Part 3

It may be expected, perhaps, that I should endeavour to explain, how the Fibres come to receive a greater Power to act, by being often put upon Action, and to shew wherein the Elater, the Spring of the Solids, does consist; but this has been attempted so largely by an Eminent Author, Dr. _Baglivi_, and so much to the Disgust of very many, that it’s better to rest contented with plain Experience, than to frame an _Hypothesis_ for the _Modus_ of so abstruse a Method of Nature, which, in all likelyhood, Mankind will ever be ignorant of; but as far as we may reasonably guess, by frequent Distension the Nerves receive a greater quantity of Animal Spirits, because the Limb which is most us’d, grows biggest; and there is reason to induce us to suspect, that the Fibre it self strengthens by Use, has a peculiar Faculty to exert it self more and more, as often as the _Imperium Voluntatis_, the _Fiat of the Will_, sets it upon Motion. But unless we knew the Bond of Union, and understood how the Rational Soul acts upon the Animal Powers, we must be content to be most ignorant, the nearer we approach in our Disquisitions to that Union; but the Experimental Knowledge of these Parts sufficiently reproves those who hope to be deliver’d from some Distempers seated in the Solids, without acting suitably to the Nature of the Solids, the Subject of their Distempers: As for Instance; Suppose a Person, by frequent and unnecessary Use of the Bagnio, and more unnecessary Bleedings; by the Use of hot Liquors, and a perfect Disuse of all Bodily Exercise; by Passions of the Mind, and other Irregularities, is brought into the very worst of Hysterick Symptomes, with a Flaccidity and Relaxation of the whole Nervous System; How ridiculous is it, for such a Person to expect to be perfectly restor’d to a firm Habit of Body by internal Alteratives, and Methods little different from those things which occasion’d the Distemper; which tho’ they may give wonderful Relief in the Paroxysm, yet can never restore the Tone of the Solids, which must be treated in a manner proper to themselves, by Frictions, Exercise of the Body, the Cold Bath, and the like; which are very likely to be able to succeed to a perfect Cure? For why ought we not to suppose, that as all Fluids have more or less a Tendency to purifie and exalt themselves by Fermentation, the Solids should otherwise have a Propensity proper to their Make, to recover themselves by a due Tension? And what can be more reasonable and natural, than to conclude, that if a Supine and Luxurious Course of Life has enervated the Body, an Active and Vigorous one should restore it? If it be objected, That gentle Emeticks have gone a great way towards procuring a perfect Recovery from some Hysterick Cases; I have premis’d already, that they act upon the Fibres, and put ’em upon frequent Contractions, much after the same manner as a total Exercise of the Body; and therefore in this last Case, where the first Passages are not in Fault, their way of acting illustrates what I assert, that the Solids must be made to strengthen themselves, and recover their Spring by frequent Endeavours. But for Alteratives, strictly taken, I think it may be justly a Question, Whether there is that Medicine in Nature, that can remove this Distemper, when it has been of long continuance, tho’ the World has been taught above an Age ago by _Paracelsus_ and his Followers, to expect what I fear is not within the Extent of Nature; and the Impudence of Empiricks is so great, as to promise every thing that is absurd and Romantick; which keeps People up with hopes, that they may be so happy as to meet with that mighty Secret, which even in the quantity of a few drops, shall as it were charm away the most troublesome and riveted Distemper, and so instead of being Cur’d, they are Kill’d by Expectation; when the Power of Recovering their Health was in their own hands, if they had resolutely set about the proper means; like the Country-Fellow in the Fable, who when his Cart stuck fast in the Mire, must needs be calling upon _Hercules_ to come and help him, when with setting his own Shoulders to the Wheels, he might easily have got clear.

