A 
DISSERTATION 
ON THE 
INFLUENCE 
OF THE 
PASSIONS 
l * 
UPON 
DISORDERS of the BODY. A 
DISSERTATION 
ON THE 
IN FLUENCE 
OF THE 
PASSIONS 
UPON 
DISORDERS of the BODY. 
B Y 
WILLIAM FALCONER, M. D. F. R. S. 
AND CORRESPONDING MEMBER OF THE 
MEDICAL SOCIETY OF LONDON. 
BEING 
The ESSAY to which the Fothergillian 
Medal was adjudged. 
LONDON: 
Printed for C. Duly in the Poultry; and J. Phillips, 
George-Yard, Lombard-Street. 1788. INTRODUCTION. 
As the following Eflay has been crowned 
with the firft prize medal of the 
Medical Society, it may not be 
improper to explain the origin of the 
inftitution of the Fothergillian 
Me dal, by the infertion of the fub- 
fequent letter. 
st To the Medical Society of London. 
(t Gentlemen, 
« preferve the memory of illuftrious 
" X charafters by lome permanent me- 
<c morial, is not only grateful to the friends 
16 of the deceafed, but excites in the living 
" that commendable emulation, which leads 
" to great and virtuous aftions. Such were 
" thofe which will render dear to diftant 
a pofterity ii 
ef poflerity the name of Dr. John Fother- 
<c gill ; in memory of whom I have order-' 
<c ed a medal to be flruck, under the pa- 
<c tronage and at the difpofal of the Medical 
(t Society of London. It will be in gold, 
(e of ten guineas value, to be called the 
<c Fothergillian Medal, and be given an- 
" nually, on the Sth day of March, to the 
<c author of the bell Efiay upon a prize 
6C queftion, propofed by the Society, on a 
" fubjedt of Medicine or Natural Hiftory. 
<c The manner of propofing the annual 
" queftion, and of determining upon the 
<c merits of the memoirs of the candidates, 
<f I refer to the determination of the Society ; 
" being perfuaded, from the unanimity of 
Cf their meetings, and the learning and 
" judgment of their members, that their 
<c decifions will be calculated to promote 
" medical fcience in particular, and phyfics 
<f in general, which are my motives for re- 
ct quefting their patronage of the Fother- 
" Gillian Medal. 
" JOHN COAKLEY LETTSOM » 
London. 
May 25, 1784. iii 
Medical Society of London' 
June 1784. 
ef Sir, 
<f AT a fpecial meeting of the Medical 
cc Society, convened for the purpofe of 
" taking into confideration your very liberal 
<c propofal of the Fothergillian Medal, to 
<6 be difpofed of annually, at the option, 
<£ and under the patronage of this Society: 
" I am ordered to inform you, that the 
<e fame has been confidered accordingly, and 
<c met that warm reception and approbation 
<c fuch a diftinguiflied favour was fo well 
entitled to : 
<c And that this Society, being highly 
Cf fenfible how much you had thereby con- 
<c tributed to its advantage and reputation, 
" order me to prefent you with the Thanks 
r< which were unanimoufly voted to you at 
<c this meeting. 
By order of the Society, 
Wm WOODVILLE, 
(one of the Secretaries.) 
« To J. C, Lettjom, M. D, 
REGIL 
a 2 iv 
C{ REGULATIONS rejpeffing the Medal? 
1. " THAT the Medal be given annually 
c< to the author of the belt Differtation, on a 
f< fubject propofed by the Society, for which 
** the learned of all countries fhall be invitedt 
" as candidates. 
2. " Each Differtation fhall be delivered to 
" the Secretary, written in a legible hand, 
in the Latin, Englilh, or French language, 
" at leaft two months before the meeting for 
55 adjudging the Medal. 
3. (( With it fhall be delivered a fealed 
ss packet, with fome device on the outfide ; 
cc and within, the author's name and defigna- 
<c tion. 
4. « The fame device fhall be put on the 
tc Differtation, that the Society may know 
<c how to addrefs the fuccefsful candidate. 
5. " There (hall be a Committee appoint* 
ss ed by the fociety, for the purpofe of ad- 
cc judging this Medal, confifting of the 
" Council 5 v 
«£ Council j to whom fhall be joined fuch 
other Members as the Society fhall think 
<f proper ; and their fentence fhall be final. 
6. " The Medal fhall be adjudged on the 
<c 8th day of March, that being the birth-day 
<c of the late Dr. Fothergill. The firft 
«e Medal fhall be adjudged in the year 1786. 
7. <e No difiertation with the name of the 
author affixed can be received, that the 
te Committee may decide on the merits of 
<f each, without any knowledge of, or par- 
tiality for, the author. 
8, <c All the Differtations, the fuccefsful 
<c one excepted, fhall be returned, if defired, 
« with the packets unopened which contain 
<f the names of the authors." 
The Medical Society further teftified 
their approbation, by propofing an intereft- 
ing queftion as a fubjeft of the firft prize, 
which produced two differtations, to one of 
which* 
* 3 vi 
which, by Dr. Falconer, of Bath, was ad- 
judged the Fothergillian Medal, 
On the 6th day of June, 1787, the day 
appointed for declaring at a publick meet- 
ing of the fociety, the adjudication of the 
Medal, and for the prefenting it to the fuc- 
cefsful candidate; Dr. Falconer, who hap- 
pened fortunately to be in London, attended, 
when the following dddrefs was delivered 
by Dr. Letlfom. 
il The Practice of Medicine, in a compre- 
<c henfive fenfe, is conduced in this country, 
<f by Phyficians, Surgeons, and Apothecaries: 
<c for, however one profeffion may be inde- 
<f pendent of another, the prevalence of 
<f cuftom has given them fuch a relation, as 
<c renders them conftituent parts of the fame 
<c ftrudlure. 
ee Pharmacy, in a literal conftruction, is 
tf the art or practice of preparing medicines ; 
" and it is natural to infer, that thofe who 
&re converfant in the compofition of medi- 
<c cines, may be capable of applying them ; 
<f and. vii 
<c and popular opinion, we all know, has 
<f introduced Apothecaries to the cham- 
<c bers of the fick, in the firfl: onfet of their 
" maladies, when the uncertainty of 
" toms muft exercife fagacity, and experi- 
" ence refult from practice. 
<c Surgery, which implies manual opera- 
<c tion, and the treatment of difeafes by out- 
ward applications, is now cultivated on a 
<( more extenlive fcale, which unites the 
6C operative art, with an enlarged chirurgical 
<f pathology. 
" Indeed many celebrated Phyficians of 
t{ the prefent century, have originated from 
<c thefe departments, and their admiflion into 
" literary focieties hath not diminifhed the 
dignity and luftre of fuch inftitutions. 
" To promote therefore the healing art in 
" the moft ample manner, this fociety is 
" conftituted of Phyficians, Surgeons, and 
" Apothecaries, who firlt united in the year 
<c 1773, under the title of the Medical 
£ Society of London, and their publica- 
" tions 
a 4 viii 
<s tions evince that it hath not been inftituted 
<e in vain : and in order to bring to light, 
<c talents which would otherwife lie dormant, 
<c and ufelefs to the community, the fociety 
<c have refolved to give a Silver Medal annu- 
" ally to the author of the beft memoir that 
(C Ihall be communicated within the year. 
<f Further to promote thefe inftitutions, 
*f they engaged to give annually a Gold 
" Medal, of the value of ten guineas, diftin- 
<e guifried by the title of the Fothergillian 
<c Medal, in memory of the late illuftrious 
<c Dr. John Fothergill, to the author of the 
<c beft diflertation on a fubjeft propofed by 
the fociety ; and the following queftion 
,e was agreed upon according to the eftablifli- 
" ed regulations, as the fubject of the firft 
<f Prize Medal. 
<c What dijeafes may he mitigated or cured, 
<e hy exciting particular affections or paffions of 
mind ? 
(i Of the anfwers, which this gave rife to, 
the medal was adjudged to the author 
" of ix 
" of the diflertation, diftinguiflied by this 
f( infcription : 
Fo/Xi J's Td TVf J*-™. GCep.tL'lQi' 
<c Man, organized as he is by his nature, 
<c with fenfitive powers, and improved and 
refined by experience and civilization, is 
momentarily influenced by imprefllons of 
•f mind, which impel to action, in propor- 
" tion to the force of impulfe, and irrita- 
" bility of his iyftem. 
" Of the influence of the human pafiions 
c< and affeAions, no man of feeling is igno- 
" rant •, thefe mix in every aftion of life, 
" and determine our enjoyments in every 
« ftation we occupy, with an evidence fo 
prominent to obfervation, as to depift in 
« expreflion of feature the emotions of heart 
fc and intellect. 
" Every pra&itioner, therefore, who ftudies 
<c the honour of his profeffion, and the hap- 
pinefs of his patients, ihould feduloufly 
" endeavour x 
ec endeavour to cultivate an acquaintance 
with the anatomy of the mind, as well as 
" that of the body. The firft, arduous as it 
ec is, is fo connected with the rational and 
t( metaphyfical nature of man, and all his 
ffc moral adions, as to add to inveftigation, 
<c the knowledge moft highly eftimated by 
cc fages, the knowledge of our/elves* 
<c I had once propofed to myfelf the tafk 
" of attempting to trace, and defcribe the 
<f paflions of the mind in health, and their- 
" influence in inducing difeafe : to profe- 
<f cute this, I had confulted authors of an- 
" tiquity, both facred and profane : but the 
ff materials grew fo voluminous, that 1 found, 
ff it impracticable to condenfe them within 
" the compafs of your leifure to attend, and 
<c of my time to arrange. I have, therefore, 
" drawn my materials from one fource alone, 
tc the molt ancient and inftruCtive hiftorical 
" volume in the world ; in which fuch an, 
sc interefting view of the paflions is exhibited, 
<c as would alone enable fagacity to develop 
(( their fource, their varied progrefs, and 
(C wonderful xi 
' wonderful influence. Their powers indeed 
tc operate almofl: at the moment of human 
" exiftence. Shame, that penitent paflion of 
cf confcious guilt, follows the awful interro- 
<c gation of the firfl: man ; Adam, where art 
<c thou ? Ttiffimulation, a paflion unworthy 
<c of a liberal mind, the refult of fear com- 
<c bined with guilt, is immediately promi- 
" nent in the affumed exculpation, " She 
<e gave me of the tree, and I did eat." The 
<c facred hiftorian, who lived to the age 
" of no years, had been dead five years 
<f before the foundation of Troy was laid 
<c by Scamander, and confequently many 
tf centuries before Homer painted the ire 
" of Achilles, pourtrays the dreadful impe- 
" tuofity of Anger in the firfl: - born hu- 
<c man Being, who affords an example of 
wrath of the moft implacable nature• ■ ■ 
tc the religious wrath of one brother, profe- 
<c curing another unto murder! preceded 
<e by all the groveling fufpicions of fupe- 
<c rior merit, expreffed in a fullen, or " a 
" fallen countenance " " and avenged by fu- 
(< preme juftice, in an appeal to the heart, 
<( that almofl: chills the blood- ' What 
" baft xii 
haft thou done ? 'The voice of thy 
" blood crieth unto me from the ground." 
" In the underplot of finifter pafiions, we 
fee in a wife and a parent, the influence 
<f of prejudice3 infinuation, and treachery ; 
<c ftill further degenerating into avarice in 
the chara&er of one fon, and pathetically 
<c contrafted, in the generofity of an injured 
" brother, after the emotions of anger had 
6t fubfided; who ran to x meet him3 and 
'6 embraced him3 and fell on his neck, and 
(( kijfed him3 and they wept* The picture 
<f indeed for ftrength of colouring for the 
<f chafte union of ftrong and tender pafllons, 
<c is not, perhaps, exceeded by any thing 
ce ever recorded. Its force and imprefllon 
" are not inferior to that exhibited by the 
<c Hebrews in the court of Pharaoh ; or to 
et the animated friendlhip of the 
<c ed Greek, for his Patroclus. 
<£ I have already intimated that I had 
et originally defigned to have followed the 
* Gen, ch, xxiii. ver. 4. 
" ancients* xiii 
♦f ancients, in their delineation of the human 
" pafiions j and gradually to have defcended 
" to more recent writers : few fubje&s can 
appear of greater importance, in the hif- 
<{ tory of the medical profeflion, when it is 
<c confidered that at leaft, half of the difeafes, 
<f to which we are prone, originate from the 
<c influence of the pafiions on the human 
<f fyftem. It was not defigned to introduce 
" the hiftory of difeafes, or of the pafiions 
sc which mitigate or cure them-This is the 
5t object of the prize diflertation. 
" In health indeed, the operation of the 
c< pafiions is no lefs varied than wonderful; 
(C fome excite ; others deprefs the vigour 
" of life ; and thefe again, by fome reflex 
" and active powers of the mind, acquire 
" a new influence, totally independent of 
" their primary impreflion: thus Anger, a 
•c fubjeft already mentioned, which accele- 
" rates the motion of the blood, and de- 
c< termines its impetus to the head and 
<c fuperior parts, is one of the moft violent 
<f and vigorous paflions of the mind : it 
" glows in the eyei the cheeks redden j the 
" voice xiv 
<€ voice is thick and Hammering, bilious 
" vomitings or a copious falivation fre- 
<c quently follows; with apoplexy, pleurify, 
<f haemorrhages, phrenitis, or violent fever. 
" But to thefe, high, as they fometimes rife, 
ct not unfrequently fucceed debility, lan- 
<c guor, and depreflion, as the turbulent 
ocean finketh into a filent calm. 
<£ In the oppofite and fedative paffion 
<£ of Grief, that oppreffive load of the heart, 
" the circulation of the fluids is lan- 
£t guid, the folids are relaxed, the appetite 
<c and digeftion are weakened ; the bowels 
<f are flatulent; the cheeks grow pale and 
<£ wan; the eyes lofe their brilliancy; flow 
cc deep fighs ar.e raifed; the ftrength is 
<c exhaufted; the fecretions and excretions 
££ are irregular; hyfteria, hypochondriafis, 
<£ dropfy, tabes, or fatal marafmus enfue. 
<£ But grief in excefs has imitated the vio- 
<£ lent efforts of anger, and terminated in 
" phrenitis, apoplexy, mania, or fuicide 
cc Love, the moft univerfal and grateful 
'' paflion of human nature, which, in general, 
" neither xv 
*6 neither afliimes the violence of anger., nor 
<f finks into the depreflion of grief, may be 
" confidered as a temperate paflion; but in 
" its viciflitudes and extremes, acquires the 
" impetuofity of the firft, or the defpondency 
cc of the latter, like the fury of Potiphar's wife 
<f againft Jofeph, or the infinuating folici- 
<c tude of Ruth towards Boaz. In Love, in 
" propitious Love, the heart beats with joy ; 
(C vivacity cheers the countenance, the 
t{ eye is brilliant, fociety is courted, lan- 
<c guage is animated, and vigour augment- 
<f ed. But when this paflion has taken deep 
<c pofleflion of the heart and foul, with a 
tc dubious or adverfe return, it is expreffed 
" by deep involuntary fighs; every incident 
re that excites emotion, efpecially the tender 
<c emotions of fympathy, make the heart 
fC palpitate, and fuffufes the face with faint 
<c blufhes; the voice is low, languid, flow 
" or faultering; the eyes are downcaft or 
penfive ; and the breaft heaves and falls, 
" like the motion of gently difturbed waters. 
<c Solitude, lhades and evening walks are 
" frequented ; objects of pity are cherilhed, 
<c and all the effufions of fentiment are ten- 
" der, xvi 
** der, fedate, and fympathetic. The face at 
{t length becomes pale and wan, the eyes 
" fink, the appetite for food is obliterated, 
6f frightful dreams invade the tedious night* 
(C Melancholy, defpair, and mania, terminate 
cc the heart-felt conflict. 
<£ If man be thus fubjeft to the influence 
" of the paflions in health, how great mutt 
cc be their effeds when vigour of health no 
<c longer fuftains his frame ! Wifely there- 
ce fore did this fociety propofe a prize 
<c queftion, fo confonant to our imbecilities, 
<c fo interefting to our nature, and fo appli- 
" cable to the virtues of the phyfician, from 
" whom our medal is denominated. Huma- 
" nized as the medical character naturally 
" becomes, by impreflions of fympathy with 
" human woe, did any individual ever ex- 
tc hibit fuch an interefting combination of 
« tendernefs and dignity as united in him 
*c whom we now commemorate 1 
<c Sagacity to difcriminate difeafes, and 
te judgment to apply remedies, is the ufual 
" refult of erudition and experiences but 
<' in xvii 
(e in him were fuperadded thofe lenient man* 
" ners which footh affliction, and fufpend 
" the preffure of pain; for his approach in 
" ficknefs was like a guardian angel's, that 
" infpired confidence in the feeble heart, 
" and renewed energy in the depreffed mind, 
<c often to arreft, and overcome the powers 
" of difeafe. 
