Part 6

The ill Success of our Diuretick Method in this Distemper, is very much owing to our giving those Medicines in so small a Quantity, and to our not changing ’em for some of a quite different Nature, when one sort us’d pertinaciously does not take; that the quantity must be encreas’d, there needs no better Argument, than what is brought for the use of Purgers; for if the Blood can dispense with the Particles of a Purgative, it will certainly bear a great quantity of those which are Diuretick only. What Wonders has that Golden Remedy of _Pythagoras_ done, the _Acetum Scylliticum_, when given to a proper quantity? And what may not be expected from the _Sal Succini_, which may be given to a Dose large enough to irritate the Fibres of the Stomach, and in some measure supply the place of a gentle Purger; but when it is come into the Blood it may prove Cordial as well as inciding? And now I am speaking of augmenting the Quantity of our Diureticks, I can here affirm a very strange Effect that follow’d upon an excessive Dose of _Millepedes_ in an odd kind of a Rheumatick Case, for the Cure of which, several things had been try’d in Vain, by very good Advice; the _Millepedes_ were given to a quantity scarce credible, to several Ounces, and gave a Relief in a little time that exceeded all expectation. This with other instances something of the like nature, every where to be met with, may convince, us that we ought to advance the quantity of these Medicines, to which if we apply the Use of Exercise, the highest Advantages may be expected: For to grant as much as the favourers of the Purging Method can demand, that by reason of the foremention’d Ropiness of the _Serum_, the Diureticks and Chalybeates will but distend the parts, and make the Juices grow Turgid. Is there no way to remove the Dam, but by shaking all Nature at the same time? Must we blow up the House to get the Enemy out? To what purpose do we talk so much of the Animal Oeconomy, if we reduce its Rules to Practice no more than we do? We are taught the Benefit arising from the Constriction of the Muscles upon the Vessels; and can there be any Case which does more apparently call for it than this? When it is hazardous to attempt by inward Violence to dislodge the Viscous Concretions, certainly it is high time to do it by Muscular Force. This _Hippocrates_ seems to be experimentally convinc’d of, by his frequent inculcating the Use of Exercises in this Distemper, Δεῖ ταλαιπωρέειν _you must labour_, is his constant Expression, whenever he speaks of the Dropsie; which, whoever considers the Conciseness that is in all the Writings of that Great Man, will be apt to imagine that it carries its Weight with it, and implies the absolute necessity of acting upon the Lentor of the Phlegm, by the playing of the Muscles. Besides Exercise will help to restore the Tone of the Parts, which is sometimes spoil’d by too great a Distension, even so much as to be in a manner benum’d, which _Helmont_ seems to lay much stress on, when he, according to his odd fantastick way, calls it the _Anger of the Archæus_, that won’t let the Waters pass; and if there is this kind of Spasmodick Affect in the Parts leading to the Kidneys, then certainly there is as much Reason for one in a Dropsie to get into a Coach upon his taking his Medicines, that the frequent jolting may assist their Operation, as there is for one in a Fit of the Gravel so to do. The Heat that is acquir’d by the Motion of the Body, must needs comfort the Parts, and rarifie a great deal of the Moisture, so that it may the more easily pass the Membranes, as they are dilated by Exercise; and if we can by squeezing, make Water pass through Leather, the whole Skin dry’d and prepar’d, may it not much more easily pass the Membranes of a living Animal, when work’d and stretch’d by Motion, and assisted by the Warmth which that Motion produces? These may be thought little things by some, but they will be found to be of great Consequence; by such minute Measures, Nature can produce great Effects; and by a Neglect of these things, many a great Life has been lost, in Dependence upon something of a greater Name, that has had no Relation to the Genuine proceedings of Nature.