But moreover, a second Advantage arising from Exercise, is, that it gives the Solid and Nervous Parts a grateful Sensation, which in some Cases is not contemptible; a gentle Agitation of the Spirits being able to remove some Pain situated in those Parts, which perhaps nothing else would remove so surely and so soon. To explain the manner of this by a trivial Observation (if any thing in Nature can be so) let us consider, how we can separate the _Cuticle_ from the true _Cutis_ without Pain; it can’t be done with an Instrument without extream Pain, it can’t be done by Vesicatories without some Pain; but it may be done with Chafing without any Pain at all, or rather with some Pleasure, till you leave off Rubbing, and the Air comes to act upon the naked Fibres. Now this can’t be attributed to the Heat of the Part only, for then hot Medicines apply’d to the Skin; would do it as easily but must be suppos’d to be owing to a certain Agitation of the Spirits in the Extremity of the Fibres, which affects ’em with so agreeable a Sensation, as to surmount even the Pain of a Separation of their Covering, the Scarf-Skin. Now it will be allow’d by all, that whatsoever Sensation there is in the Extremity of the Fibre, the same there is at the Origine of it in the Brain; so that a pleasant Sensation in the Extremity, must needs be the same in the common _Sensorium_; and therefore ’tis easie to account for the good Effects of Frictions of the Limbs in some sort of Fits, by giving a new and different Motion to the Spirits, and thereby disengaging ’em from their disorderly Motions. And then if acting thus upon the Extremity of the Fibres produces such an Effect in ’em, ’tis natural to imagine, that that Motion, or gentle Concussion, which much after the same manner, in some proportion acts upon the whole Body of the Nerves, must affect ’em with a Sensation proportionably agreeable, and may prove sufficient to dispose the Spirits to leave their Displosions, and irregular Motions, when they happen to be so discompos’d, and consequently remove the troublesome Watchings and painful Symptomes occasion’d by those Displosions, when other Means prove ineffectual. Thus we see how natural it is for those Hysterick Persons, who are vexed with obstinate Watchings, to fall into a true and refreshing Slumber, by the Motion of a Chariot, when Opiats will have no effect upon ’em, but rather encrease their Watchings: The Spirits being the most stubborn Part of the Animal Oeconomy, and not always to be compel’d, even by that potent Drug.

The abstruse Nature of this Part of the Animal Oeconomy, will not permit us to come at a fair Explication of these Phænomena, any otherwise, than by what we at different times experience; for we must first understand, as the Author of the _Dispensary_ very well expresses it.

_How the same Nerves are fashion’d to sustain_ _The greatest Pleasure, and the greatest Pain._

Dispens. _pag. 3._

But we may discern, that the very Interruption of Pain is some degree of Pleasure; and that the lesser degrees both of Pain and Pleasure have something of a Relative Nature in ’em; a Person that is afflicted with some Pain, finds some Alleviation of it by tumbling and tossing in his Bed; which tumbling and tossing, at another time, would be a sort of Pain; and if any one thinks this ought to be imputed to Phancy, rather than Reality, I answer, ’Tis such a Phancy as none can be free from; and the denying a Person, in such Circumstances, the Liberty of gratifying it, would be the greatest Cruelty, and a high Aggravation of the Pain: Besides, in Pains of the Membranes, proceeding from the Corrosion of Sharp Humours thrown upon ’em, where the Part cannot but be very sensible of the Pain those Particles cause; yet even in this Case, the Spirits may be interrupted or diverted from the performing so acutely their Office of Sensation, by being put into different Motions. I knew a hardy labouring Man, who hapning to be seiz’d with a violent Pain in his Hip, for two or three Nights, as soon as he came to Bed, kept beating his bare Hip with a Bed-staff a great while together, before he could get any Rest, and by that Means blunted the Pain, and tired himself into Sleep; (tho’ afterwards he removed both the Pain and the Cause, by running a Packneedle himself thro’ part of his Hip); now if thus much may be done in the Membranous Parts, where the Cause of the Pain is _ab extra_, what may not be done in Nervous Cases, where the Disorders of the Spirits are the prime Occasion of the Pains, if we can communicate to those Spirits, a Motion contrary to that Motion which occasions the Pains, which certainly may be done, by moderate and agreeable Exercise?

