avoid too warm a dress, for fear of sweating, which is always detrimental to perspiration; the forced strainers remain the weaker, and perform their functions the worse: too cool a dress is also to be shunned, as that is an enemy equally to all cutaneous evacuations. The part which every person, and especially the weak, ought to keep the warmest, is the feet. This easy precaution would never be neglected, if the importance of it to the preservation of the whole machine was sufficiently known. Frequent catching cold of the feet disposes to the most terrible chronical diseases. There are many on whom it immediately produces bad effects. But those especially who are subject to disorders of the breast, to cholics, or to obstructions, cannot too much guard against these dangers. Those priests who used to walk bare-footed on the pavement of the temples were often attacked with violent cholics.

The _saliva_ often is an over abundant secretion in weak persons; which is owing to a relaxation of the salivary organs. Now if the patients spit out continually this saliva, thence result two evils; the one, that they exhaust themselves by this evacuation; the other, that this humor, so necessary to the work of digestion, which without it operates but imperfectly, fails, and thereby renders it laborious and defective. I have already sufficiently explained myself on the dangers of a bad digestion, not to need here much insistence on those incident to an evacuation, on which the digestion so essentially depends. For this reason it is that Mr. LEWIS forbids smoaking to his patients. Smoaking, among its other inconveniences, disposes to an abundant salivation, by the irritation it produces on the glands which furnish this secretion.

Might not the inhalation from one person to another, which I have precedently mentioned, be here recalled to mind as one of the means of cure? CAPIVACCIO had judged it of use to the person under his care, that should lie between the two nurses that suckled him; and it is very probable that the inhalation of their atmosphere contributed perhaps as much as their milk to restore his strength.

ELIDÆUS, cotemporary with CAPIVACCIO, and preceptor to FORRESTUS, who has preserved to us this observation[114], advised a young man, who was in a _marasmus_, to asses milk, and to have his nurse lie in the same bed with him, who was a woman extremely healthy, and in the flower of her age: this advice had the greatest success; nor was the compliance with it discontinued till the patient owned he could no longer resist the inclination grown upon him, to make an illicit use of the strength that was returned to him. A remedy, on the foot of this utility by inhalation might be preserved, and yet the danger be prevented by not mixing the sexes.

_The PASSIONS._

The intimate union of the soul and body has been precedently mentioned; how great the influence is of the well-being of the first, over the last, cannot have escaped comprehension; the sinister effects of melancholy have been pointed out; so that it is almost needless here to add, that too great care cannot be taken to avoid the unpleasant sensations of the soul, and that it is of the highest consequence to procure for it none but the most agreeable ones; indeed in all distempers, but especially in those, which, like the _tabes dorsalis_, of themselves dispose to sadness, a sadness which, by a vitious circle, considerably augments those distempers. But (and this makes one of the difficulties of the cure) it often happens that the patients take a kind of pleasure in this symptom of their disorder, and there is no prevailing on them to determine upon making any efforts to get the better of it. Besides, not to deceive ourselves, we must not imagine that it is enough to prescribe to a person to be chearful, for him to be so. Mirth is voluntary. Laughing is no more to be commanded than it is to be forbidden. A man can no more help his being sad, than having a fit of a fever, or the torture of a tooth-ach. All that can be required or expected of the patients is, that they will no more refuse their yielding to accept or try the remedies prescribed to them against their melancholy, than they refuse yielding to other remedies. Now the remedies are not so much, in this case, company, (we have already observed that it was displeasing to them, for particular reasons) as a variety of situations. A continual change of objects for a succession of ideas that diverts them, and this is what they need.

Nothing can be more pernicious to persons inclined to deliver themselves up to one idea, than inaction, or want of occupation. But, above all, nothing is worse than that for the case here treated of: the patients cannot too much avoid idleness, and the being too much left or abandoned to themselves. Rural exercises, or employment, comprehend the most powerful diversion. M. LEWIS advises, “that the sick should, if possible, see none but those of their own sex;

“_Nam non ulla magis vires industria firmat_ _Quam Venerem et cæci stimulos avertere amoris._ VIRG.

“that they should never be absolutely alone; that they should be kept from giving themselves up to their own reflexions; that they should be diverted or kept from reading, or any occupation of the mind; all these, (as he observes,) being so many causes that exhaust the spirits and retard the cure.” I should not, however, be for totally debarring them from all reading. It might be enough to forbid their reading for too long a time at once, if it were but on account of the weakness of their eyes; or all reading that should require too much application, but especially and severely any kind of reading that might recall to their mind ideas, or to their imagination objects, of which it were to be wished they should lose the remembrance: but there are subjects which, without much fixing the attention, and without recalling dangerous images, might agreeably divert, entertain, and prevent the terrible dangers of a wearisome idleness.

_REMEDIES._