" In ancient fchools of philofophy, we 
<f are told, that man is not born for himfelf*, 
({ but where is the difciple whofe actions 
" correfpond with the fentiment ? With an 
tc amplitude of professional employment, 
w that barely allowed our deceafed friend 
<f the neceflary refrefhments of life, he ac- 
" quired the reward of a princely income; 
" but let it be remembered as a trait of his 
<€ character, that he died-not rich-Why ? 
<c Becaufe he realized the abftradt refinement 
" of philofophers-He was born, not for 
st himfelf; and he lived, but for others. 
"To purfue this theme might be conge- 
" nial to the liberality of your minds, as it 
" is to the gratitude of my heart; but the 
b " impor- xviii 
<f importance of your time, and the nature 
" of the prefent meeting, call attention to 
<c another object, that of the delivery of the 
<c Fothergillian medal. 
fC There is a perfonage in thefe king- 
<r doms, who has acquired, not lefs univer- 
<c fally, the affections of the people for his 
" many virtues, than their refpeCt for his 
" fupreme rank, to whom the firft gold 
<f medal has been prefented. His illuftri- 
«< ous qualities, as the patron of fcience 
cc alone, entitle him to this diftinClion : 
Cf might we have exprefled our eftimation 
<f of his private virtues, we would have 
" wreathed the civic olive with the royal 
(t laurel on the reverfe of the medal. The 
<e gracious manner with which our Sovereign 
" has condefcended to accept this medal, 
demands our gratitude. 
<f Before I deliver the medal adjudged to 
" the prize difiertation, fuffer me to indulge 
(( the recolleftion of a circumftance, which is 
" this day forcibly impreffed upon my mind: 
" many years before I enjoyed the perfonal 
{t acquaint- xix 
<f acquaintance of the fuccefsful candidate, 
Cf I had the pleafure of his correfpondence, 
<c which I commenced at the exprefs delire 
" of the late Dr. Fothergill, who then in- 
f( formed me of the fatisfaftion he had derived 
" from the fame channel. It is to this learn- 
<f ed and diftinguifhed phyfician, the living 
" friend of the deceafed Fothergill, that the 
" pleafing talk is committed to me, of prefent- 
fC ing the firft prize medal, at the unanimous 
" adjudication of the Medical Society of 
" London; and in their name, and by their 
cc order, I do with fingular pleafure prefent 
" it to Dr. William Falconer, as the juft 
" tribute of his merit, and of the decided 
t€ fuperiority of his invaluable diflertation." 
A DIS- A 
DISSERTATION, &c. 
QjJ E S T I O N. 
What Difeafes may be mitigated or cured, 
by exciting particular Affections or 
Paflions of the Mind ? 
BEFORE I attempt to offer any argu- 
ments on the above queftion, it will be 
proper to notice fome of the rules or laws, 
by which the human fyftem and conftitution 
are, in thefe refpects, governed and con- 
duced. 
I do not, however, mean to purfue this 
train of reafoning farther than may be necef- 
fary for the illuftration of the prefent fubjedt. 
Firft then, we have reafon to think, that the 
mind, •when awake, is constantly in a Jiate of 
affion 
A 2 
aElion or employment. Experience feems to 
favour this theory, which I believe has almoft 
univerfally prevailed. 
The Grecian philofopher defines the ftate 
of a waking to be that in which the mind is 
employed, and b Haller has expreffed himfelf 
on the fame fubjedt in terms nearly fimilar. 
The next rule or canon is, I apprehend, 
only the converfe of the former ; namely, 
that when the action of the mind is diminifhed 
or weakened to a certain degree, jleep neceffarily 
follows, and probably, could we remove all 
impreflions upon the corporeal, as well as 
a co yA<> rev yvco^ou.Z:', toutco x} 
tov votvouvta' tov yA° Ai&AvopAVov tovtov 
Vo^i^op-Zv• 7ov zygiryogoTA ts-avta >; tcov tiv@- 
cu&Avt<£rAt, n T<yv zv avtco 7iv@- MVHtrzw" ei toivvv to 
tyyiyotpVAi zv (Mi/zvt aKKco n tw J'tfAoy 
otz wirzf ztai ToVTco TA iy°Uyo^o7A7 
KAQzvJ'et 7a nAdiv/oV7A- Ariftotel. Hgjz Tttvh zyfHyo- 
fHcrs®?. Cap. I. 
b Haftenus vigilias defcripfimus, cum certe hominis 
ftatum in quo mutationes in fenforiis organis per cor- 
pora nobis circum pofita fa&a menti noftrae reprzefen- 
tantur, atque ea apprehenduntur. Halleri Phyfiolog. 
Vol. V. p. 592. 
upon 3 
upon the mental fenfations, death muft be 
the confequence, as the vital fundhions are, 
we fuppofe, maintained only by repeated 
irritations. 
I mean, however, only to fay, that the 
mental functions are fufpended to a certain 
degree during deep. Dreams and other fen- 
fations prove, that the fenfes are not alto- 
gether inactive. But we fhould at the fame 
time refleft, that fleep admits of feveral 
degrees, and that its moft perfect and natural 
Rate approaches c nearly to that of total in- 
fenfibility. We have no knowledge of what 
pafles, no memory of the length of time 
we have remained in that ftate, and all other 
e In eo ftatu corpus quidem eo minus movetur, quo 
perfeftior fomnus eft ; ftimuli fenfuum, foni, titilla- 
tionis, non percipiuntur, nifl validiores fuerint; etiam 
interni ftimuli debilitantur, ut fitis, aut tuflis, quarum 
utramque fomnus placat, ni fuerit nimia, Halleri 
Phyfiol. Vol. V. p. 595, 596. 
In time of fleep the fenforium commune rema'ns in 
a great meafure at reft, and confequently the ufual 
exercife of the internal fenfes and the voluntary mo- 
tions are fufpended. Whytt's Works, p. 175. Quarto 
Edition 1768. 
A i 
mental 4 
mental fundlions appear to be equally fuf- 
pended. The corporeal functions coincide 
herein with the mental: the organs of hear- 
ing, fmell, and touch, have not only their 
fenfibility, but their irritability alfo dimi- 
nifhed. That ftimulus, the ufual effedt of 
whofe application to the nofe is cough or 
fneezing, fails of producing thefe convulfive 
efforts during fleep. Purgative medicines 
have their operation fufpended in the fame 
manner, and the like appears to be the cafe 
with all thofe that tend to increafe the fecre- 
tions, that of perfpiration excepted. 
From what has been before laid down, a 
third rule or canon may be deduced.-That 
as the mind when waking is always active and 
employed, we have no method of banifhing one fet 
or train of ideas, but by fubftituting another in 
its place. 
This fad is well known from experience, 
as well as from reafoning, and ferves to fhew 
the extent of the terms in which the pro- 
pofed queftion is couched, which other- 
wife would have appeared rather defective, 
as 5 
as perhaps occafions more frequently occur, 
wherein we would defire to fupprefs, rather 
than to excite mental affections > but as this 
can only be accomplifhed by exciting d others 
in their room, both thefe intentions are com- 
prehended in the queftion as above expreffed, 
and fo I prefume it is to be underftood. 
I mean to go even a Hep farther, and 
extend it to thofe paflions or affections of 
the mind, which we would with to prevent 
being excited at all. 
The propriety of thus extending the quef- 
tion will, I hope, be evident, as it will 
fcarce be difputed, that prevention is prefer- 
able to remedy. 
d Hine prudentes medici omnes Illas notas corporeas, 
quae renovant has ideas, live per fenfus, five per me- 
moriam, tollunt infeio aegro ; quaecunque alia ipfis 
offerunt, ut nafcantur aliae ideas, quae fenfim minuant, 
vel que deleant nimis validam illam impreflionem, hoc 
vocatur, divert ere. Sufficit ad hanc rem, ut quocun- 
que modo mutetur cogitatio, ne eadem idea, diutiflime 
haerens, tandem totam mentem occupet, indelebilis pof- 
tea. Van Swieten, Vol. I. p. 149. 
A 3 
Another 6 
Another rule or canon depends on that 
aptitude or difpofition of the mind, to combine 
ideas together in fuch a manner, that the recol- 
lection of the one brings the other to the mind, 
and often, in conference thereof, re-produces 
fimilar effects, to what the original idea had 
done when frjl excited *. • 
Numerous inftances of this might be pro- 
duced, but they are too familiar to the ob- 
fervation of every perlon to be necefiary. 
Another important law of the fyftem de- 
pends on the e effects of habit and cuftom, 
and confifts in a difpojition to repeat actions, 
fenfations, or motions, in the fame manner, and at 
thefame intervals, as they have before taken place. 
* Mirabilis hasc obtinet in mente noftra proprietas, 
quod poflimus ideas cogitatas alligare quibufdam fignis 
mere arbitrariis, inter quae figna et ideas cogitatas 
nulla occurrit omnino fimilitudo, tamen poftea vifis his 
fignis praefens redditur eadem idea mend. Van Swiet. 
Vol. I. p. 148. 
e A/ct ya° tovto 70 e9©- oti th ([wet 
estn&v, Evsi'®- Xiyei, Qnp.i (ji.eM7W' 
qixt T0.V7W 7iXzvTatj-Av etva.t» 
Ariftot. de Moribus. Lib. VII. Cap. XI. 
This 7 
This holds full as ftrongly in the f animal 
and corporeal, as in the mental functions, 
perhaps becaufe the former are lefs under the 
controul of the will, and of courfe lefs fub- 
jeCt to be influenced by its caprices. 
Another law of the fyftem, nearly con- 
nected with that juft mentioned, is that ten- 
dency to imitation, which feems to pervade in 
a good meafure the whole animal creation, 
and to be an inftinftive propenfity. To in- 
ftance this in children, and even in other 
animals of inferior rank, in what regards the 
mind and fenfible faculties, would be unne- 
ceffary; but it is a curious fad, that the 
fame difpofition takes place to a certain de- 
gree in the s bodily organs, and prevails in 
various periods of life. 
Having laid down thefe rules by which the 
fyftem is governed, to which feveral others 
f Sec Whytt's Works, p. 162. 167. 169. 
s This is called in a late publication, not improperly, 
t{ Cette imitation machinale, qui nous porte, malgre 
nous, a repeter ce qui frappe nos fens." 
Rapport des commiflaires charges par le Roi de 1'ex- 
amen du magnetifme animal. 
A 4 
might 8 
might perhaps be added, I fhall next pro- 
ceed to defcribe the general effects of the 
paffions on the frame and conftitution. 
The paffions may be confidered as of two 
kinds, h fuch as excite the powers of the 
vital fyftem, or roufe the faculties into adtion, 
or fuch as deprefs and debilitate them. 
A pleafurable 1 ftate of the mind tends to 
roufe the vital functions into aftion, and to 
give as it were new vigour to the heart 
and circulation. The k perfpiration is in- 
creafed, the refpiration eafy and free, and 
the powers of the fyftem that conduce to 
health are univerfally ftrengthened. 
The effects of joy are of the fame kind, 
but more powerful. When moderate, it in- 
creafes the a&ion of the heart and arteries, 
h Fere ad duas clades reduci poffunt, quorum alii 
motum fanguinis debilitant, alii intendunt. Hallen 
Phyf. Vol. V. 589, 590. 
1 Haller. Phyf. Vol. V. p. 581. 
k Sanctor. Medic. Static, Seft.VII. § 1. 2.6. 19.24. 
and 9 
and together with it the heat and ' perfpi- 
ration. It frequently produces a flow of 
tears, which generally ferve to relieve the 
painful ftruggles of nature, and are moftly 
accompanied with high mental gratification. 
If this paffion be in excefs, and efpecially if 
it takes place on any fudden occafion, it 
may and has produced fevers m, depravation 
of underftanding, deliquium, and even fud- 
den n death. 
To what immediate caufe thefe effefts are 
to be afcribed, is difficult to determine. 
Sanftorius 0 thinks they are owing to an in- 
creafe of perfpiration, which he fuppofes 
forces out fome of the nervous juices, and 
thereby occafions a lofs of ftrength. Ano- 
ther p writer thinks that the blood, being 
1 Robinfon on Food, p. 71. 77. 
m Haller. Phyfiol. Vol. V. p- 581. 
n Thorelby's Nat. Hiftt of Seeds, p. 625. Nichol's 
Anim. Medic, p. 16. 
Spartana mater inter ipfos amplexus reducis filii, 
quern in pugna csefum putabat, mortua corruit pras 
nimio et fubito gaudio. 
0 Sandor. Seft. VII. § 28, 29. 
P Parfon's Phyfiog. p. 80. 
fuddenly 10 
fuddenly propelled from the heart to the 
extremities by the increafed force of that 
organ, and the large arteries that lie neareft 
to it, does not return foon enough to the 
heart to keep up the circulation without in- 
terruption. Haller q fufpefts a kind of apo- 
plexy is produced by the increafe of the 
action of the vefiels of the brain, and in- 
duces as a proof hereof the rednefs of the 
face, increafed heat, and deliquium animi 
that accompany this date. Dr. Cullen thinks 
that the fudden relaxation fucceeding an 
overftrained exertion produces fuch a lofs of 
tone, as the fyftem cannot recover. <c Non 
noftrum eft inter tantas componere lites." 
The paffion of love, perhaps, as being a 
pleafurable fenfation, produces effects very 
fimilar to thofe of joy. It excites the powers 
of the mind and underftanding, as well as 
thofe of the body, caufes a rednefs and heat 
of the fkin, and acceleration of the pulfe, 
which is however moftly accompanied with 
fome r irregularity, caufed perhaps by doubt 
9 Haller. Phyiiolog. Vol. V. p. 581, 582. 
r The celebrated ftory of the difcovery of the love of 
Antiochus 11 
and apprehenfion for the fuccefs. In pro- 
portion to the vehemence of the paffion, 
thefe fymptoms are increafed, and when vio- 
lently excited, fever attended with great 
heat, palpitation of the heart, and a fenfe of 
* burning diffufed through the circulatory 
veffels, has been the confequence. 
A vehement defire for any object whatever, 
efpecially if attended with a profpeCt of fuc- 
cefs, produces effects nearly fimilar. It ex- 
cites the circulation ** and perfpiratory dif- 
charge, has relieved and even cured paralytic 
affections, has roufed the body to s exertions 
far 
Antiochus for his ftep-mother Stratonice, is a noted 
inftance. 
* Haller. Phyfiol. Vol. V. p. 582. 
** Ibid. 
8 Muley Moluck borne on his litter, and fpent with 
difeafe, was roufed to extraordinary efforts in the laft 
battle he fought. Perceiving his troops to give way, he 
threw.himfelf out of his litter, though very near his 
laft agonies, rallied his army, and led them on to the 
charge, which ended in a complete viftory to his party. 
He had no fooner brought his men to the engagement, 
than finding himfelf utterly fpent, he was again replaced 
in his litter, where laying his finger on his mouth to 
enjoin 12 
far above thofe to which the ftrength feemed 
adequate, and has even protracted death 
itfelf. When very intenfe, it is faid to have 
produced 1 epilepfy, and by exciting irregu- 
lar motions of the heart an u aneurifm of the 
aorta. 
Anger is another of the ftimulating, though 
it can fcarcely be termed with propriety, one 
of the pleafurable paflions. 
It roufes the powers of the body and mind, 
and impels them into action, w accelerates 
the pulfe, and produces x rednefs and heat 
of the fkin. Thefe exertions however ap- 
pear unfriendly to health. They exhauft the 
ihrength both of mind and body, as appears 
from the tremor and faltering voice with 
which they are moftly accompanied. When 
enjoin fecrecy to his officers, who Rood around him, he 
died a few moments after in that poRure. See Vertot's 
Revolut. of Portugal, and No. 349, Spectator. 
' Hoffm. Medic. Confult. C. IV. D. II. C. 6. 
u Haller. Phyf. Vol. V. p. 582. 
w Haller. Phyf. Vol. V. p. 586. 
s This holds of other animals, as we fee the fame 
appearances take place in turkeys. 
excited 13 
excited to a great degree, ecchymofes, y he- 
morrhages, z apoplexies, great a diftenfion of 
the heart, ruptured b cicatrices of wounds, 
local inflammations, profufe perfpirationc, 
vomiting d, and diarrhoea, have all been pro- 
duced. The increafe of the biliary fecretion 
by this paflion is a remarkable, but well at- 
tefted circumftance in ancient as well as 
modern obfervation. Epileptic fits, the iliac e 
paflion, fever, and fudden death, are alfo 
numbered among the direful confequences 
of anger. 