These are some of the Reasons which have convinc’d me of the Preference of the Diuretick Course, and which I think can’t be overthrown, by all the Examples of the Success of Purgers, because if we compute the Ill Effects of ’em likewise, and set ’em to balance the good, the very Cures done by ’em, will seem but as so many _Splendida Peccata_. We ought not hastily to quit safe Means for those which are dangerous, only because they are a little more expeditious; when a Case is within our Reach, we ought to Establish our Prognosticks upon sure ground, tho’ they may not be so quick as could be wish’d; we have other Dropsies that are dubious enough, but in this Case we ought to study to bring things to a certainty as much as possible; which how can we do unless our Methods are Uniform? It behoves the Patrons of Purgatives to assign some certain Rule, to render the Use of ’em alwayes safe, which seems impossible to be done; and it behoves those who are for insisting on Diureticks, to find out some such Measures, as may make these milder Medicines always Efficacious; which is what I have been attempting to do; and which, if I don’t flatter my self, I think I have made to appear plain and obvious; for if we can’t arrive at some comfortable certainty in this Case, I don’t know in what we can do so; for we are so happy as to have those things as will certainly act upon such a Crasis of the Blood, as will revive and enrich it, when decay’d, tho’ not always in the like space of time; and when they act too slowly, we can enforce their Virtue, by these ways I have been speaking of.

These things are no Figment of mine, they have been the Practice of Ancient Times, and are so natural a Result from a due Consideration of the Animal Oeconomy, that I cannot enough wonder that in so many Discourses upon those Fundamental Rules, there has been so little Notice taken of the Effects of the Motion of the whole individual, as superinduc’d to the internal Motions, that make up the Oeconomy; for if this had been duly regarded, it could not but have been reduc’d to Practice, and apply’d particularly to the Cure of this Distemper.

_Lastly_, I know these are hard Sayings to some People, who send for a Physician, as for one that deals in Charms, and can remove all their Afflictions, while they are wholly Passive; and they would take it very ill that they should be compell’d to a sort of Labour, while they carry about ’em a Load in their Limbs; but yet for all this, Nature will be Nature still; and if this be her Voice it must be obey’d. He that is in a Dropsie ought to be Alarm’d, and look upon himself as in something the like Case with those Criminals whom the _Dutch_, upon their refusing to Work, confine to a Cellar, and let the Water in upon ’em, that they may be in a Necessity either of Pumping or Drowning. And I believe there are but few, but who, upon their being convinc’d of the real and surprising Benefit of these Means, would readily undergo the Fatigue of ’em; and things may be so manag’d, that Exercise may not be so troublesome as the Sick imagine; an easie Pad will quickly grow familiar; and where the Legs happen to be so very much distended, that there may be some danger, lest the Skin should be rub’d off, a Chaise may serve the turn.

OF THE _Hypochondriacal DISTEMPER_.