From these Considerations I cannot but be induc’d to think, that in all obstinate Pains, caus’d by the irregular Motions of the Spirits, and in the true Hysterick Colick, one of the most frequent of those sort of Pains; it would be more natural, and in no wise absurd, to recommend to the Patient, the Use of a Chaise, or light Calash, even in the Paroxysm it self, than the Fatigue of Medicines; the best of which, except Opiates, so often prove delusive. That Exercise is convenient for Women, with Liberty to sit or lie; and tho’ the Motion at first may seem a little troublesome, and the Shocks too rude; yet I think, upon what I have hinted before, there is great Reason to expect, that after a little Patience the Spirits would be brought to relent, and disengage themselves from the _Plexus’s_, where they occasion so great Pain. I am the more confirm’d in this Opinion, because there is a Pain which seems more deeply rooted, even in the Tendons of the Muscles, _viz._ the Cramp, which will frequently go off, by changing the Posture the Part was in, when it was first seiz’d; and especially by getting out of the Bed, and walking a little while, when no Pressure or Ligature will remove it, unless the Person rise; by which undoubtedly the Spirits are call’d back into some of the superiour Muscles, or some way or other put into a new sort of Motion.

This Opinion may be corroborated likewise by what has been experienc’d by some Hysterick People, who when they have lain perhaps half a Night restless and disturb’d, and without the least Inclination to Sleep, upon getting out of their Beds, and walking a turn or two about the Room, shall find themselves quite alter’d, and when they come into the Bed again, sleep well; so that if so sudden and short an Alteration of the Posture of the Body, can produce so good an Effect, much more may be expected from the Exercise I have above mention’d; wherein the sick Person may at once enjoy the Convenience of a Cradle, and the Vehemence of a Exercise.

I might pursue this Notion, in considering the _Scorbutick Rheumatism_; in which Case the Persons afflicted are generally strong, and able to undergo any sort of Exercise; and therefore all the sorts of Exercise which I shall hereafter mention, will agree with ’em: But it will be needless to multiply words, that Distemper being chiefly seated in the Nerves, what I have said already will serve to illustrate the Advantage, which Persons griev’d with that Distemper might receive from a resolute and prudent Use of Exercise.

I hope these Observations on the Solids, will suffice to shew the Power of Exercise on this part of our Bodies; and if any of these Speculations may seem too nice, I would be understood, that I consider ’em as brought to a Habit, as frequently and closely repeated; not as the Use of Exercise is generally abus’d, being frequently undertaken, but seldom gone thro’ with. ’Tis the want of a due Notion of a Habit, which has occasion’d the Neglect of this valuable Medium in Physick: Did People allow but the same regard to this, as they do to all other Alterative Physick, it would soon appear, how great Effects it could produce.

How ridiculous would a Man seem, who, when his Physician had recommended some Medicine to be taken to the quantity of a Drachm, or half a Drachm, should go and take half an Ounce of it, and then exclaim against the Medicine, that it disturb’d him, and did him a great deal of Mischief, and that he would never take it more: Or if instead of taking a moderate Quantity twice a day, for a considerable time, he should take that moderate Quantity but once in two or three days, and then exclaim that the Medicine was ineffectual? He that should act thus, would be thought to be a very unreasonable Person; and yet after this manner most sick People set upon the Use of Exercise. You shall have a Man ride fifteen or twenty Mile, when he should ride seven or eight, come home very much tyr’d, resolve never to be so serv’d again; and so perfectly lay aside all hopes of any good from the more moderate Use of that Exercise: Another shall ride out five or six Mile once in two or three days, finds no great matter of Relief, despairs of any Success from that Course, thinks it a trivial Thing, a meer Phancy, when the Physician does not know what to do, and so he wholly leaves off too: Now allowing moderate Exercise to be a Medium for the Recovering our Health, this is a very unfair way of making use of it; for when once a Distemper will not be driven out by rough Means, by Purging and Vomits, but we must come to Alterative Physick, the Work must go on gradually, and that Physick must be us’d without Intermission. What is the difference between Aliment and a Medicament, but this? The first is chang’d into our Nature; the last changes our Nature. Now it would be as ridiculous for a Man to expect that gentle Drugs or gentle Means should alter his Constitution, if taken with great Intervals, as it would be for a Man to expect that the Bulk of his Body should keep up or encrease, tho’ he eat but once in two or three Days; and whatever Regard is due to internal Alterative Physick, the same is due to the moderate Use of Exercise; for if by it the Secretions are equally promoted, and the Subject-Matter of the Disease brought to despume slowly; it is highly requisite, that these Means should be closely repeated, with Moderation; that Nature may not be confounded and weakned, instead of being reliev’d; and without any irregular Intermission, lest the Springs should run down again; lest the Disease should have time to ruine faster than the Means of Cure can build up.