On the other hand, fome good eft efts have 
at times, and perhaps accidentally, refulted 
from it. Thus f gout, pally, dumbnefs, have 
all been removed by paroxyfms of rage, and 
life itfelf evidently prolonged feveral days. 
y Aretaei L. II. C. i. Haller. Vol. V. p. 587. 
z Haller, ut fupra. 
a Harveii Exercitat altera ad T. Riolanum. 
b Hildan Epift. I. 
c Sandorii. Sed.VII. §1. Robinfon, on Food, p. 77. 
d Young, on Opium, p. 113. 
e Haller. Phyf. Vol. V. p. 587. 
f Ibidem. Halleri. 
Hope 14 
Hope is alfo a ftimulating paflion, but of 
the milder kind. Its effects are to excite 
moderately the ftrength and powers both of 
the body and mind, and direct them to their 
proper objefts. No ill effects, that I can 
learn, have ever refulted from it. 
So far on the ftimulating paflions : let us 
now turn to thofe of the debilitating kind. 
Fear is evidently one of thefe. Under its 
influence the force s of the heart is diminifli- 
ed, and the pulfe rendered weak, variable, 
and intermittent. The circulation is fome- 
times fo retarded, that the blood does not 
flow from an open veflel. * Palenefs, fliiver- 
ing, and faintnefs, are alfo attendant fymp- 
toms. Hence the ftoppage of hemorrhages 
of every kind, and of the natural lecretions, 
as of the milk and the fluid of perfpiration. 
The latter of thefe is indeed fometimes 
excited by fear, but it is always cold and 
g Van Swieten. Vol. III. p. 271, and Vol. I. p. 148. 
* - vto 7« yv7a. 
*a4 7,a.vi'/a^ntrey, &Xf'of 75 Plv 6,AS 
Horn. Iliad III. 34, 35. 
uncomfortable 15 
uncomfortable to the fenfations, and refembles 
that which attends fyncope, and great weak- 
nefs. Diarrhoea h, jaundice, fcirrhus, and 
gangrene, are faid to have been hereby pro- 
duced. It weakens the powers of digeftion, 
and caufes flatulency, eruCtations, acidity, 
and other concomitants of want of power in 
the ftomach and bowels. 
It has too a remarkable efledt in rendering 
thofe affedled * with it more liable to the in- 
fection of contagious diftempers. When the 
impreffion has been very ftrongk, tremor, 
melancholy, infanity, palfy, 'apoplexy, blind- 
nefs, epilepfy, and fudden death, have been 
the confequence. 
h Haller, ut fupra, ubi loci citantnr. 
1 Haller, Phyfiol. Vol. V. p. 584. 
k Vidi in hac urbe virum, qui in aetatis vigors 
dormiens, horrendo tonitru fragore expergefaftus, ful- 
mine domum incenfum efle credidit ; et poftea in talem 
tremorem totius corporis incidit, ut nullus omnino muf- 
culus voluntatis imperio mobilis ab illo immunis foret. 
Vixit in hoc ftatu per viginti annos, in reliquis fanus. 
Van Swiet. Vol. II. p. 183- 
1 Van Swiet. Vol. III. p. 271. Aretaei Morb. diuturn. 
Lib. I. Cap. VII. 
Sometimes, 16 
Sometimes, however, its effects have been 
lefs injurious. Pains of the body, and ma- 
niacal diforders, are faid to have been re- 
lieved, and even cured, by infpiring ideas 
of fear and apprehenlion of danger. It can- 
not, however, be denied, that this paffion, 
when raifed to a great height, becomes 
powerfully ftimulant. Violent exertions of 
ftrength have been manifefted, m fpeech has 
been reftored to the dumb, and ftrength to 
the paralytic patient. Gout, fciatica, inter- 
mittent fevers, delirium, and diarrhoea, have 
received a cure, and even perfons apparently 
at the point of death, have been recovered 
by it. Thefe effects of fear on the corporeal 
organs, referable thofe produced by it upon 
the mental. Fear and hope, as Milton jufhly 
obferves, are always, concomitant paffions. 
When there is no room for hope, the mind 
m At the taking of Sardis, a certain Perfian, not know' 
ing Craefus, advanced to kill him, when his fpeechlefs 
fon, feeing his father's danger, cried out, <f Man, kill 
not Craefus." Thefe were the firft words he uttered, but 
continued from thence to fpeak plain the remainder of 
his life. Herodot. Lib. I. Paufanias tells a ftory of one 
Battus, who recovered his fpeech on the fright occafion-« 
ed by the fight of a lion. Lib. X. 
is 17 
is fubjeft to acquiefce no longer under di- 
flrefles, but to attempt fome violent exer- 
tion, and on finding " no reinforcement to 
be gained from hope,0 to take, like the in- 
fernal fpirit, " refolution from defpair." 
Grief is another of the debilitating paf- 
fions, and its effects refemble in feveral in- 
ftances thofe of fear, with, however, fome 
variations, owing, perhaps, to its being in 
general of longer duration. Grief diminifhes 
the bodily ftrengthn in general, and par- 
ticularly, the force of the heart and circula- 
tion ; as appears by the frequent fighs and 
deep refpirations which attend it, which 
feem to be necelTary exertions, in order to 
promote the paffage of the blood through the 
lungs. It diminifhes perfpiration, obftrudts 
the menftrual difcharge, produces palenefs 
of the fkin, and* oedematous complaints, and 
fcirrhus of the glandular parts. It aggra- 
vates the fcurvy, and the malignity of pu- 
trid and contagious diftempers, and renders 
people more apt to receive the infection of 
■ Haller. Vol. V. p. 583. 
B 
them. 18 
them. When it comes on fuddenly, and in 
a great degree, it caufes a palpitation of 
the heart, and renders the pulfe irregular. 
Blindnefs, gangrene, and fudden death have 
followed the excefs of this * fenfation. Its 
effects of changing the colour of the hair are 
■well known. 
Pity is another pafllon nearly allied to grief, 
but differing from it in fome refpeds, as be- 
ing combined with fomewhat of regard and 
affedtion. Its effects are feldom very violent, 
but it is obferved, that it tends more to ex- 
cite tears than even forrow itfelf. 
Shame is another paflion of the fame ten- 
dency, but I apprehend rather more powerful 
than the one laft mentioned. It is particu- 
larly remarkable for its effects in accumu- 
lating the blood in the extreme veflels, which 
is principally obfervable in the face, but in 
reality takes place over the whole body. 
This is probably owing to a fpafmodic 0 con- 
ftridion of the venous fyftem, as fome of the 
* Van Swieten. Vol. III. p. 365. 
• Haller. Phyf. Vol, V. p. 582. 
veins 19 
veins are faid to have been ruptured by it* 
and the menftrual difeharge obftrufted. 
Difguft and averfion to any objeft of fight, 
or tafte will often produce violent effects; 
ficknefs, vomiting, p diarrhoea,q fyncope, and 
even death itfelf, have been the confequences 
of the imprudent impofition of fome odious 
or difgufting articles in the way of food, 
which ought to caution thofe difpofed to 
this fpecies of humour, not to carry this 
matter to too great a length* 
Envy is a paffion of a rather equivocal 
nature, being ftimulant or fedative, accord- 
ing to circumftances, which is natural enough 
to fuppofe, it being compofed of paffions 
of an oppofite kind, namely, forrow and an- 
ger. It is faid to caufe palenefs of the com- 
plexion, and to excite the biliary difeharge* 
Its other effects refemble thofe of the paffions 
of which it is compofed, accordingly as either 
of them predominate. 
p From a mole put into a cup wherein a perfon was 
drinking. 
i From ferving up a cat as food. 
B 2 
Jealoufy 20 
Jealoufy is another pafllon of an ambigu- 
ous kind. It feems to be compofed of fear 
and anger, and its effects partake of the 
nature of that pafiion which is moft preva- 
lent. The peculiar effects of jealoufy in 
producing a fpafm on the biliary dudts, and 
throwing the bile into the circulation, are 
very remarkable, and well attefted. 
rFrom this view of the effects of the paf- 
fions on the corporeal and vital fyftems, we 
may 
r Two other mental affections, fcarcely reducible to 
the clafs of paffions, are of great importance in medicine. 
The firft of thefe is, a high degree of faith and confidence 
in the efficacy of remedies. Whether this operates by 
engroffing the mind and attention, and thereby ren- 
dering it inacceffible to other.imprefficns, or by impart- 
ing fuch a degree of tone, or lirength, as enables the 
fyltem to refill their attacks, is difficult to determine. 
It is found molt efficacious, either in fuch diforders as are 
apt to recur at intervals, or elfe in fuch as principally 
affeft the mind and fpirits It is, however, obfervable 
that, unlefs the prepoffeffion be very ftrong, it is apt to 
fail in producing a cure. Another mental affeftion that 
has fometimes produced great effects, is a determined 
refolution of mind to refill the accefs of the complaint. 
However extraordinary this may feem, it has been prac- 
tifed 21 
may generally infer that, in cafes wherein 
the powers of life are depreffed or weakened, 
attention ffiould be paid to the excitement of 
fuch paffions as counteract the leading fymp- 
tom of the difeafe, and that when the diforder 
itfelf confifts in, or is aggravated by, too 
vehement an excitement of the vital func- 
tions, recourfe may be had to the debili- 
tating paffions. 
Many difficulties, however, muft occur 
in the management of thefe nice and pre- 
carious inftruments. Their effeds are far 
from being precifely afcertained in their 
quality, and ftill lefs in degree. What may 
ftimulate and roufe the fpirits and faculties 
in one conliitution, may have an oppofite 
tendency in one of a weaker frame. Thus 
joy has been before obferved to have pro- 
duced effects equally fatal with grief or terror; 
which was probably owing to the relaxation 
tifed with fuccefs in feveral diforders. It appears like 
that laft fpoken of, to have been principally of fervice 
in periodical and nervous complaints. There feems to 
be no doubt that it afts by infpiring ftrength and, 
tone into the fyftem. 
B 3 
or 22 
or nervous collapfe fucceeding an overtrain- 
ed exertion. The debilitating paflions wiU3 
on the other hand, aft as ftimulants. Thus 
fear will excite ftrength and aftivity, and 
aft as a powerful excitement both to the 
mental and corporeal faculties. Of all the 
paflions, hope, both as a gentle ftimulant, 
and compofing fedative, feems, in general, to 
anfwer the belt purpofes, and to be moft in 
our power to manage, and is further fervice- 
able, as it tends to infure the compliance 
of the patient with the rules prefcribed. 
Having finifhed thefe previous remarks, I 
(hall next attempt an application of what has 
been faid to particular difeafes. In this I 
propofe to follow the order laid down by 
Dr. Cullen, in his laft edition of the Synop■ 
fis Nofologias Methodical. Vol. II. 
CLASSIS 23 
CLASSIS I. 
P Y R E X I ZE. 
ORD. I. 
Febres. 
SECT. I. 
I NTER M I T T £ NTES. 
SCARCELY any difeafe exhibits ftronger 
marks of the influence of the imagina- 
tion and paffions, than the intermittent fever. 
It is well known that numerous cures of this 
diforder have been performed by medicines 
of little, or even of no medical efficacy 
whatever in themfelves, which effect could 
proceed only from the opinion the patient 
entertained of their powers; as a proof of 
which we find that the certainty of the cure 
has almoft always depended on the degree of 
the patient's confidence in the fuccefs of his 
remedy, 
To recite inftances of this kind would be 
unneceflary, as they occur almoft to daily 
obfervation. Suffice it then to fay, that the 
remedies 
B 4 24 
remedies have been either fuch, as by their 
odious and difguftful nature were calculated 
to make a ftrong impreffion upon the fenfes, 
as live fpiders fwallowed in that ftate, fnuffs 
of a candle, and fuch like ; or elfe when the 
remedy has been adminiftered in form of a 
charm, it has been uffiered in with a cere- 
monious pomp, and affectation of myftery, 
that nearly anfwered the fame purpofe. 
By what mode of agency thefe cures are 
performed, it is difficult to explain. Is it that 
the confidence of recovery by means of the 
remedy, as being a ftimulating paffion, com- 
municates a degree of firmnefs to the fyftem, 
fufficient to counteract the debility and con- 
fequent irritability, which we have fo much 
reafon to think the predifpofing caufe of the 
febrile paroxyfm ; or does it ad by abforb- 
ing a the attention in fuch a manner, as to 
render the fyftem infenfible to other im- 
preffions ? 
a Quintius Fabius Maximus was cured of a quartan 
ague by the vehement attention he paid to military 
operations. Plin. Hift. Natural, Lib. VII. Cap. 50. 
It 25 
It is well known that perfons under ftrong 
prepoffeffions of mind, as enthufiafts and 
madmen, have expofed themfelves b to ex- 
treme bodily tortures without expreffion of 
pain, and have alio endured extremities of 
heat and cold, intemperance in diet, the in- 
fection of contagious diftempers, and other 
hazardous experiments, without feeling the 
confequences that would moft probably have 
taken place, had not the nervous feelings 
been more forcibly pre-occupied. 
I have not been able to learn whether the 
excitement of the mental affe&ions above 
referred to, has proved efpecially efficacious 
in any of the particular fpecies of intermit- 
tents ; but it is reafonable to conclude that 
the degree of the paffion proper to be ex- 
cited, muft in fome meafure correfpond with 
the violence and obftinacy of the difeafe. 
b Famem frigus et moleftias quafcunque abfque nota- 
bili noxa perferunt. 
Hoffman. Affeft. maniac, fenfuum augum. ft ip at Tole- 
rantia inediae atque algoris mirabilis. Boerhaavii Apho- 
rifm. 1120. 
It 26 
It is ufeful to remark that it is generally 
advifeable to continue the delufion, if necef- 
fary, for keeping up the impreflion for fome 
time after the diforder is apparently removed. 
The force of habit is of longer duration than 
we could well imagine, in predifpofing the 
body to a recurrence of the paroxyfms at cer- 
tain intervalsc, and until this be obviated by 
a continued interruption of the fits, it is ha- 
zardous to remove the imprefiion, it having 
been found by experience, that in fuch cir- 
cumstances the diforder frequently came on 
again. 
Perhaps the relaxation, or nervous collapfe, 
incident to a fudden cefiation of the exciting 
caufe, might ftrengthen the predifpofition, 
and render the patient particularly liable to 
a renewal of his complaint. 
The fadls above-mentioned, feem to fug- 
geft the propriety of adminiftering the Pe- 
e Si febris quievit, diu meminifle ejus dici convenit: 
eoque vitare calorem, cruditatem, laffitudinem. Facile 
enim revertitur niii a fano quoque aliquamdiu timetur, 
Celf. Lib. III. Cap. 16, 
ruvian 27 
ruvian bark itfelf in this difeafe, with the 
ftrongeft affurances of fuccefs prudence will 
admit of. 
S E C T I O N « II. 
C O N T I N U A. 
GENUS V. 
Typhus. 
CONTAGIOUS fevers afford ftrong in- 
ftances of the influence of mental af- 
fections, both as prophylactics and remedies. 
The plague is a remarkable example, and 
the fame reafoning extends to other diforders 
of a febrile contagious nature. 
Fear, it is well obferved by Dr. Cullen, 
by a weakening the body, and thereby in- 
creafing its irritability, is one of the caufes, 
which, concurring with contagion, * render 
it more certainly active, which he afcribes 
to its weakening effects on the body, by 
• See p. 13. Quotation a. 
♦ Firft lines in the Practice of Phyfic, 
which 28 
which its irritability is increafed. Againft 
this therefore he directs the mind to be 
particularly b fortified, which is belt done 
by giving people a favourable idea of the 
power of prefervative means, and by de- 
ftroying the opinion of the incurable na- 
ture of the diforder, by occupying the mind 
with bufinefs or labour, and by avoiding all 
objects of fear, as funerals, palling bells, and 
any notice of the death of particular friends. 
Even c charms might be ufed with good 
b Hoffman gives the fame advice : Temperare fibi 
ab omnibus, quae viribus adverfa, languidiorefque fa- 
ciunt excretiones, animi fcilicet vehementibus commo- 
tionibus, mcerore, terrore, cura. De febribus petechi- 
alibus veris.-Meticulofos ac terrore de levi perculfos 
facili occafione incurrere in peftem. Et Sennertus inter 
caufas peftis imaginationem terrorem ac timorem ponit 
et hanc caufam putat primariam quod vefpillones et 
clinicae mulieres chirurgi et alii qui animo praefenti et 
alacri pefte infeftus et mortuis fuas operas locant raro 
pefte inficiantur qui vero minus praefentes funt fubito 
inficiantur et extinguantur. Hoff, de O/ig. et Natura. 
Peji is. Vide etiam Riverium de Febre Peftilent» p. 329. 
c Amuleta contra peftem prseftantiflima effe reme- 
dia non novum, fed in vulgus notum eft non vero alio 
modo operantur quam quod magna fiducia praediti 
non timeant peftem unde ab ipfa communes degunt. 