The third and last Case, which I shall expresly consider, is the _Hysterick_ or _Hypochondriacal_ Case; in the Cure of which the several Exercises, which I shall hereafter Recommend, may all be us’d. This Distemper falls the most under a Gymnastick Method, because the least proper to be treated with much Internal Physick; this is a Distemper which will not drive, as we say, but if kindly treated will lead, that is, will not be expell’d by Purging, Bleeding, Sweating or the like, but must be treated by more gentle and leisurely Methods; ’tis a Distemper of the Spirits, and the Vessels which immediately convey ’em; and therefore those means by which they are more immediately affected, are the most likely to prove beneficial. Here it is, if ever, strictly true, that a little Matter gives the turn, but then that little matter must be equally apply’d; we must give an equal lift to all the Parts of the Oeconomy at the same time, we must not apply to the Fluids, and neglect the Solids. ’Tis the want of this Distinction, which I take to be the Ground of all our mistakes in the Cure of this Distemper; we cure but half the Man, When I meet with a Languid Hysterick Pulse, I can easily raise it, and give a full Beat to the Artery, by Anti-Hysterick Medicines; but then what becomes of the Nerves, they are not much help’d by this, But sometimes impair’d by it? but then let the same Person have Recourse to some moderate Exercise, his Pulse shall rife as high as upon the use of Internals, but with this Difference, that the Nerves as well as the Blood partake of the Benefit. For we may distinguish between this natural advance of the Bodily heat, which is procur’d by Exercises, and that which is acquir’d by Medicines, just as we may between the Effects of the Kindly Heat of the Sun, and those of an Artificial Fire: Now in the matter of the Vegetation of Plants, and the Management of some sorts of nicer Workmanship, tho’ the greatest Care and Industry be us’d to raise a gentle heat, which to our Senses and even to the Measure of the Thermometer, may seem equal to that of the Sun, yet it shall never be able to produce the same exquisite effects, as the heat of the Sun does. And so we see in this Case the mildest and seemingly most agreeable Gumms prove Purgers to some of these People, others again can’t bear _Castor_, without some troublesome inconveniences; and how much soever some People may be Rapt up with their _Sal Volatile_, and such like Preparations, I can perhaps give an instance of more wonderful Relief given in this Case, by a more Common Cordial, than ever those splendid Medicines could produce; it may not be amiss to relate it in this place, because it serves to illustrate my Design in shewing that nothing that has the least seeming Violence in it, or rather that nothing, which is not very mild and agreeable to Nature, can be of very great moment in the Cure of this Distemper. The Instance then I mean, was communicated to me by an Eminent Physician, and very Learned Writer, and is this; He was call’d to see a Maid which had been severely Tormented with Hysterick Fits for several days, and had taken plenty of the Remedies usual in that Case, without any effect; upon which he was resolv’d to try, what a good large Dose of a true generous Wine would do, considering she was a Servant, and consequently could not be suppos’d to be accustom’d to that Liquor, which would have render’d his attempt fruitless; he therefore prescrib’d some Pouders of no Efficacy, to obviate the Phancy of the By-standers, and order’d the Apothecary to ply her with some Wine of his own procuring, that he could depend upon, till she had taken a quantity, which to her might be reckon’d very large; this succeeded like a Charm, after a good Sleep, she was freed of all her terrible Symptoms the next Morning, tho’ before she could scarce stir her head from the Pillow, but she fell into a Fit. And I have twice had the Occasion, to see something of the like nature my self; the first was, where a large Dose of Wine took off some very ill Symptoms, occasion’d by strong Purgers, erroneously repeated in a certain Nervous Case. But the Person had not been us’d to drink Wine, otherwise it could not have produc’d such a happy effect. I instance in these things only to shew, that the Remedies which are most proper and adequate to this Case, must be such as have something of an inimitable Mediocrity in ’em; and that Exercises do produce Alterations in the Body, which resemble the effects of such a singular and Noble Mean, is not improbable, in regard they act so equally (as I observ’d before) both upon the Solids and Fluids. And one would think the Ill Success of any thing, but like Violence, should lead us to some such Measures as these. One would be apt to think that when a Distemper, which carries as little, or may be, the least danger of Life in it, of any whatsoever, tho’ so very troublesome, when this nevertheless becomes one of the most difficult to be perfectly rooted out, one would think, I say, that this odd Circumstance, so like to Contradiction, should prompt us to look out for the real Reason of it.

Upon these Considerations I can’t but admire, that the same Administrations, or with very little difference, (excepting the Chalybeates which may be allow’d in both Cases) are thought proper for Temperate Women, and Men of Intemperance, when they happen to fall into the Hypochondriacal Affect, as is frequently enough known; one would think that when the Disorder in these latter is owing to the excess of a Liquor, both wholsom enough and Cordial enough in it self, which by its too frequent use has relax’d the Nerves, and consequently impair’d the Spirits, there should be little likelyhood it should be remov’d, and taken off by hot Medicines in a Solid form, which perhaps don’t differ so much as most People imagine, in their real intrinsick Energy from that Noble Liquid, to which these Gentlemen owe their Malady; I say, one would think that some such surmises as these, should naturally lead us to an immediate attempt, upon the parts affected, _viz._ the Nerves, which must be done by means suitable to ’em, that is by Exercise.