We see, by continual dropping, so soft a Body as Water can act upon a Stone; we see by incessantly following his Blow, the Smith can bring Heat into his Bar of Iron; so that where the Act it self, simply consider’d, is weak and trivial, yet the Habit is of the greatest Efficacy.

Neither ought this to discourage any, who will give themselves leave to consider, how slow, and yet how sure, some of the Despumations of general Secretions of Nature; are wherein, if the Certainty and Security will compensate for the Slowness of the Progress, they have Reason to acquiesce and submit, when there is no other Remedy left. How often has it been observ’d, that in some Paralytick Cases, after a considerable Use of the Hot Baths, the sick Person has gone away disconsolate, without any present sensible relief, and yet found himself cur’d in a Month or two after; the Morbifick Matter being just mov’d and brought to flow, when he left off Bathing, and yet not perceptible to himself; and if Nature can be enabled to make such real tho’ flow, and for a time, insensible Advances towards Health, in a Subject half dead; may not we, with a great deal more Reason, expect the same and much more in a Person who has his Nerves free, the Use of his Limbs; and who, notwithstanding his Decay, is able to set upon a Course of Exercise? If Men were not wanting to themselves in a Resolution to undergo with Patience the Fatigue of Reducing Nature indispos’d to its former State, by slow Measures, when violent are absolutely to be omitted; they would at last be really convinc’d, that Health, as well as Sickness, may approach insensibly; and that their tedious Struggles, and seemingly fruitless Endeavours did gain ground upon the secret and intimate Springs of the Oeconomy, before they come to be sensible of any the least Relief: for when once upon the use of such gradual Means, there appears a sensible Amendment, the Point is almost gain’d, and the Work more than half done: As we see that upon the Return of the Sun, after Winter, towards us, ’tis some Months before the Earth shews any great Signs of his Influence; yet when once it displays the Effects of it, we can very well discern, that they are such as must have been brooding long before we perceiv’d ’em. And why should not some Distempers go off leisurely, when we see so many come upon us so? There seems to be a Parity of Reason for it, tho’ it is no very comfortable Consideration. We know the Poison of a mad Dog encreases in the Body for a Month or more, before it displays its fatal Symptomes; and there is a great deal of Reason to believe, that a Cancerous Humour is some Years ripening, before it creates any Trouble to the Person in whose Body it is bred; Why should it seem strange then, that some Diseases require a gentle and gradual Conflict of two or three Months, when perhaps they have been a longer Time growing upon the Patient?

What I have said would make the greater Impression, could we but have a History of the fatal Miscarriages which have hapned upon preposterous Methods of Cure; an History, which, I doubt, would prove a very Voluminous one; that Rashness being too usual in both Acute and Chronical cases; In the first, Many are apt to force an Indication, rather than wait for one. In the latter, The World abounds with Examples of the Folly and Impatience of Mankind. To instance but in the Dropsie; Who is there almost, who cannot furnish you with the Story of one, who, from a hopeful Condition in the use of Diureticks, and Corroborative Things, cast himself into the Grave, by violent Purgatives, recommended by some compassionate Friend or other, to carry off the Waters at once, with a Beadroll of Stories to vouch its Success; when the other Method, with a little Patience, had certainly brought him to his former Health, and perhaps in much less time than his Disease was contracted. So difficult it is for unhappy Man to bear the Penalty of some Months, for the Demerits of some Years; and by Manly Consideration to keep from entangling himself in his Chain, instead of getting out of it.