Neque 29 
effect, could we promote a ftrong prepof- 
feffion of their efficacy, either by the con- 
fidence they infpire, or by their ingroffing 
the attention of the d mind. 
It is no lefs certain, that a ftudious regard 
to promote hope and confidence, in recovery, 
is equally neceflary for the cure, as for the 
prevention of fuch diforders. 
We know that contagious fevers have a 
peculiar tendency to diminifh the energy of 
the brain, and of courfe to debilitate e the 
whole fyftem ; and that this is efpecially the 
cafe with the plague, <c which produces the 
molt confiderable effects in weakening the 
Neque dubium eft quin formidine depofita et excuffo 
protenus timore quod cum tempore fit peftis vehemen- 
tiam tandem remittat. Hoffman ibid. 
d Cullen's firft lines of the Pra&ice of Phyfic. § 
DLXXXIII. DLXXXIV. 
e The proftration of fpirits, weaknefs and faintnefs, 
are very often furprizingly great and fudden, though 
no inordinate evacuation happens. Huxham on putrid 
malignant Fevers. See loo his Dijfertation on the ulcerous 
Jore Threat. 
nervous 30 
fiervousf fyftem or moving powers, and id 
difpofing the fluids to a general putrefcency 
and Dr. Cullen 8 is of opinion, that to thefe 
circumftances, as the proximate caufes of 
the plague, regard fhould be chiefly had 
both for the prevention and cure of this dis- 
order. It muft therefore be highly neceflary* 
during the courfe of this difeafe, to attend 
to the fupport of the fpirits, as on thefe the 
vital principles greatly depend, and they can 
be by no means fo effectually kept up, as by 
infpiring a confidence of recovery. 
f cN rr 7? wu?, n t» etfiufjud} 
VTOTS 7lf eUado/70 KcLfJ.VMVy ('STJO? 70 AVikTriSW 
tvQuf 7WQ/f»(UM, 'SMAAtt /ZXAAoV 'JrpOltl'70 o\px$ 
ctvrcvf x) kjc W7a%oy.) Thucydid. de Pefte Atheni- 
enfium. 
Typhus maxime contagiofa cum fumma debilitate. 
Cullen. Defin. Peftis. 
An intenle head ach, uncommon giddinefs, and a 
fudden lofs of ftrength, were the firft complaints of 
thofe who were feized with this diftemper. Ruflel's 
Defcription of the Plague at Aleppo, p. 230 
« Cullen's Firft Lines of the Practice of Phyfic. 
GENUS 31 
GENUS V. 
Typhus. 
i. Typhus mitior. 
THE flow nervous fever of Dr. Huxham, 
and of moft other writers, or the Ty- 
phus mitior of Dr. Cullen, affords a ftriking 
inftance of the power of mental affections. 
In attention to the management of thefe po- 
tent, but delicate inftruments, 1 think I may 
be allowed to fay, that the writers of anti- 
quity have fhewn judgment and penetration 
fuperior to the moderns in general. 
All the authors who have defcribed this 
fever, fpeak of it as being accompanied with 
great depreflion and weaknefs of the a facul- 
a Animi defponfio, cum vigiliis jugibus. Invol un- 
taria lachrymatio. Cal. Aurel. 
Senfuum externorum et internorum hebetudo et tar. 
ditas-anxietatis et animi deliquia. Heme. Prine. Medic. 
Senforii punftiones plurimum turbatae. Cullen. Sj- 
nofrfis. 
Heavinefs and dejection of the fpirits, with load, 
pain, or giddinefs, Huxbam* 
ties 32 
ties of the mind as well as body. Grief* 
fear, and other mental affections of the b de- 
bilitating kind, are efteemed to be among 
the caufes that produce it. Neverthelefs very 
few of the medical writers of later times, 
even thofe who have given the moft accurate 
defcriptions of the complaint, and have fhewn 
the greateft judgment in the •■recommenda- 
tion of medicines, have paid much attention 
to what particularly regards the mind and 
fpirits, Dr. Buchan * muff indeed be except- 
ed, as his directions exprefsly Comprehend 
this article, and are, it mult be acknow- 
ledged, very proper and judicious. 
This diforder was known to the Greeks 
and Romans, principally under the name 
b Mcellitudo vel timer. Cadi us Aurel. 
Animus triftitia depreffus. Home. 
* " The mind of the patient ought not only to be 
kept eafy, but foothed and comforted with hopes of a 
fpeedy recovery. Nothing is more hurtful in low fe- 
vers of this kind, than prefenting to the patient's ima- 
gination gloomy or frightful ideas. Thefe of them- 
felves often occafion nervous fevers, and it is not to be 
doubted that they will likewife aggravate them." 
Bucnan's Domeftic Medicine. 
of 33 
ofc 'Noroe or d Morbus cardiacus, 
and the perfons afflifted with it were called 
KafJ'ia.x.oi, or Cardiaci. Morbus pituitofus, 
and febris fyncopalis, are terms by which it 
is faid to be denominated, but I believe they 
are ufed with greater latitude than the term 
firfl: mentioned. 
Aretseus, fully fenfible of the neceflity of 
fupporting the ftrength of the fyftem in ge- 
neral, and how much this depends upon the 
fpirits, exprefsly counfels the patient e " to 
ec be of good heart; and advifes the phy- 
<f fician to entertain him with fuch difcourfe, 
<c as might tend to encourage his hopes of 
" recovery." 
Even fome circumftances of more remote 
influence are not thought unworthy the at- 
tention of this fagacious writer. He directs 
c Galen et Aretaeus 
* Celfus et Caelius Aurelianus. 
e XfH av AUTQV 75 CtMlHSyTA t[J.(J.'-VAl 70? 
evrecri p.iv et eueMrstw lypevai' Arete 
c 
" that 34 
that the f eyes of the patient fliould be 
ft entertained with the fight of plants, paint- 
" ings, and waters, in fuch a manner, as that 
<f every thing he fhould look on fliould bear 
(C a pleafing afpeft. He fliould be amufed 
(C with the chearful difcourfe of his attend- 
,f ants, but fliould be filent himfelf, and 
(f keep his mind as much as pofiible in a 
<c pleafurable ftate." He further recom- 
mends that the {C g bed of the patient fliould 
cc be placed, if pofiible, in fuch a manner, 
<f that he may overlook from it a beauti- 
(( ful profpedt of the country. The view 
<f of meadows, fountains, and murmuring 
<c ftreams, and the frefli odours exhaling 
<c from thence, cherifli (he fays) the fpirits, 
f v/ctTav cot o$m&ai 7 A 
<7TAV7A AitA/r) 70V QlkQ [J.£lJnf HtVy/lfr 
za voitiovtos Ibidem. 
6 Erw Ji Zlt telp-VVAt, £, 'TTiiyAt, WfXAfU?OV 7At 
oyi7OVt Kj yA§ JL) 70 ZV'TTVOOV 70V cTg, H £u/ZHcP<H, 
7iw 4V%1> -3-aAttjz, jy 7W ifvaiv A7A» jy 
ci; 7<s qAyziv 7« %/g/p. Hf A i>r' Airols p.n ta/z 7m 
€V7Vp/H, kj 4,vXf>"' ZVUthcrf 
ticToym Kj apw ZAgot, mJ?avSwi 70171 
$q$wav7A 7MV yUh Ibid. AreUei, 
" roufe 35 
<e roufe the powers of nature, and excite ap- 
c< petite for both folid and liquid aliment. 
tf If thefe advantages of fituation cannot be 
<£ he direfts the chamber of the 
" fick to be ftrewed with flowers, and other 
vegetables, fo as to bear fome refemblance 
" to the face of the country in the fpring 
<c feafon. He likewife direfts branches of 
" fweet feented vegetables to be employed 
" as fans, to cool the air for the refrefhment 
<f of the fick perfon." 
The particularity of thefe directions, in a 
writer fo little apt to be diffufe, as Aretseus, 
fhews, that he thought the obfervance of 
them a matter of important confequence. 
Caslius Aurelianus, though lefs exprefs, fuf- 
ficiently fhews, that the eafe and quiet of the 
patient's mind was by him deemed worthy 
particular regard. With this view, among 
others, he is fo precife in directing what 
<c fituation would be preferable for the 
<f chamber of the lick perfon, that it fhould 
" be cool and fhadyh, with a northerly afpeCt, 
h Tacere facimus locis refrigerantibus, atque um 
brofis et obfcuris, ut funt plerumque hypogaea vel 
fpeluncofa. 
C z 36 
<f and feldom vifited by the fun ; that it 
i( fhould be of fuch a fize as not to be 
<f heated by the prefence of the neceflary 
" attendants, or to have the air injured by 
" their breathing it frequently. For the 
<f fame reafons he orders the windows to be 
c< opened when the weather permits, and this 
" not merely for the purpofe of coolnefs, 
" but alfo that fuch air as is of a pure quality 
" may be admitted, which by its freflmefs 
ff and gentle approach is likely to prove 
<c grateful to the fick perfon. On the fame 
(t account he advifes the ufe of fans, and 
t( that the floor fliould be fprinkled with 
fpeluncofa, atque ad aquiloniam partem conclufa, 
(cbnllrufta) vel certe folis taftui difficilia. Nequeplus 
fatis brevia, funt enim przefocabilia, et quse facile fer- 
vorem ex ingreflu hominum concipiant, quos naturalis 
fpiratio aerem accipere atque reddere anhelitus, raptii 
neceffario cogit. Denique fe non fuerit naturaliter fri- 
gidus locus, hoc affedtabimus, fpecularia detrahentes, 
nifi fol obftiterit, et aeris inequalitas. Adjungitur fri- 
gori indudto purgatior aer ingrediens locum, qui fua 
novitate, ac rniti acceflu reficiat aegrotantem. Flabel- 
lis etiam latenter aerem frigerandum dicimus, aqua 
frigida afpergentes folum, &c. Cad. Aur. L. II. 
C- 37- 
" water, 37 
<f water, and ftrewed with vegetables of a 
<c pleafant, but not too ftrong odour, as of 
<f rofes, &c. He is equally attentive to the 
<c furniture of the bed. He directs the bed- 
* clothes to be light, and the bed a proper 
<c medium of confiftence between hardnefs 
<c and foftnefs, and of a large fize." Thefe 
" directions, he exprefsly fays, " are * not 
<c only to promote fleep, but to produce 
<c repofc of the mind and thoughts alfo." 
It appears to me very probable, that the 
good effe&s of wine 1 in this complaint, which 
have been obferved in ancient as well as in 
modern practice, may be in a good mealure 
owing to its influence upon the mind and 
fpirits, which communicates by fympathy, 
tone and ftrength to the reft of the fyftem. 
* Jubentes eos quiefcere non folum corporis officio, fed 
fi fieri potent cura animorum. Ibidem. 
1 Cardiacorum morbo, unicam fpem in vino effe, 
certum eft. Pli.iii Hiji Nat. L. XXIII. C. 2. 
StJ'oVttl 76 OIX, OX.OO'OV Civ LtlPUJCtl 'TS'ieiV' ya,* 
oiv@~ eKTtii e; Aretaus. 
Ad vini dationem defcendimus, quod ita fummum 
generaliter probamus, ut album atque non confufum et 
medii temporis eligamus, &c. Cal. Aur. IL 37. 
c 3 
Aretaeus 38 
Are tarns mentions among the figns of the 
medicines he advifes, of which wine is the 
principal, taking effeft, " that the k voice 
<f returns to its natural tone and pitch," 
and, as he exprefies it," <£ becomes every 
" way alive, the fenfes are reftored, and 
nature feems to be again reproduced." 
Caelius Aurelianus reckons exprefsly among 
the good effects of wine, " its 1 diminifhing 
<f the infenfibility and ftupor, and caufing 
*c the patient to regard with pleafure the 
" endeavours of the attendants for his fer- 
« vice." 
Opium too, which has been introduced 
into m practice of late years in the nervous 
fever, and frequently adminiftred, and in 
pretty large dofes, is well known to exert 
great cordialn effects on the mind and fpirits. 
k lutpuv®- Tct 'WM'Tct. 
J'tTW Ctlfftyl(FIV9 0.70,% Mcf' g£«CAct-:»U£ Trtiz 01W. 
Aretans. 
1 Torpor atque ftupor corporis infraft us (diminutus) 
ad omnia quseque facilis segrotantis arrifio. Cal. Aurel. 
m Wall on the Ufe of Opium in low Fevers. 
n Parva dofi. pulfum validum efficit et alacritatem 
inftar cardiaci affert. Rutty Mat. Med. 
Duftorum 39 
The accounts given of its efficacy in this 
way among the Turks, and other nations that 
are habituated to its ufe, prove this Effi- 
ciently, and it is probably owing entirely 
to this effect of it upon the nervous fyftem, 
that it becomes ufeful in this complaint. 
0 Galen feems to have recommended the- 
riaca, which is well known to be no more 
than an opiate combined with fpices, with 
this intention in the morbus cardiacus, which 
I have before mentioned to be the fame with 
the nervous fever. 
Neither opium, nor any of its preparations 
much in ufe in the prefent age, are efteemed 
Dudlorum veritas e fingulari hilaritate, quam opium 
czteraque hujus commatis modice ufurpantibus in prin- 
cipio conciliant maxime elucefcit. Gentes pene omnes 
in India, Japonia, Turcia, Perfia, ac reliquis regio- 
nibus, orientalibus opio depurato, et variis inde prse- 
paratis, nec minus inebriantibus, et narcoticis aliis fre- 
quentiffime in conviviis, et extra ilia ad hilaritatem fibj 
conciliandam maeroremque difcutiendum. Cartheufer 
Mat. Med. Ruf el's HIJl. of Aleppo, p. 84. Hajfelquefl's 
Travels. 
• De theriaca ad Pifones. 
C 4 
to 40 
to poflefs confiderable antifeptic qualities, 
or indeed any others, by which it could aCt 
in any material degree on the fluids of the 
body ; and if it did poflefs fuch qualities, 
the quantity in which it is given is too fmall 
to admit the fuppofition of its operating by 
means of them. Is it not probable then, 
that its good effeCts are produced, by its 
compofing the nervous agitations, and by its 
introducing fenfations of an agreeable kind, 
which tend, of courfe, in the fame manner 
with joy, and fuch like exhilarating paflions, 
to excite the motion of the heart, and blood 
veflels, and to ftrengthen the natural func- 
tions of the fyftem in general ? This con- 
jecture wlil receive additional ftrength, if 
we reflect that the debilitating paflions, as 
fear, grief, &c. have been in all ages reck- 
oned among the principal caufes of the ner- 
vous fever. The fimilarity in the effeCt pro- 
duced, renders it highly probable, that wine 
and opium owe the principal advantages 
they procure, to the fame general property. 
Wine indeed, largely taken, might be ufeful 
as an antifeptic ; and I by no means deny, 
that it may be of fervice fpecifically, when 
admi- 41 
adminiftred with that intention. But if opium 
produces nearly the fame effects (as it is 
faid to do) we muft look for fome other 
caufe of the efficacy of wine, and refer it to 
fome qualities which it poffieffes in common 
with opium, which can be no other than 
thofe of a fedative and cordial kind, the 
action of which is confined to the nervous 
fyftem only. 
O R D O 42 
O R D O II. 
Phlegmasia. 
GENUS IX, 
P H R E N I T I S. 
ATTENTION to mental affections is 
here highly neceffary. Some of the 
writers of antiquity have given very judicious 
directions with regard to this point, Are- 
taeus condefcends to remark feveral circum- 
Itances apparently minute, but in reality very 
important. Thus he advifes quiet and calm- 
nefs both to the fick perfon and his atten- 
dants, and that he Ihould be placed in a 
chamber of a moderate fize, with the a walls 
fmooth, uniform, and regular, and without 
projections, and not ornamented with variety 
of colours or paintings, as thefe, he fays, 
a ToT-yo Keioh op.ahoh pnJ' aypat, 
/zmcPs ewcor/Mf ya? 70/ycy?a<pht. £ 
ya? a ?o Tav a[atpai?zw<ri viva ivJ'a.k- 
para, x} ra /zh z laycvra w wj'i'jywra, 
waca 7t?Wa<ri<; avam» Aw<r/? 9°^(' ArcU 
de Cur. Acut. Ivlorb. L.I. C. i. 
are 43 
are apt to diftraft the mind, and impofe on 
the patient for realities. He orders even the 
bed-clothes to be even, and of a regular 
furface, that the patient may not be induced 
to fatigue himfelf with b picking their irre- 
gularities. He alfo directs, that fome of 
his moft intimate e friends fhould have accefs 
to him, and by amufmg difcourfe and mild 
expreflions, endeavour to pacify and com- 
pofe his perturbation of mind. 