Wherever there is a Dejection of the Mind, and a Propensity to Phantastick and Imaginary Fears, there is reason to suspect the Solids, that is, the Nerves are more in fault than we think for; we may consider that when a Man is Drunk, he seldom loses his intellectual Faculties to any great degree, till the Nerves are quite stress’d with the Load of Wine, and his Feet go commonly before his Reason; and if this were a proper place, perhaps, I could shew some Reasons for us to suspect the same, in the Deliriums of People in a Feaver, that the intense heat must first evidently impair the whole body of the Nerves, before the Understanding will be quite lost. We don’t know what a great deal of Rotation and irregular Agitation the Spirits strictly taken will bear, without any Damage receiv’d; but when the Nerves, the Container of those Spirits, are considerably affected, the Spirits contain’d must partake of the Mischief. We know but little of that inconceivable connexion of Soul and Body, but the wonderful Bond of Union, seems to terminate very much in the Fibre. For we may observe, that those Poisonous Vegetables which intoxicate, and attack the Rational Faculty, do chiefly display their Power on the Nerves, ’tis in their very Nature, and in the least quantity to hurt the Nerves; and when Wine, tho’ in its Quality most agreeable, is by the Quantity and Repetition of it, made to be prejudicial to the Nervous System, I can’t imagine, how other Cordial Medicines, which must still in some Measure keep up the Stress upon the weakned Nerves can be the adequate Remedy of this Disease, but that the Nerves, must be assisted after their own way, after a manner suitable to their Nature, that is by Exercises; for it is, and ever will be one of the Properties of a Fibre, to be the stronger for Motion, the better for wearing; and it is but a Law of Nature, arising from the Necessity of the Constitution, that while the Fluids are continually wasting and running off the faster, for the Motion of the whole Individual, the other part of the Constitution, the Solids, the Fibres should by the same Means reap some Advantages proper, and in some measure sufficient to Balance the Consequences of such a _Dispendium_.

All this receives certain weight from the Argument which is so Naturally suggested to us, by the familiar and daily Observations, which every one cannot but make on the Health of the Poorer sort of People, especially their immunity from this Distemper. That it is matter of wonder that the Spasms, the Tremors, the Shiverings, the Watchings, and all the very numerous Plagues of an Hysterick Person, should not be able to rouze People into a Quest of Health, upon Measures suitable to the Causes of things; that such Painful experience should not animate ’em, into a Resolution to exchange the Pains of a sedentary, for the Indolence at least, not to say, the Pleasures of an Active Life. I am confident no one could forbear making these Inferences, and reducing ’em to practice, who has been any considerable time infested with this Distemper, were it not for the present Comfort and false Hope, which are conceiv’d from some Palliative Remedies, in too much use in this Case; I mean Vinous Spirits, and Compositions Distill’d upon ’em, which because in the beginning of this Distemper, they are found to be comfortable and really useful, entice People to have recourse to the use of ’em, oftner than they ought to do, and in time seduce ’em so much by that Delusive flash of Ease, which they give in the first Moments of their Drinking, that they cannot have a due Regard to the Evil Consequences of such a Practice; these Liquors prove a meet Charm, they creep into the Understanding, and teach People to impose upon themselves, and fansie Excuses for the use of ’em, till they come to be so blinded as to think that Health it self, is scarce an equivalent for the Pleasures which must be deny’d, in the Abstinence from ’em. They who have brought themselves to such a Custom, are not unlike some of our Debtors, who after they have been some time in a Prison, and learn’d the way, of living an Idle Life upon other Folks Cost, tho’ under Confinement, they lose all sense of Liberty, and never desire to subsist again, upon the severe Conditions of Industry and Labour; and so those who have learn’d to sip of this Spirituous _Lethe_, quite forget the value of Health and Strength; they can drown their Vapours, blunt their Pains, and rub on without great danger a good while, and therefore as for brisk Exercise, the Cold Bath, and the like, they desire to be excus’d; there’s too much Danger in the Practice, there’s a _Lyon in the Way_; and thus a sickly complaining Life they lead, because they will not take Courage, to use the Just endeavours after a real State of Health. These I take to be some of the Reasons, why this Distemper is so seldom totally extirpated, and is become the _Opprobrium_ both of the Patient and Physician; for else it would be impossible, that People should generally resist the Consequence of that Observation which I hinted before: For if the Labour of the Poor generally secures ’em from this Distemper, and if this Distemper, whenever it seizes, is of so nice and tender a Nature, that it will scarce allow of any of the common Methods us’d in the Cure of other Distempers, certainly it behoves the Persons so griev’d, to try whether those Means which are Preservative to others, may not prove Curative to them; which, by reason that the Subject of the Distemper, _viz._ the Spirits and Nerves are primarily affected by Exercise, proves highly probable. For why there should be such dependance on Internals universally, and even in this Case, I can’t see; to me it seems almost as Ridiculous, as if a Workman should use but one sort of Tool in working on Wood, Stone, Brass, and all other Materials.