I am not unaware here, how hard it is to frame Arguments that can have Force enough to prevail against the Apprehensions of the Pain and Trouble to be undergone in the first Attempt of Exercise, which most sick People have conceiv’d; and which are oftentimes so strong, as to blind the Mind, or bribe the Will and there is no way to deal with those People, but by Precedents; by shewing ’em, that those Difficulties have in many Cases been easily overcome: And here the Cold Bath offers it self, a severe Method of Cure taken up lately among us, and which upon the first Consideration carries Terrour enough in it; which if anyone had presum’d to recommend some Years ago, he would have been thought one of the most Wild and Barbarous of Men; and yet we see now the tenderest of the fair Sex dares commit her self to that terrible Element; and upon the first Experiment the Fears and Amusements vanish. How severe is the Sickness upon a Man’s first going to Sea; equal seemingly to the Effects of any strong Poison; and yet Nature soon accustomes her self to that Motion which is the Cause of it, and the Sailor quickly grows well! And here it must not be suppos’d, that any salt Vapours arising from the Sun, do contribute to this Vomiting, for it is now well known to every one, who had but the least smattering in Distillations, That Salt will not rise with a much greater Heat than that of the Sun; besides it is observable that the oldest or most accustomed Sailors shall Vomit in bad Weather, when the Ship is put into an unusual and irregular Motion; so that it is plain, that the Motion of the Ship is the only cause of that Sea-sickness: if therefore Nature can so soon suit her self to a Motion that can cause such terrible Symptomes, how unreasonable, how Childish it is for any one to object against the Use of Exercise, because of the common and (in comparison of Sea-sickness) trivial inconveniencies which must be born in the first Tryals! Some strong People shall be confounded with a very few Glasses of Wine; and yet if those very People fall to keeping of Company, and addict themselves to Wine but a little while, they shall drink vast quantities without any Disorder. The first Pipe of Tabacco disturbs Nature to the utmost, but after two or three more, she becomes pleas’d with that, which before disturb’d her. In the Animal Oeconomy, every thing is so wonderfully contriv’d, and made to conspire for the Preservation of Life, that Nature can adapt her self to all Circumstances; she can expand her self to bear the Luxury of a Palace, and contract her self to the short Allowance, the Bread and Water of a Prison; she can be easie under a Bloated Habit of Body, and she can make a shift to suit her self to the Expence of Fluxes and other Evacuations; accustoming her self so to bear ’em, that the longer they last, they may be in some Proportion the more familiar. But above all, she, with the most Ease, accustoms her self to the Use of Exercise; she may be said to delight her self in that, it being in a manner, _de Essentiâ Naturiæ_, and therefore it is in vain, when Exercise is really necessary, for a Person to complain after the first Tryal, and say, I’m tyr’d, my Bones are sore, my Head akes, I’m ready to faint, or the like; for all this must be endur’d, and upon patiently repeating the Motion, tho’ no Abatement appear for some Days, yet the Reward will come At last: and as these Symptomes go off, the strength of the sick Person will encrease.

From these Considerations I think it sufficiently appears, that what I have before hinted, is not at all unlikely, _viz._ That in some Cases, a distemper’d Person may acquire, by suitable Exercise habitually us’d, a degree of Strength, as much greater, than that of other sick People in the same Circumstances, who wholly neglect all Exercise, as the Strength and Agility of Robust Men, bred up to Violent Motions, is greater than the Strength of other People, who tho’ Healthy, yet are not us’d to such Things, and therefore incomparably Weaker.

Having thus Explain’d the Power of Motion, both on the Solids and Fluids, and having shew’d how necessary it is, that such Motion or Exercise should be continued to a Habit, that it may be render’d sufficient to procure those Ends it is directed to; I hope after these Considerations, it will appear pretty plain, that Exercise may deserve to be taken as a _common Aid_ to Physick, (to use the Term which _Asclepiades_ gave it) and ’tis under that Notion, that I propose it as so Beneficial a Medium in the Art of Curing; so that Exercise in this Sence is to Physick, as Bandage is to Surgery, an Assistance or Medium, without which, many other Administrations, tho’ ever so Noble, will not succeed. It is a kind of Reserve, but yet of that Efficacy, that the thing you most depend upon, and tho’ in it self very powerful, may yet receive its _Derniere Puissance_ from this Reserve. And to this it is that we most undoubtedly attribute the wonderful Success which the Antients had in their Curing with such indifferent Materials, as their Pharmacy afforded ’em.

This will prove an Aid in a double Respect, _viz._ both of the Distemper, and of the Medicine.