He recommends likewife a compliance, 
as far as poflible, with all the defires of the 
patient, efpecially if he is prone to anger 
and violence, If light is offenfive, or feems 
to aggravate the diforder, by fuggefting ob- 
jects to the imagination, he orders the cham- 
ber to be kept dark ; but if darknefs, from 
the uncertain Rate of mind it induces, caufes 
dread and horror, light is direded to be let 
in. 
b Ej/ *[ihoi!Ti 7cl! a? [M V'7ro(j.vwi{ 
tit. Ibidem. 
c E/cotPoz rav pifioi, x} AatA/n, /zm •3-v/xsJ'tf- 
K€ift TFAV7A yA% ev6up.iiadai yjH [J-AKLSA 70131 if OgyHP 
n 'tfAgapogH- Ibidem 
Caelius 44 
Cselius Aurelianus agrees in moft of thefe 
points with Aretseus, to which he adds fome 
ufeful caution of his own. Thus he directs 
the light to be mild and gentle, as of a lamp, 
or that of the day, let in through a fmall 
aperture d, and directed principally to the 
face of the patient, as an objeft to fix his 
attention, and prevent the mind wandering 
in uncertain thoughts and ideas; a precaution 
frequently ufed in modern practice, and 
known to be of the grpateft efhcacy in calm- 
ing delirium when not very violent. He 
alfo recommends that fuch c perfons fhould 
abfent themfelves to whom he bore any aver- 
fion or diflike in f his natural ftate of health, 
d Tenue atque blandum lumen immittere, lucernag 
aut lucis aetheriae, fed arguto ufu machinatum, quo 
velut per quandam cavernam, asgrotantis vultum per- 
fundat, et nullas tangat alias corporis partes. Sic 
enim mitigabitur alienationis augmentum, et adju- 
torium id paffioni aptum congrue fervabit qualitatis 
effedum. Caeiii Aurelian. Lib. I. Cap. IX. 
c Denique fi quos fanitatis tempore invifos habue- 
runt, intrare prohibemus, ne his vifis afperentur. Eos 
vero quos metu aut verecundia coluerunt, per inter- 
valla intrare permittimus, parit enim frequentia con- 
temptum. Ibidem. 
f Cglfus gives much the fame advice. III. 18. 
and 45 
and that thofe people fhould be introduced 
whom he had been accuftomed to refpedt 
and reverence, but that the vifits of thefe 
fhould be only at intervals, in order that the 
influence of them on the mind might not be 
deftroyed by habit and familiarity. All thefe 
precautions are extremely proper, being 
founded both in reafon and experience. I fhall 
fpeak more on this fubjeft, when I come to 
treat of Mania and Melancholia. 
GENUS XXIII. 
Odontalgia. 
THE effects of fear on this fenfation 
are a fubjedt of common obfervation. 
The fight of the inftrument for extracting 
the tooth, often gives a perfect, though only 
a temporary relief, and this even though the 
pain has arifen from a a carious tooth. It is 
a curious faCt, that this effeCt is produced 
without any removal of the ftimulus by 
which the pain was excited. 
a Haller, Phyfiol, Vol. V. p. 585. 
This 46 
This effect is moil: frequently noticed in 
the tooth-ach, but holds, I make no doubt, 
in many other painful fenfations, wherein 
the health is but little affedted. I never 
knew any application of it to pradtice, and 
as the relief is but tranfitory, it would be 
fcarcely worth the trial b. 
b Since the writing the above, I have recollefted 
that this complaint, when not very violent, is often 
cured by the application of the artificial magnet; which, 
whatever the fupporters of the impofture of animal 
magnetifm may alledge in its defence, could be only 
owing to the confidence the patient had in its efficacy 
of the remedy, which I doubt not was much enhanced 
by the knowledge of the real powers of that wonderful 
fubftance, and its being here applied in a way that 
gave no information as to the manner in which it could 
operate, which added to the impreffion by increafing 
the myftery. If the patient's faith be not very flrong, 
the remedy fails of effeft. It is more than probable, 
that feveral whimfical applications recommended in the 
rheumatifm, as the nine times dyed blue flannel, &c. 
owe their efficacy, if they have any, to the fame caufe. 
GENUS 47 
GENUS XXIV. 
Podagra. 
THIS complaint, which is generally 
held to be fubjedt to be produced or 
excited by the paffions of the mind, has, it 
is faid, in fome inftances, been cured by the 
fame means. 
Van Swieten relates from Hildanus, that 
a man difguifed to reprefent a ghoft or 
fpedlre, took another labouring under a gouty 
paroxyfm out of his bed, and carried him 
upon his back down the flairs, dragging his 
feet and legs which were the feat of his pain 
down the fteps, and placed him at lafl on 
the ground. The man thus treated, imme- 
diately recovered the ule of his limbs, and 
ran up the flairs again with great fwiftnefs, 
and under the flrongeft impreffions of terror. 
After this * incident he lived many years 
free from any fymptoms of the gout. A 
* Van Swieten, Vol. IV. p. 307. 
different 48 
different and indeed oppofite paffion, in a 
good meafure to the former, has, we are 
told, produced the fame effe&s. 
A perfon, who had for forty years been 
afflifted with the gout, was condemned to 
capital punifhment, and in confequence there- 
of led to execution. Juft when he expected 
death, he received an unhoped for pardon, 
which affedted his limbs in fuch a manner, 
as to reftore to them activity and ftrength, 
whereas before that event their ufe was nearly 
loft. This perfon, as well as the other, lived 
many years totally free from the b gout. 
Haller c quotes a cafe ftill more extraor- 
dinary of the cure of the gout by a paroxyfm 
of anger. 
Such facts are, however, rather matters of 
curiofity than utility, and what we can make 
no application of to practice. The laft men- 
tioned of the above paflions is held to be 
fo congenial with the gout, that Sydenham 
* Van Swieten. Vol. IV. p. 307. 
• Haller. Phyf. Vol. V. p. 517. 
was 49 
was of opinion a fit of the gout might with 
equal propriety be called a fit of d anger j 
an obfervation that, although probably car- 
ried rather beyond the mark, has notwith- 
standing confiderable foundation. 
Our pradtice therefore muft be directed 
not to excite, but to c moderate fuch paf- 
d Non enim reftius Podagras, quam iracundiae pa- 
roxyfmus omnes dici poteft, cum mens et ratio ufque 
adeo ab infirmato corpore enerventur, ut vel leviffimo 
adfeftuum motu impellantur et vacillent, unde non 
magis ipli fibi quam aliis gravis eft. Quid quod et 
casteris paflionibus eft obnoxius, timori videlicet, foli- 
citudinique, atque aliis id genus. A quibus pariter 
torquetur donee morbo evanefeente animus, quoque 
priftina tranquillitate recepta una convalefcet. Sydenh. 
Trad. de Podagra. 
e Tranquillitas omni ope ftabilienda eft, Cum per- 
turbationes omnes, ft repagula femel effringunt, ad 
podagrse generationem, et incremqntum multum faci- 
unt. Sydenham. 
Nonnulli equidem audores irse et mceroris affedum 
perfepe utilem in podagra fuifte referunt, eumque arti- 
ficiose in quibufdam excitare commendant, at me ju- 
dicc infida et medico plane indigna funt hascce remedia. 
Quis enim fana ratione prseditus podagricis terrorem 
fuaderet injiciendum ? quum inde aeque facile, imb 
magis adhuc, tragicus, quam exoptatus effedus fit ex- 
pedandus. Hoffm, de Cura Dolor. Podag. praef. 
D 
lions, 50 
fions, as are fymptoms, and thofe not the 
leaft troublefome of the diforder itfelf; and 
to endeavour to reftore, by any fafe means, 
that calmnefs and tranquillity of mind, 
which thofe who are fubjedt to the gout 
find on the going off of the paroxyfm. 
ORD. III. 
Exanthemata. 
GENUS XXVIL 
P E S T I S. 
See Typhus. Page 23. 
ORD. IV. 
Haemorrhagic. 
HAEMORRHAGES, generally confider- 
ed, have likewife afforded a fubjedt for 
the employment of mental affe&ions. The 
difciples of Stahl applied jafper and hema- 
tites to their patients, and it is poffible that 
the confidence in thefe remedies, however in- 
fignificant in themfelves, might, by abftraft- 
ing 51 
ing the attention from the local affe&ion, 
and compofing the mind, be of fervice. 
The paffion of fear * has been employed in 
a fimilar manner. A live toad, hung about 
the neck, is a noted remedy among the lower 
kind of people for a bleeding at the nofe, 
and it is not improbable that the fentiments 
of averfion, dread, and horror, impreffed by 
fuch an odious contact, may acft as a power* 
ful fedative, and of courfe be ferviceable in 
the difeafe, by diminilhing the force of the 
circulation. 
Few regular phyficians in the prefent age 
would chufe to ftand the ridicule that would 
• I believe that thefe remedies (fuch as are here 
fpoken of) have been fometimes ufeful in imprefling 
the mind with horror, awe, or dread. Cullen, firft 
lines, § 764. 
May not the advantages, faid to arife in cancerous 
complaints from the application of live toads, if it be 
really true that any fervice has been done, be derived 
from the fenfation of horror and deteftation imprefled 
thereby, which might aft as a powerful fedative and 
repellent of the local inflammation ? 
probably 
D 2 52 
probably attend fuch an application, and 
indeed the diffufed date of knowledge, in 
modern times, would probably difappoint its 
efficacy, except among the lowed ranks of 
people. The late difcoveries that a toad is a 
creature perfectly innocent, may contribute, 
probably, to ruin its character as a remedy. 
The above fafts, though fcarcely applicable 
immediately to practice, fuggeft neverthelefs 
fome ufeful inferences. We fhould be cau- 
tious how we attempt to raife the fpirits, or 
agitate the minds, of thofe labouring under a 
prefent dangerous haemorrhage. Low fpirits, 
and a certain degree even of defpondency 
for a time, may be of fervjce in retarding the 
impetus of the blood, and allowing a throm- 
bus to be formed. On this account we fhould 
not be too forward with affurances of fafety, 
but rather leave them in fome degree of 
doubt and apprehenfion. Much injury has, 
I think, been done in pulmonary confump- 
tions attended with hsemoptoe, by the af- 
furances of fafety given by well meaning,- 
though imprudent friends. It tends to fti- 
mulate the fpirits, already too much agi- 
tated, 53 
tated, and of confequence to accelerate the 
circulation, and increafe the fever and dif- 
charge of blood, and is farther injurious, by 
caufing the patient to pay lefs regard to 
other falutary regulations. 
On the other hand, when the haemorrhage 
is natural, or falutary, as the menftrual eva- 
cuation in women, and perhaps that of the 
haemorrhoids in men, and is not exceffive in 
quantity, we ffiould be cautious of exciting 
the debilitating paffions, at the time when 
it is prefent. Many of the diforders of women 
that are connected with menftrual obftrudi- 
ons, owe their origin to mental impreffions. 
GENUS XLII. 
Menorrhagia. 
SPEC. II. 
Menorrhagia abortus. 
THE effect of mental perturbations in 
caufing mifcarriage in pregnant women 
is well known as a fact, but difficult to be 
accounted for. Some circumftances, how- 
ever, 
» 3 54 
ever, relative thereto, are worthy remark. 
Firft then, the nervous fyftem in general, 
feems to have its irritability increafed by a 
3 pregnancy, and to be in fome meafure al- 
tered in its nature, which is manifefted by 
the change of temper, depravation of appe- 
tite, and in fome perfons, of underftanding; 
which are undoubtedly owing to the ftate 
above-mentioned. 
Whether this can be afcribed to the diflen- 
tion of the uterus, and its confequent preflure, 
both on the nerves that contribute to form 
its proper ftrufture, and on thofe of the 
vifcera in general, or perhaps to fome other 
caufe more direft and fpecific, we have not yet 
fufficient knowledge of the human frame and 
conftitution to determine. But though we 
cannot account for the mode of operation, 
we may reafonably conclude that, in the ir- 
regular and weak ftate of nerves incident to 
this fituation, the debilitating paffions muft 
be remarkably dangerous, as they tend to 
produce convulfion, the natural effefts of 
a Cullen's Pratt, of Phyfick. 
weaknefs5 55 
weaknefs, which would be especially evident 
in the part whofe nerves were primarily and 
probably in the greateft degree affedted, and 
which, from its Structure, is formed for Strong 
mufcular efforts, and endued at this time, 
by nature, with a peculiar tendency to exert 
them, in order to the exclufion of the foetus. 
The ftimulating paffions, though perhaps lefs 
hazardous, are not without their Share of 
danger. Anger particularly, though Stimu- 
lant in its firft effects, foon becomes fa- 
tiguing, and of courfe debilitating, and is 
on that account particularly to be guarded 
b againSt. Even great joy is apt to produce 
nervous collapfe, after the Stimulus has 
abated, and on that account Should be very 
cautioufly and gradually excited. Hope, or 
b Fcemina triginta annorum robufta que procerae fta- 
turae verfabatur fere quotidie in foro, ubi que rixis 
quotidianis que iracundias indulgere folita eflet fatis. 
Cum jam termino graviditatis proxima eflet fubita ex- 
candefcit ira dum vicina mulier puerum ejus quin- 
quennem percuteret. Mox aliquid infoliti fentiens in 
corpore praedixit fe inde morituram. Poll aliquot dies 
fubito profufa uteri haemorrhagia fequitur unde con- 
vulfa periit antequam quid tentare poflet ut fervaretur. 
Van, Swieten. Vol. IV. p. 497. 
D 4 
rather 56 
rather fuch a degree of confidence of the 
fuccefs of the event, as tends to make the 
condition as little a fubjeft of reflection as 
poflible, feems to be the ftate c of mind moft 
to be defired for a woman in that fituation. 
CLASSIS II. 
Neuroses. 
ORD. I. 
C O M A T A. 
GENUS XLIV. 
Apoplexia. 
VIOLENT paflions of the mind, either 
of anger or * fear, are enumerated 
among the caufes of apoplexy. It feems, 
however, probable that the ftimulating paf- 
e Omnes ergo animi motus cavendi fedulo funt ab 
omni cura rei domefticae arcendas funt puerperae, nec 
laetus, nec triftis, nuncius ne pacata ferenae mentis 
tranquillitas turbetur ullo modo. Van Swieten. Vol. IV. 
f. 601. 
a Van. Swieten, Comm. Vol. III. p. 271. 
fions 57 
lions would be more likely to produce it in 
perfons of a plethoric habit, Ihort neck, &c. 
and this would probably be of the kind 
called the fanguineous apoplexy ; whereas 
the debilitating pafllons would be more like- 
ly to induce the ferous apoplexy, which takes 
place generally in perfons of a fpare habit, 
and weak nervous fyftem, and is connected 
rather with inanition than plethora. The 
ftimulating pafllons, if violent, may, how- 
ever, produce this latter kind of apoplexy, 
by the relaxation that fucceeds over-ftrained 
exertions of the ftrength and fpirits. The 
application of thefe fads is eafy and obvious. 
ORD. II. 
A D Y N A M I /E. 
GENUS XLIV. 
Syncope. 
THE effects of mental perturbations in 
caufing fainting, are well known. 
Thefe have been fometimes fo violent as to 
prevent the readion of the fyftem, and of 
- courfe 58 
courfe to caufe fudden death. The a debili- 
tating paffions are more commonly obferved 
to have this effeft, but the llimulating have 
fometimes operated in a fimilar manner, joy 
particularly. Thefe fafts fuggeft obvious 
cautions, but we ffiould be careful not to 
carry even thefe to too great a length. It is 
no difficult matter to induce a habit of faint- 
ing in perfons indued with great irritability 
of nerves, and nothing conduces more to 
increafe this, than a ftudious folicitude to 
avoid every thing that might poffibly have 
that effeft. It fixes the mind on the very 
object we would wiffi to avoid, and by aug- 
menting the effects of trivial accidents, mul- 
tiplies the number of caufes that may pro- 
duce the diforder feared. A firm refolution 
to refill the effects of frivolous incidents 
upon the mind, and of courfe on the nerves, 
is far preferable. Haller has related a ftory 
where a difpofition of this kind was conquer- 
ed by a vehement exertion of the will, and 
* Mr. Sauvage mentions that he himfelf was affefted 
ed with Lipothymia at feeing a criminal broken on the 
wheel. Nofol- Method. Ant, Lipothymia. 
al moil 59 
almoft every perfon has feen temporary pa- 
roxyfms of a fimilar kind, put off by the 
ftruggles and refolution of the perfon at- 
tacked. 
GENUS XLVI. 
Hypochondriasis. 
THIS diforder, which manifefts itfelf 
principally in its effects on the mind 
and fpirits, admits of great fcope for manage- 
ment of the paffions. Great delicacy, how- 
ever, is requifite. The fufferers are moftly 
of gloomy difpofition, and fubjeft to a de- 
fpondency of mind concerning their own 
fituation in point of relief, and want cordial 
and exhilirating remedies to the mind as 
well as body. 