I need not here take Notice of any of the particular Symptoms of this variable Disease, they all being liable to the same Regimen; I have already in another place hinted what Relief may be procur’d by this Method in the Hysterick Colick, and in the obstinate Watchings, which will scarce submit to the use of _Laudanum_, or at least without ill Consequences. Therefore I shall conclude they all fall under the Power of a Resolute COURSE of EXERCISE.

The Exercises most proper here are _Riding_, and the use of the _Cold Bath_; the first prepares for the second; which Rule if some People, who are the most weakly, wou’d observe, they might secure themselves, from some of those few Accidents that have befel the too rash entrance into the Cold Bath. Instead of Riding on horse-back, Women may take a Chaise, which will allow of swift Motion, and comes little short of the Horse for Agitation of the Body; tho’ I can’t see any breach of _Decorum_, if a Lady, attended with a Servant, should ride on Horse-back daily for Health, if she like it best; as for those, who upon the Account of their being very Fat, have some Reason to be cautious, how they go into the Cold Bath, lest some Apoplectick Symptoms should ensue, they may have recourse to another of those Exercises, which I shall treat of, _viz._ the use of the _Brush_, or _Chafing_, which if us’d in good earnest, will not prove so trivial as perhaps some People imagine it to be.

These are the Chief Exercises which I would recommend in this Case, and which if us’d with Prudence and Application, I doubt not are able to effect a compleat and Eradicative Cure of this Distemper, as certainly as more violent internal Means are expected to succeed in any other Case, the Spirits and Nerves being not so much more untractable, than the Blood and Humours, if treated after a manner suitable to their Nature.

What I have said of these three Cases, may serve to illustrate the necessity of this Method in some few other Cases, which I need only Name; as the _Scorbutick Rheumatism_, which being a Nervous Case, will admit of the three Exercises I have mention’d, which if strenuously put in Practice at proper Seasons, will do Wonders in the removing of those Pains. The _Nervous Atrophy_ is another Case, which may be remov’d by a Gymnastick Method, when all the Pompous Internal Medicines will not avail.

_Lastly_, there is one more Case, to which Riding seems to be in a peculiar manner appropriated, and that is, that Decay of Nature which is occasion’d by Passions of the Mind, which we commonly call, Breaking the Heart; here the Spirits are broke, and ruined by the stress of Thought, the Mind drinks up the Vital Fluids, and the Ravage proceeds so fast, that nothing can avail, but what can in some Measure interrupt the Eagerness of Thought, and repair in Proportion to the wast of the Spirits, which Riding seems most likely to do, because it gives an Alacrity beyond that of Wine; because the Briskness of the Motion, must take a Man off from close thinking, and such Exercise continued long, even to some Journeys, must by Tiring incline to Rest, and break off those voluntary Wakings and anxious Thoughts, which are so pernicious; and if some intervals of Ease can be gain’d in this Case, there is hopes that Reason or Religion may take place, and the Passions may be laid: For ’tis the first Fury that is the most Dangerous and Violent; if that can be manag’d, the Point is gain’d, and there is nothing like Hurrying the Body, to divert the Hurry of the Mind.

These are most of, if not all, the Cases which fall under the Power of Exercise as Curative; as for the Benefit which may be obtain’d by Exercise, in the Gravel, the Gout, and the like, it is purely Palliative, and therefore out of the Scope of my intention in this Treatise: I shall now proceed to consider briefly, those several Sorts of Exercise, which seem proper to my Design.

And here I shall not insist upon the various Exercises of the Ancients, or all those in Use now in our Days, but shall make choice of but a few, that seem most Compatible with the Weakness and Infirmities of Sick People, and the particular Circumstances of those Distempers which I have already mention’d, and I shall begin with the chief of ’em, which is that of RIDING.

OF THE EXERCISE OF RIDING.