To treat fuch diforders as merely imagi- 
nary, generally irritates choler, and impreffes 
a belief that their friends have but little 
concern for their fafety or welfare ; and on 
the other hand, to coincide in opinion con- 
cerning the melancholy fituation of fuch per- 
fons, deprefles the fpirits, and tends above 
all things to aggravate the complaint. 
The 60 
The moft judicious courfe feems to be to 
endeavour to excite the a fortitude of the 
fufferers, by reprefenting to them, that is is 
unworthy a brave and refolute character, to 
be always complaining of misfortunes, which 
are in a good meafure the common lot of 
mankind, that it is more manly to ftruggle 
with ill fortune, than to fink without refift- 
ance beneath its preflure. 
Frequently a little raillery, if ufed with a 
great moderation and perfect good temper, 
will have an excellent effedt. But great de-> 
licacy is requifite in its application. 
It fhould likewife be the conftant endea- 
vour of thofe who attend fuch perfons, to 
abftradt their minds b as much as pofiible, 
* Hypochondriaci admonendi funt, virum fortem de- 
decere hanc levium malorum intolerantiam, atque con- 
tinuam de hifce querelam. Si enim Tatis perfuafi fo- 
rent neminem ex omni parte beatum in hac vita, nifi 
qui tedia et labores, turn animi, turn corporis eodem 
animo patitur, ac natus paterna manu caftigatus, illi 
leves fanitatis alterationes non tanti facerent. Sauvages 
Nofol. Methodic. Claff. VIIL Genus V. 
b Expedit ut aliis fortioribus ideis excitatis, idea 
morbi ex eorum animo deleatur ; plures vifi funt, qui 
fuperveniente 61 
from refle&ing on their own fituation and 
condition of health. Bulinefs, travelling, di- 
verfions, are all of them, when judicioufly 
managed, conducive co this end ; and I ap- 
prehend, that even exercife of body owes its 
principal, though not all its efficacy, to the 
circumftance. It has been remarked, that 
its good effects are by far moft confpicuous 
when they can be combined with fomething 
that may intereft the mind, and draw the 
attention. Riding on horfeback is, I appre- 
hend, preferable to exercife in a carriage, 
for this reafon chiefly, that a conftant atten- 
tion of mind is neceflary for the management 
of the horfe. 
fuperveniente liti, aut gravi negotio, morbi fui ob- 
liti funt, et qui ejus oblivifci poteft falvus eft. In hunc 
finem nihil convenientius equitatione per loca amcena, 
tempeftate ferena, aut quod eodem recidit peregrina- 
tione, navigatione, rufticatione ; aft equitatio praeftat 
caeteris; omni enim inftanti continue novis et variis 
objeftis vifus, auditufque percellitur, ita ut fere impof- 
fibile fit animam ab attentione funefta non averti, et 
aliis cogitationibus non afluefeere, in quo magna pars 
curationis confiftit. 
Sauvages Nof. Meth, Claffis VIII. Gen. V. 
GENUS 62 
GENUS XLVII. 
Chlorosis. 
ONE of the fpecies of this genus, the 
the chlorofis amatoria, is ftrongly con- 
nected with mental impreffions. But the 
management of thefe muft be left to pru- 
dence, guided by the particular circumftances 
of the cafe, and is indeed improper for a 
more particular difcufiion in this place. 
ORD. IIL 
S P A S M I. 
GENUS LIU. 
Epilepsia. 
FE W diforders (hew the power of mental 
affections more ftrongly than this. It 
is often produced originally by paffions of 
the mind, and is in moft inftances liable to 
a renewal of the paroxyfm by fuch caufes. 
Various paffions have excited it, whether of 
the exhilirating or depreffing kind. Anger, 
joy, terror, and grief are all faid by Van 
Swieten, 63 
4 Swieten, to have been obferved by him to 
have caufed this diforder. The power of 
aflbciation of ideas in the mind is here very 
remarkable. A child was frighted into an 
epileptic paroxyfm by fear, induced by a 
great dog leaping upon him b. The fit re- 
turned upon his feeing fome time afterwards, 
a larger dog than the one which had caufed 
his terror, and even by hearing his barking 
at a diftance. It is well known, that even 
the mention or recalling to the mind the 
circumftances attending fuch paroxyfms, will, 
in many inftances, reproduce them. Hence 
Galen c very judicioufly advifes all things to 
be avoided, that lead to recalling the difor- 
der to the memory. Others of the ancient 
phyficians, obferving how much this com- 
plaint is connected with mental affections, 
and how it may be reproduced by reflecting 
a Van Swieten, Vol. III. p. 414. 
Morgagni de fed. et caus. morbor. Epift. LXIV. 
Art. 5. 
Morgagni relates a ftory of a man becoming epileptic 
by terror. Epift. LXII. Art. 5. 
' b Van Swieten ibid. 
c Ta 'aradnf a''A[j.vwai> Confil. pro puero epileptico. 
Cap. II, Chart, Tom. II. p. 288. 
upon 64 
upon it, have endeavoured to abftraft the 
mind from fuch ideas, by introducing im- 
preffions ftill more powerful. Upon this 
principle it was, I apprehend, advifed by 
Pliny d, for the patient to drink the warm 
blood of a gladiator newly (lain. Scribonius 
Largus dire&s a portion e of his liver to 
be eaten for the fame purpofe ; and Are- 
tazus not only mentions thefe, but feveral 
others of the difgufting kind, as the raw 
heart of a coot, the f brain of a vulture, &c. 
d Sanguinem quoque gladiatorum bibunt ut viventibus 
poculis comitiales morbi quod fpedare facientes eadem 
arena feras quoque horror elt at hercule illi ex homine 
ipfo forberi efficaciffimum putant calidum fpirantemque, 
et una ipfam animam ex ofculo vulnerum cum plagis ne 
ferarum quidem admoveri ora fas fit humana alii me- 
dullas crurum quaerunt et cerebrum infantium. Plin. 
Hift. Nat. Lib. XXVIII. Cap. I. 
e Item exfecinore gladiatoris jugulati particulam ali- 
quam novies datam confumant. Quaeque ejufdem ge- 
neris funt extra medicinae profeflionem cadunt quamvis 
profuiffe quibufdam vifa funt. Scribon. Larg. Cap. II. 
f id) oti yuvQ- eyxs&x./&, aicfruHS apw 
XgCtJ'W} 01 IVOIK-Ct/Ol yclMM 70V VH7GV. 
fya S't Tcov J's ax J's ye 
veoirvctyec'Jt V7ro(hi7ac yiaMt 7a 7^17.0,71 
70? cll!J.dL\@- AAAI) J's 7/4 i}7TA] 
(pctyew, Are tai Diut. Morb. L. I. Cap. 4. 
If 65 
If thefe ftrange and hideous remedies could 
have any efficacy, it muft be owing to their 
abforbing the attention, and of courfe leaving 
no room for the apprehenfion and recollection 
of the diforder to operate, and in this way 
it is poffible they may have been of fervice. 
It is remarked of this complaint, that it 
is fubjedt to be produced even in thofe not 
before liable to it, by the fight of s perfons 
in the convulfive paroxyfm. This muft be 
referred to the principle of imitation before- 
mentioned, which is in this inftance ftrongly 
exemplified. 
A very remarkable inftance of the power 
of imitation occurred to the celebrated h Bo- 
erhaave. A perfon in a hofpital fell down 
in an epileptic fit in the fight of the other 
patients. The 1 effedt of this was fo ftrong, 
8 Hildan. HI. Obf. 8. 
h Impetum faciens Hippocrati diftum. 
1 " The commiflioners charged by the French king 
with the examination of animal magnetifm, have proved, 
by the moil: decifive experiments, that the imagination 
alone is capable of producing all thofe convulfive effe&s, 
which have been falfely attributed to the power of the 
magnet. 
E 66 
that great numbers of them became imme- 
diately affected in the fame and 
magnet. They relate an hiftory, which has a ftrong 
refemblance to that recorded by Kaun Boerhaave." 
" Le tour de la ceremonie de la premiere commu- 
nion fait en la paroifle de St. Roch, il y a quelques 
annees (1780) apres 1'office da Soir, on fit, ainfi qui 1* 
eft d'ufage la proceffion en dehors, A peine les enfans 
furent ils rentres a l'Eglife, et rendus a leurs places 
qu'une, jeune fille fe trouva mal, et eut des convulfions. 
Cette affeftion fe propagea avec une telle rapidite, que 
dans 1'efpace d'une demiheure 50 ou 60 jeunes filles de 
12 a 19 ans tomberent dans les memes convulfions ; 
c'eft a dire ferrement a la gorge, gonflement a 1'eftomac, 
letouft'ement, le hoquet, et les convulfions plus ou moins 
fortes. Ces accidens reparurent a quelques uns dans 
le courant de la femaine ; mais, le dimanche fuivant, 
etant aflemblees chez les Dames de Sainte Anne, dont 
l'inftitution eft d'Enfeigner les jeunes filles, douze re- 
tomberent dans les memes convulfions, et il enferoit 
tombe d'avantage, fi on n'eut eu la precaution de ren- 
voyer, fur le champ, chaque enfans chez les parens. 
On fut obliges de multiplier les ecoles. En feparant 
ainfi les enfans, et ne les tenant aflembles qu'en petit 
nombre, trois femaines fuffirent pour diffiper entiere- 
ment cette afFeftion convulfive epidemique." 
Rapport de commiflaires charges par le Roi, de 1'ex- 
amen du magnetifme animal, p. 54. See Medic. Tranf. 
Vol. III. p. 124. 
their 67 
their paroxyfms continued, and were repeated 
at the fight of one another in that Hate. 
The opinion of the great phyfician above- 
mentioned was requefled on this occafion. 
He judicioufly reflected, that, as thefe fits 
were originally produced by impreffions on 
the mind, that the moft proper means of 
cure would be to eradicate thefe impreffions 
by others ftill more powerful. He therefore 
directed actual cauteries to be prepared, and 
kept hot, in readinefs to be applied to the 
perfon who ffiould next be affefted. The 
confequence was, that afterwards not one 
perfon was feized. The number of ftrange 
and whimfical remedies for this diforder, the 
fuccefs of which, as well as of many quack 
medicines, is often llrongly vouched, mult 
be referred to this mode of operation. The 
confidence with which they are adminiftered, 
is perhaps in all of them the moll powerful 
ingredient. 
To the fame head may be referred the 
efficacy of many remedies of a fuperftitious 
caft. Relicks of faints, and fuch like trum- 
pery, 
E 2 68 
pery, have, I am informed, gained great 
credit for their effects iri convulfive diforders, 
and it is highly probable not altogether with- 
out caufe, as the prepoffeffion in favour of 
their efficacy was fo much the ftronger, on 
account of the religious ideas thought to be 
connected with it. 
CLASSIS IV. 
Sauvages hand Cull. Synopfis. 
S p a s M I. 
O R D O I. 
Spasmi tonici partiales. 
GENUS V. 
C R A M P U S. 
THE cramp is a noted inflance of the 
power of mental affections. To enu- 
merate the whimlical remedies recommended 
for it, would be a ridiculous talk. Suffice it 
then to fay, that they are almoft altogether 
totally inefficacious in themfelves, and de- 
pend upon the imagination for their fuccefs. 
Some of them are calculated particularly to 
affect 69 
affedt the mind with furprife or horror, as 
the breaking of a roll of brimftone held in 
the hand, the wearing rings formed out of 
the nails or furniture of old coffins, and fuch 
like fanciful conceits. The operation of thefe 
appears to be fimilar to that of other reme- 
dies that work upon the mind in fpafmodic 
difeafes. 
CLASSIS V. 
Sauv. haud in Cull. Nofol, 
Anhelationes. 
ORD. I. 
Anhelationes 
GENUS IV. 
Singultus accidental! s. 
THIS fpecies of the hiccup, which is the 
only one that is the fubjedt of the pre- 
fent enquiry, can feldom be called a diforder, 
but is to fome people a very troublefome 
circumftance. The cure of it by mental 
affedtions is fo commonly pradlifed, as to be 
rather a matter of jeft or merriment, than 
bearing 
E 3 70 
bearing any relation to medicine. The effedt 
of it, however, is worthy the obfervation of 
a phyfician, as it is far from improbable 
that the fame means might be employed in 
difeafes of greater importance. It is found 
to be ftopt by whatever engages the atten-r 
tion, whether the paflion connected a there- 
with, be of the fame ftimulating, or debilir 
tating kind. 
GENUS LXI1L 
Hysteria. 
THE preceding obfervations, relative to 
epilepfy, refer almoft equally ftrongly 
to this diforder. 
It is well known how irritable the mind 
and pafiions ufually are in hyfteric people, 
and that irrefolution and unfteadinefs are 
efteemed diagnoftic fymptoms. A morbid 
a Quod animae imperium clare denotat, nuncio quo- 
cunque gravi, aut fermone fingultientis admirationem, 
verecundiam, aut pathema, quodvis excitante illico 
fiftitur. Sauv. Clafs. V. Gen, Singultus. 
fenfibility 71 
* fenfibility appears always to accompany this 
complaint, which is very liable to be excited 
by the mind and paffions. Nothing con- 
tributes to aggravate it more than 4 indolence 
and vacancy of mind. Some interefting pur- 
fuit that will occupy the attention is therefore 
by all means to be fought out and affiduoufly 
followed. Even fear itfelf gradually intro- 
duced, and when no imminent danger is 
apprehended, has been efficacious in pre- 
venting this diforder. The difpleafure of a 
parent, fuppofed to be likely to be incurred, 
by the return of hyfterical paroxyfms, has 
contributed to prevent them : and I have 
been informed from the beft authority, that 
during the troubles in Scotland, in the years 
1745 and 1746, the hyfteric difeafe fcarcely 
made its appearance. 
* Principium proximum hyfteriae eft fumma philau- 
tia, feu amor eftraenis vitae et voluptatum, unde mini- 
morum incommodorum intolerantia, exaggeratio, pro- 
pofiti inftabilitas fumma fenfibilitas irritabilitas. Sauv. 
Art. Hyfteria. 
a Dum corpus otio indulget, animae negotia faceftunt 
pathemata ira, invidia, zelotypia, amor, taedium, lites, 
aerumnae. Sauv. Art. Hyfteria. 
E 4 
The 72 
The hyfteric paroxyfin, as well as the epi- 
lepfy, is extremely apt to recur on the fight 
of people fo affefted. I once had an oppor- 
tunity of feeing an inftance of this kind at 
one of the publick water-drinking places in 
this kingdom. A lady was feized with hyfte- 
rick convulfions during the time of divine 
fervice. In lefs than a minute, fix perfons 
were affe&ed in a fimilar manner, fome of 
whom had never before been fubjedt to fuch 
attacks, but were notwithftanding violently 
agitated and convulfed in body, as well as 
mind. But though fuch inftances as thefe 
fhew the propriety of prudent caution, yet I 
am fatisfied that too great folicitude to avoid 
every thing likely to give uneafinefs, efpeci- 
ally if fuch folicitude be very apparent, is 
likely to do as much mifchief as fervice. 
Nothing fo much enhances the apprehenfion 
of danger, or fo often caufes thofe on whole 
account the care is taken, to believe that 
the hazard is greater than it really is, and 
fuch circumftances frequently recurring, keep 
them perpetually in a ftate of painful irrita- 
bility, which in reality conftitutes the difor- 
der. It would be much better to inure fuch 
perfons 73 
perlons b gradually to the common occur- 
rences of life, and to the occafionalc mention 
b This feems agreeable to the advice of Aretaeus. 
x'i sy to? 'ttavti (ha/jn otu&uyjiw ctaymrav e.u.7rmii/» 
Aret. Cur. Diut. Morb. L. IV. 
c It is the opinion of fome eminent writers, that 
impreffions which aft upon the fenfibility, are diminifli- 
ed by repetition; whereas thofe that aft upon the irri- 
tability of the fyftetn, are augmented. But I apprehend 
this depends in a great meafure on the ftrength of the 
firft impreffion, whether that be direfted to the fenfible 
faculties, or merely to the animal organs. Purgative 
medicines lofe their effefts by repetition, and opium 
and tobacco, if not taken beyond their ufual dofes, 
ceafe to ftupify or intoxicate thofe who are habituated 
to their ufe. Our concern of mind ceafes in like man- 
ner, when the fame event recurs frequently. It is pro- 
bable that butchers muft at firft be ftruck with remorfe 
at their firft killing fo many noble and harmlefs ani- 
mals, but by cuftom this fenfation wears off, and the 
thing becomes a matter of courfe- The fame is true of 
fear. Thofe objefts that at firft fight affefted our 
minds with awe and wonder, come at laft to be fcarcely 
regarded. A battle or a ftorm, however terrible at 
firft, lofe much of their effeft by cuftom and habit. 
On the other hand, when the firft impreffion is very 
ftrong, and the effeft produced very violent, a force or 
power, inferior to the original one, will produce the 
fame effeft. Thus it has been remarked, that if a 
perfon, unaccuftomed to the ufe of purgatives, was to 
take 74 
of fuch things, which, if not magnified by 
the relators, or dwelt on as meriting particu- 
take at a dofe fifteen grains of aloes, the fmartnefs of 
the operation would leave fuch a lafting impreffion, 
that an equal effect would afterwards be produced by 
one half, one fourth, or even one-tenth, of the fame 
quantity ; whereas, had the original dofe been only a 
grain and half, it might have been necefiary to increafe 
it to ten or fifteen, in order to procure the effect defired. 
Had the man who firft beheld with concern the {laugh- 
ter of an ox, feen in place thereof an inhuman murder, 
he poffibly might not have been able to endure the 
killing a brute animal afterwards. It is related of 
Theodoric, the celebrated king of the Goths, that 
fome time after his unjuftly putting to death Boetius 
and Symmachus, the head of a large fifh was ferved up 
to table, which the unhappy monarch, confcious of, 
and repentant for his cruel treatment of thofe innocent 
and illuftrious perfons, figured to his diftrafted imagi- 
nation to be that of Symmachus, upbraiding him as it 
were with a ghaftly threatening countenance for his 
cruelty. This wrought fo powerfully upon his mind, 
that he was inftantly fo opprefled with horror and 
amazement, as to render it necefiary to carry him from 
the table to his chamber, where the impreffion conti- 
nued fo ftrong, as in a few days to put an end to his 
life. Our great poet Shakefpear has finely depicted a 
fomewhat fimilar fituation. 
A vacant place at the table fuggefts to the guilty 
mind of Macbeth his late crime, and his diftrafted 
imagination 75 
lar attention, will come in time to be difre- 
garded, and their effefts deftroyed. Inftead 
of this it is but too ufual with parents to 
fofter the fenfibility of their children, efpe- 
cially females, to an unnatural degree, by 
officious attention to remove every thing that 
can give the leaft interruption to pleafure, or 
even awake the mind to it natural and necef- 
fary exertions. An d of the under- 
ftanding and mind, and a Ms7f/o%et£g/* of the 
will, feems to be the modern, as well as 
ancient fceptical fyftem of polite life5 and 
appears to be fcarcely lefs injurious to the 
body than to the mind, by the effeminating 
effects it produces upon both. 
Affe&ation contributes its (hare to enhance 
thefe complaints. An unnatural and morbid 
fenfibility is often encouraged under the idea 
imagination fills it with the perfon who had been the 
object of his cruelty, exhibiting at the fame time every 
horrid circumftance that had attended the commiffion of 
that atrocious deed, 
d Qzu.tv vw 'TZXat iiva.1 tou 'S.tctTTTiMU tuv tv 
'ran n&\a> ct\a,§ a.^iav3 x) tv roit Kct/iwa.yyaLtrp.t- 
voif Sext. Emp. L. I. C. 12. 
of 76 
of delicacy and tender feeling, and even 
ficknefs itfelf is fometimes feigned, as being 
imagined (however falfely) a mark of a dif- 
pofition of this kind. But if we examine 
human nature more accurately, we fhall find 
that the liberal and truly amiable virtues of 
humanity and benevolence, are much more 
frequently found in perfons of a fteady mind 
and temper, who have experienced variety of 
fortune, than in thofe who have pafled their 
lives in an uniform courfe of luxurious indul- 
gence, which always generates felfifh and 
mean ideas and fentiments. 
It is the remark of an eminent moralift, 
that men who have met with an uniform 
compliance with their will, are inclined to 
cruelty and feverity. A mixture of adverfe, 
with profperous fortune, is, he obferves, ne- 
ceffary, in order to infpire humanity and 
pity. 
GENU S 77 
GENUS LXVI. 
Melancholia. 
THE diftinguilhing charadler of this 
diforder, is an attachment of the mind 
to one object, concerning which the reafon 
is defective, whild in general, it is perfect 
in what refpedls other fubjedts. 
It is obvious that there muft be here a 
large fcope for the management of the mind 
and paflions. The point to be aimed at feems 
to be, to interrupt the attention of the mind 
to its accuftomed object, and to introduce 
variety of matter upon which it ipay exercife 
itfelf. This, however, requires the greateft 
caution and delicacy in the execution. Moft 
melancholic perfons are jealous of being 
efteemed to be fuch, and have generally a 
great opinion of their own wifdom and fa- 
gacity, and are apt to hold very cheap the 
common amufements of life, efpecially thofe 
eonnefted with focial intercourfe and com- 
pany, efpecially as they are inclined to think 
themfelves neglefted and defpifed by the 
world. 
Travel- 78 
Travelling a feems the belt calculated for 
a cure of any thing, as it induces a gradual, 
yet interefting variety of objects and fubjedts 
of attention, which are the more pleafing, 
as they have not the appearance of being 
intentionally introduced. 
The purposes of travelling alfo (to thofe 
whofe fituation and circumftances admit of 
it) may be varied according to the difpo- 
iition of the patient. Van Swieten b relates 
from his own knowledge, that feveral literary 
perfons, who were thus affedted, would by 
no means be perfuaded to go to any mineral 
waters for relief, which they thought would 
* Precipua curatio in hoc confiftit, ut anxia ilia et 
perpetua cogitatio, cui mens inhaeret, mutetur : verum 
hie multa cautela opus eft. Omnes enim melancholic! 
folent indignari, ft pro talibus habeantur : morofi funt, 
plus fe fapere credunt quam reliquos homines, et aeger- 
rime folent ferre, ft obleitamenta illis offerantur, tunc- 
que faepe pertinaciflime omnia ilia repudiant; et tanto 
magis fugiunt confortia hominum, a quibus fe contemni 
credunt. Prae reliquis omnibus profunt itinera: tunc 
enim nova occurrunt atque infolita objedta, quae fatis 
efficaciter in mentem agunt et cogitationem mutant. 
Van Swieten. Vol. III. p. 478. 
b Ibidem. 
confirm 79 
confirm the opinion of the world concerning 
their diforder, but were eafily induced to 
travel for the purpofe of viewing feveral 
libraries and reforts of learned perfons, and 
the variety of attentions thereby produced, 
had the beft effects in working a cure. 
It is fometimes recommended to endeavour 
to excite fuch paffions as are of an oppofite 
c nature to thofe that have prevailed during 
the courfe of the diforder. Thus the timid 
are to be fupported with fuch arguments 
and difcourfe as may tend to roufe the cou- 
rage and refolution ; the gloomy are to be 
cheered with merriment and pleafure ; and 
the violent and paflionate * to be reftrained 
by fear. This advice feems proper, but I 
fear is feldom prafticable. 
c Van Swieten. Vol- III. p. 512, 513- Celf. III. 18. 
* Fuit homo fatis Celebris apud Batavos infanientium 
cura qui hac methodo utebatur et multos fanabat. Si- 
mulac delirarent traftabat miferos ferarum inllar ver- 
beribus catenis perfufione aquae frigidiffimae fame fiti, 
&c. Dum mitefcebant omni inodo blandiebatur illis 
nihilque omnino negabat illarum rerum quas defidera- 
bant. Hoc modo effecit ut metus verberum coerceret 
incipiens delirium et tandem deleret vanas illas imagi- 
nationes. Van Swiet. Vol. III. p. 514, 
Even 80 
Even fhame may be fometimes ufed fuc- 
cefsfully in preventing the confequences at 
leaft of thefe diforders. d Plutarch relates, 
that the virgins of Miletus were feized with 
an epidemic madnefs, that prompted them 
to deftroy themfelves. This was in vain at- 
tempted to be prevented, until it was ordered 
that the bodies of thofe, who thus put an 
end to their lives, Ihculd be dragged naked 
through the ftreets. Shame here proved a 
more powerful motive than the fenfe of duty, 
or any of the focial affeCtions. 
It is generally found conducive to the 
cure, not to contradict too peremptorily the 
ideas or opinions of the patients. Oppofi- 
tion, if too direct, ferves only to irritate the 
temper, and to confirm erroneous opinions. 
Such a degree of e compliance, as expreffes 
d De virtutibus mulierum. 
e Saepius tamen aftentiendum quom repngnandum 
eft, paulatimque et non evidenter ab his quae ftulte 
dicuntur ad meliora mens adducenda. Celf. III. 18. 
Mandandum quoque miniftris qui eorum errores con- 
fenfu quodam accipientes corrigant, ne aut omnibus 
confentiendo augeant furorem eorum vifa confirmantes 
aut rurfum repugnando exafperent paffionis augmen- 
tum; 81 
only a moderate aflent, often fucceeds. When 
the imagination is not inflamed by oppo- 
fition, it often corrects itfelf. Sometimes 
indeed, when the fenfes are violently de- 
praved, it may be neceflary to feign a more 
entire acquiefcence with the opinions of the 
melancholic perfon. 
The introduction of fports and amufe- 
ments, and fuch employment as conflfts 
in a moderate exercife of the faculties is 
likewife proper. 
Caelius Aurelianus recommends for this 
purpofe, that literary people Ihould be amufed 
with philofophical queftions f, that the far- 
mer fliould be entertained with difcourfes on 
turn ; fedinduftive nunc indulgeant confentientes, nunc 
infinuando corrigant vana, refla demonftrantes. CaeL 
Aur. I. C. V. 
f Tunc proficiente curatione erunt pro poffibilitate 
meditationes adhibendae, vel difputationes. 
Ei autem qui literas nefcit immittendae quaeftiones 
erunt, quae funt ejus artis propriae, ut ruftico rufticatio- 
nis, gubernatori navigationis ; ac fi. ex omni parte iners 
fuerit curandus, erunt vulgaria quaedam quaeflionibus 
tradenda, vel calculorum Indus. Cael. Aur. I. 5. 
F 
agrictil- 82 
agriculture, and the failor with naval affairs. 
Others, he fays, may divert themfelves with 
games of chance. Mufic s to thofe who 
have a tafte and ear for it, may perhaps be 
a powerful remedy, and is mentioned by 
fome of the ancient phyficians. 
GENUS LXVII. 
Mania. 
HIS differs from the foregoing, as 
*■* being an * irrationality upon all fub- 
jefts; whereas the former was confined to 
one. Some of the remedies ufed, appear to 
have been adminiftred with the fame intent, 
as in the Melancholia. The aim is to eradi- 
cate the former falfe impreffions by others 
ftill more violent. Hence the calling of 
fuch people into the fea, and detaining them 
under the water until they are nearly drown- 
8 Utuntur etiam cantionibus tibiarum varia modu- 
latione. Ibidem. 
Quorundam difcutiendae triftes cogitationes, ad quod 
fymphonias, et cymbala, ftrepitufque proficiunt. Celf. 
L. III. 18. 
a Differta melancholia per delirii univerfalitatem. 
Sauv. Gen. Mania. 
ed, 83 
ed, recommended by Boerhaave b, and the 
impreflions of terror and perturbation of 
mind advifed by c Celfus. 
Fortunately, on many accounts, maniacal 
perfons are almofl: altogether cowardly, and 
thofe who attend them know how to avail 
themfelves of this part of their character, 
and moftly find, that though generally irra- 
tional, they retain a great confideration for 
perfonal fafety, and that threats will often 
compel them to aft and fpeak rationally. 
GENUS LXXVI. 
Scorbutus. 
rp H E fcurvy affords a remarkable in- 
ftance of the influence of the paflions 
of the mind a. The diforder itfelf is naturally 
b Praecipitatio in mare, fubmerfio in eo continuata 
quamdiu ferre poteft princeps remedium eft. Boerhaave 
Aphcr. 1123. Vide Comm, a Van Swieten. 
c Subito enim terreri, et expavefcere, in hoc morbo 
prodeft ; et fere, quicquid animum vehementer pertur- 
bat. Celf. Lib. III. Cap. 18. 
• Sunt autem praefertim hoc in numero, (caufaruna 
jnorbi fcilicet) graves animi per anxiam curam, trifti- 
tiam, 
F 2 84 
attended with low fpirits and defpondency, 
and it is found of the utmoft confequencerto 
the cure to counteract thefe as much as pdf- 
fible. 
It was noticed in Lord Anfon's Voyage, 
from reiterated experience of this malady, 
" that whatever difcouraged the feamen, or 
at any time damped their hopes, never failed 
to add new vigour to the di(temper ; for it 
ufually killed thofe who were in the 1 aft ftages 
of it, and confined thole to their hammocks, 
who were before capable of fome kind of 
duty. So that (as the writer w'ell obferves) 
it feemed as though alacrity of mind and 
fanguine thoughts were no contemptible pre- 
fervatives from its b fatal malignity?' A re- 
markable inftance of the good effects of ex- 
hilaration of fpirits is given in Mr. Ives 
tiam, et moerorem diuturnum, inductee perturbationes. 
Sic Eugalenus conftanter praedicere aufus ell, eos facile 
omnes quos cum crafiiori v ictus • ratione, diuturnior 
moeror exercuit, ad fcorbuticum malum efle, proclives. 
Cui adfentitur Willifius, qui nonnullos fortuito timore 
perculfos, fcorbuticos evahffi obfervavir. Hoffm. de 
Scorb. et ejus vera indole. 
b Anfon's Voyage, P. III. C. 2. 
Journal. 85 
journal. " Upon the Britifh fleet coming 
into the Bay of Theres (February 1744) our 
men underflood that the enemy's fleet and 
ours were foon to engage. There appeared 
not only in the healthy, but alfo in the Tick, 
the higheft marks of fatisfaftion and plea- 
fure, and thefe laft mended furprizingly 
daily, infomuch that on the nth of Febru- 
ary, the day we engaged the combined fleets 
of France and Spain, we had not above four or 
five, but what were at their fighting c quar- 
ters." 
The fiege of Breda, however, in the year 
1625, affords an example ftill more ftrik- 
ing, " That city, from a long fiege, fuf- 
fered all the miferies that fatigue, bad pro- 
vifions, and diftrefs of mind could bring on 
its inhabitants. Among other misfortunes 
the feurvy made its appearance, and carried 
off great numbers. This added to the other 
calamities, induced the garrifon to incline 
towards a furrender of the place, when the 
Prince of Orange, anxious to prevent its 
lofs, and unable to relieve the garrifon, con- 
• Ives Journal, February 1744. 
F 3 
trived, 86 
trivcd, however, to introduce letters 
drefled to the men, promifing them the moft 
fpeedy affiftance. Thefe were accompanied 
with medicines againft the fcurvy, faid to be 
of great price, but of ftill greater efficacy, 
many more were to be fent them. The 
effects of this deceit were truly aftoniffiing. 
Three fmall vials of medicine were given to 
each phyfician. It was publickly given out, 
that three or four drops were fufficient to 
impart a healing virtue to a gallon of liquor. 
We now difplayed our wonder-working bal- 
fams. Nor even were the commanders let 
into the fecretof the cheat upon the foldiers. 
They flocked in crouds about us, every one 
foliciting that part may be referved for his 
ufe. Chearfulnefs again appears in every 
countenance, and an univerfal faith prevails 
in the fovereign virtues of the remedies. 
The effect of this delufion was truly aftonifh- 
ing, for many were quickly and perfectly 
recovered. Such as had not moved their 
limbs for a month before, were feen walking 
the ftreets with their limbs found, ilraight, 
and whole. They boafted of their cure by 
the Prince's remedy, the motion of their 
joints 87 
joints being reftored by Pimple friction with 
oil, and the belly now of itfelf performed 
its office, or at leaft with a fmall affiftance 
from medicine. Many, who had declared 
that they had been rendered worfe by all 
former remedies, recovered in a few days to 
their inexpreffible joy, and the no lefs ge- 
neral furprize, by their taking what we af- 
firmed to be their gracious Prince's cure." 
f< This curious relation," adds Dr. Lind d, 
<c would perhaps hardly gain credit, were it 
not in every refpedt confonant to the molt 
accurate obfervations, and belt attefted de- 
fcriptions of that difeafe. It is given us by 
an eye-witnefs, an author of great candour 
and veracity, who, as he informs us, wrote 
down every day the ftate of his patients, and 
feems more to be furprized with their unex- 
pected recovery, than he probably would 
have been, had he been better acquainted 
with the nature of this furprizing malady. 
An important leflbn in phyfic, adds the ex- 
cellent writer laft mentioned, is hence to be 
learned, the wonderful and powerful influ- 
ence of the paffions of the mind on the Hates 
Lind on the Scurvy, p. 349. 
F 4 
and 88 
and diforders of the body. This is too often 
overlooked in the cure of diforders, many 
of which are fometimes attempted by the 
foie mechanical operation of drugs, without 
calling in to our afliftance the ftrong powers 
of the imagination, or the concurring influ- 
ences of the foul. Hence it is, that the 
fame remedy will not always produce the 
fame effeft, even in the fame perfon, and 
that common remedies often prove wonder- 
fully fuccefsful in the hands of bold quacks, 
but do not anfwer the purpofe in a timorous 
$nd diftruftful patient," 
GENUS 89 
GENUS XCI. 
Icterus. 
SPEC. 2. 
Spasmodicus. 
rpHE jaundice was formerly efteemed to 
to be fo liable to be produced by 
mental affedtions, that a jealoufy and b anger 
are often denominated by the attendant fymp- 
toms, or fuppofed caufes of this difeafe. It 
is c certainly often produced by thefe paf- 
a Cum tu Lydia Telephi, 
Cervicem rofeam, et cerea Telephi 
Laudas brachia, vx meum 
Fervens difficili bile tumet jecur. 
Horat. Od. L. I. Od. 13. 
. ... ut mihi Lepe 
Bilem, faspe jocum veftri movere tumultus. 
Horat. Epill. L. I. Epift. 19. 
• - calido fub peftore mafcula bilis 
Intumuit. Perfii Sat. L. V. 145. 
Si forte bilem movet hie tibi verfus. 
Mart. Epig. L. V. Epift. 27. 
e Hoffman relates a cafe where the jaundice was re- 
peatedly induced by mental commotions. De cachexia 
ifterica. Obf. 5. See too a cafe in Morgagni, Epift. 
XXXVIII. Art. 2, 
fionSj 90 
fions, even in this country, and is probably 
more likely to be fo in hot climates. Why 
thefe pafiions fliould produce this difeafe, is 
perhaps one of the fecrets of nature too deep 
for our comprehenfion. We may remark, 
however, that biliary obftruftions are parti- 
cularly prevalent in warm climates, to which 
both thefe pafiions are in a manner conge- 
nial. Whether they are in fuch fituations, 
caufe and effect, or both in their turns, is 
difficult to determine. 
GENUS CVI. 
Nostalgia. 
TH E laflr, and perhaps the moft re- 
markable inftance of the effects of the 
pafiions of the mind upon the body, is that 
of the noftalgia, or that defire of revifiting 
their own country when eftranged from it, 
lo particularly prevalent among the Swifs, 
and to a certain degree among all nations, 
thofe efpecially where the government is 
moderate, free, and happy. This diforder 
is faid to begin a with melancholy, fadnefs, 
' Sauvages Nofol. Meth. Art. Noftalgia. 
love 91 
love of folitude, filence, lofs of appetite for 
both folid and liquid food, proftration of 
ftrength, and a hedtic fever in the evening; 
which is frequently accompanied with livid 
or purple fpots upon the body. Sometimes 
a regular intermittent, and fometimes a con- 
tinued fever attends this diforder ; in the 
management of which, the greateft care is 
requifite not to cxhauft the ftrength and fpi- 
rits by evacuations of any kind. Naufea and 
vomiting are frequent fymptoms, but eme- 
tics are of no fervice. The Peruvian bark 
is the belt medicinal remedy, efpecially when 
joined with opiates; but when the diforder 
is violent, nothing avails but returning to 
their own country, which is fo powerful an 
agent in the cure, that the very preparations 
for the return prove more effedtual than any 
thing elfe, although the patient be debili- 
tated and unable to bear any other motion 
than that of a litter. The loweft ranks are 
not exempted from this difeafe, Mr. Sauvages 
tells us, he has feen the children of beggars, 
who had no habitation in Swiflerland but 
the ftreets and highways, equally affedled 
with thofe of higher rank. A particular 
mufical 92 
mufical compofition is in great vogue in 
Swiflerland, fuppofed to be expreflive of the 
happinefs of the people. If this be repeated 
among the Swifs in any foreign country, it 
tends ftrongly to recall their affection for 
their native foil, and their defire of return- 
ing, and to induce the difeafe confequent on 
the difappointment of their wifhes. The 
effe&s of this piece of mufic are fo power- 
ful, that it is forbid to be repeated in the 
French camps, and military ftations, on pain 
of death. 
Perhaps this is the only endemic diforder, 
of which we have any knowledge, that can 
fcarcely be called with juftice a national 
misfortune. The foregoing pages muft be 
confidered only as fome account of the cir- 
cumftances in which mental affecftions are 
'Specifically hurtful, or ferviceable. There is 
no doubt that they have a general effect in 
every condition of health, but in moft of 
thefe they a6t only as an exciting or debi- 
litating caufe, without any diftinguifhing 
property from many others. The dropfy, 
nervous atrophy, and feveral other com- 
plaints, 93 
plaints, are occafionally induced hereby, 
but their operation is generally flow and 
indiftinft, and only tending generally to 
weaken the powers of life. The diforders 
I have recited are fuch wherein the agency 
of the mind was more direft and more ob- 
vious. Perhaps feveral other difeafes may 
be added, but this treatife is by no means 
offered as a complete inveftigation of fo 
unbeaten a path. 
The above queftion may, I think, be very 
properly extended, fo as to refpeft the con- 
duct of a phyfician towards the Tick, inde- 
pendent of the medicines or regimen of life 
that he prefcribes. His commiffion is of 
larger extent, and comprehends every thing 
that may in any way tend to reftore or 
improve health. Among fuch articles, his 
behaviour to thofe he attends is of efpecial 
importance, and demands his moft particu- 
lar attention. 
Companion towards the diftrefied is a 
general obligation, but bears a peculiar 
reference to a profeffion, whofe ible employ- 
ment 94 
ment confifts in relieving a large clafs of 
the misfortunes incident to humanity. 
It is fcarcely poflible to imagine that there 
can be any perfons, converfant with fuch 
fcenes of diftrefs, as are fo often exhibited 
in medical practice, but muft frequently 
feel their hearts fympathize with the fuffer- 
ings of their fellow creatures ; but it is well 
known that various degrees of this quality 
pertain to different individuals, and it is the 
duty of a phyfician to encourage fuch bene- 
volent fentiments, and to ftrengthen their 
force by the habit of frequent exertion, and 
not to fuffer the repeated fight of mifery to 
render his feelings callous to tender impref- 
fions. 
It is not, however, fufficient for a phyfician 
merely to poflefs a humane difpofition and 
benevolent intentions. It is neceffary that 
he fliould render it apparent in every part of 
his conduct towards the fick, that he not 
only poflefles thefe virtues, but that he ftu- 
dies to exercife them in the mildeft and moft 
agreeable manner. '' Gentlenefs of beha- 
viour, 95 
viour, fays an elegant and humane writer, 
makes the approach of a phyfician be felt 
like that of a guardian angel, fent to afford 
eafe and comfort, whilft the vifits of the 
rough and unfeeling refemble thofe of a 
minifter of vengeance and deftrudtion." 
Care fhould neverthelefs be taken that 
fympathetic tendernefs be not indulged to 
fuch a length as to impair, materially, a 
man's private happinefs, or to enervate his 
mind in fuch a manner as to prevent his 
beft exertions to relieve thofe diftrefles that 
are fo much the fubjedts of his compaffion. 
He muft not forget that fteadinefs of 
character and prefence of mind are indif- 
penfable requifites to a phyfician. A certain 
degree of tendernefs is indeed fo far from 
being inconfiftent with thefe qualities, that 
it tends greatly to promote them, by fur- 
nilhing a powerful motive for their exertion, 
but when carried too far, is apt to difappoint 
its own purpofe. It is not the lead: advantage 
that is derived from the attendance of a phyfi- 
cian that, although he is fufiiciently interefted 
to 96 
to excite his beft endeavours for his patient's 
recovery, he is generally free from thofe 
agitations, which the more immediate con- 
nections of the fick mult feel in the danger- 
ous fituation of their friends, which muft 
neceflarily cloud the judgment, and embar- 
rafs the conduCt of thofe liable to fuch per- 
turbations. 
For thefe reafons the moll experienced 
practitioners do not hefitate to afk the advice 
of their brethren, relative to the diforders 
of their family or connections, from a con- 
fcioufnefs that too much anxiety for fuccefs 
often prevents the molt likely means being 
tried to enfure it. 
Another circumftance highly neceflary for 
the medical practitioner to keep always in 
view, is the fupport of a proper influence 
and authority with thofe he attends. This is 
neceflary on feveral accounts. Firfl: of the 
profeflion itfelf, which, when the directions 
of thofe who exercife it are difregarded, is 
expofed to contempt and ridicule. Next on 
the phyfician's private account, who not only 
fuffers 97 
fuffers a diminution of the refpeCl due to his 
character, but expofes himfelf to become re- 
fponfible for the propriety of meafures he had 
no ffiare in directing. 
Thelaft, however, and the moft important 
circumftance, is that by the lofs of the phy- 
fician's authority, the patient himfclf is ef- 
fentially injured. No fixed or fteady plan 
of treatment can be purfued. Remedies are 
advifed without prudence, and left oft before 
fufficient trial of them could be had, Thefe 
are multiplied by the officious impertinence 
of curiofity, which but too frequently in- 
trudes upon the fick, under the difguife of 
friendflaip ; and fhould the patient, from the 
inactivity of the medicine, be fo fortunate as 
to efcape pofitive injury, it often happens 
that the critical moments are fuffered to 
elapfe, in which fomewhat effectual might 
have been done towards his recovery. 
The maintenance of this neceflary influ- 
ence requires great prudence and command 
of temper, but is far from being inconliftent 
with fympathy and tendernefs towards the 
fick. 
G 98 
fick. On the contrary, I believe it renders 
fuch concern more pleafing and acceptable, 
as it proceeds from a charadber which claims 
our efteem and refpedt as well as our affec- 
tions. By what means this very neceflary 
authority may be originally acquired, or 
afterwards maintained, is more a matter of 
experience, joined with prudence and faga- 
city, than capable of being reduced to rule 
and order, or of being exprefled in diredb 
words. A few obfervations, however, on the 
fubjedb, may not be unneceflary. 
Some have endeavoured to acquire influ- 
ence over thofe they attend by a ftudied 
coarfenefs of manners, and even of dialed!:, 
by confidence in delivery of their fentiments, 
and peremptorinefs in exadbing the moll im- 
plicit fubmifiion to their didbates. This 
method, however, unworthy to be purfued, 
has fometimes met with fuccefs, but it has 
often happened that, when the novelty of the 
firft impreflion is over, confiderate perfons 
are tempted to examine the foundation of 
fuch bold pretenfions, and if, as muft often 
happen, the fuccefs and abilities of the prac- 
titioner 99 
titioner Ihould not be found to correfpond 
with fuch lofty claims to deference and re- 
IpeCt, the illufion vanifhes, and he is regarded 
only as one who attempts to impofe upon the 
world by afTuming a character he is unable 
to fupport. 
Others have attempted to recommend 
themfelves to the favour and confidence of 
their patients by excefs of attention and afil- 
duity. A minute and tedious enquiry is 
ufually made concerning the moft unimport- 
ant matters, and a long and often frivolous 
detail of obfervances, efpecially with regard 
to of diet, is generally recommended. 
This mode of proceeding, though fome- 
times flattering to the patient, as fuggefting 
the idea of the care and attention of the 
phyfician is, however, frequently productive 
of inconvenience. It is an ancient and ap- 
proved maxim, that a life guided entirely 
according to the directions of medicine, mult 
be a miferable one, and the mofl judicious 
practitioners, fenfible of the truth of this 
remark, generally endeavour, in chronical 
cafes, 
G 2 100 
cafes, to give as great latitude as poffible in 
articles of diet, and to reconcile every part 
of the regimen they prefcribe, as nearly as 
they can, to the common mode of living, in 
order that the patient may be reminded as 
little as poffible of his misfortune. But the 
method, here alluded to, has a direCt op- 
pofite tendency. Every circumftance of life 
being regulated by medical directions, has 
the effeCt of recalling every moment the 
ideas of ficknefs and trouble to the mind, 
and thus embittering life, and of courfe in- 
juring the fpirits and health. 
Even many articles of diet, otherwife 
agreeable, ceafe to be fo in a good meafure, 
when they are confidered as parts of a medical 
regimen ; and thofe things that are forbidden 
are often defired with uncommon eagernefs. 
Another difagreeable confequence often at- 
tends fuch a detail of directions, which is, 
that they are but imperfectly obferved ; and 
the omiflion is as likely to take place in 
things of real confequence, as in thofe that 
are unimportant, nay, perhaps more fo. 
Perfons that are difpofed to tranfgrefs, often 
plead 101 
plead the obfervation of frivolous articles as 
an excufe for the negledt of thofe that are 
of the greateft confequence. 
The maxim of the prefident Montefquieu, 
that " laws which render thofe things necef- 
fary, which are in themfelves indifferent, 
have the inconvenience of rendering thofe 
things indifferent that are abfolutely necef- 
fary," may be applied to medicine as well as 
to legiflation. 
To point out the line of conduft proper 
for a phylician to purfue on fuch occafions, 
would be too difficult an attempt for the 
author of this paper to engage in, and would 
befides exceed the limits proper for fuch a 
work, which it is feared have been already 
tranfgreffed, and is indeed lefs neceffary, as 
much has been laid to that purpofe by the 
late Dr. Gregory, whofe elegant manners, 
and benevolent actions, were the belt com- 
ments on the very excellent rules of conduct 
which he has laid down. 
The 102 
The admirable chara&er, to whofe memory 
the prefent inftitution is dedicated, might be 
ftudied with almoft equal advantage as an 
example in points of profeffional behaviour, 
as in what regards more immediately the 
province of medicine. The accounts we 
have of his life, evidence to demonftration, 
that humanity was the leading trait in his 
defcription, and might well be called his 
ruling paflion. His benevolence was more- 
over of the pureft kind. His beneficent 
deeds were not done before men to be feen 
of them. He was not anxious to have his 
name recorded in ftone or brafs, as the 
founder of a fplendid, and, perhaps, ufelefs 
charity. The reward he fought was of a 
higher kind, it conlifted in that fecret, but 
fublime enjoyment annexed by nature to 
fympathetic forrow, in the prayers and blef- 
fings of gratitude, offered to heaven, by thofe 
who had no other recompence to offer, in 
the approbation of the good and virtuous ; 
and above all in the fecret confcioufhefs that 
fuch a conduct, as he purfued, was agreeable 
to that Being whom we are fure to pleafe, 
if we humbly and earneftly endeavour to do 
it, 103 
it, and who is incapable of fuffering fuch 
endeavours to pafs without their full reward. 
His benevolence was not only generous and 
extenfive, but perfectly liberal in its appli- 
cation. Though a zealous member of a 
refpedable religious fociety, his kindnefs 
was not limited to thofe of his own perfua- 
fion. This appears from numerous inftances 
related of him in common life, as well as in 
his profeffional character. Misfortune and 
diftrefs were to him the moft powerful 
motives of recommendation. Like Marcus 
Aurelius, however he might regard the city 
of Cecrops, his affedion was (till irronger 
for the city of his God. 
The pleafing manner which accompanied 
the performance of thefe good offices ren- 
dered them doubly valuable. It augmented 
the efficacy of medicine by the comfort and 
fupport it afforded to the fpirits, and was 
fcarcely lefs ferviceable in cafes wherein even 
a relief of the diforder was fcarcely an objedt 
of hope, by reconciling people to their fitu- 
ation, which contributes above all things to 
foften the bed of ficknefs, and (far beyond 
the 104 
the power of flattery) to <c foothe the dull 
cold ear of death." 
The pleafing manners of this amiable 
man were particularly confpicuous in his 
behaviour to perfons in inferior Rations. His 
attention was not meafured out according to 
rank and riches, but adjuRed to real necef- 
fity. His delicacy prompted him to be often 
more fcrupulous in giving attendance where 
his emoluments were little or nothing, than 
where they were largely beRowed. The cot- 
tage of the labourer was by him deemed to 
be within his fphere of duty, equally with 
the palace of the nobleman. 
Notwithftanding the condefcending huma- 
nity manifefted by this excellent man, no 
one better knew how to fupport fuch a de- 
gree of authority and influence with thofe 
whom he attended, as was neceflary to en- 
force the obfervation of his directions. How- 
ever willing he might be to make the moft 
charitable allowance for thofe changes in 
the temper and behaviour that are but too 
frequently the confequence of bodily difor- 
der, 105 
der, he difdained to be the Have of caprice. 
His reputation was raifed by better means, 
than by fervile compliance with vice or folly. 
Much more might be faid upon this fubject, 
but it is, I truft, unnecefiary. The general 
character of Dr. Fothergill is too recent in 
the memory of thofe to whom this work is 
addreffed, to require being enlarged upon 
by fuch a feeble hand; and thofe who will) 
for more particular information may receive 
full fatisfadion from an elegant as well as 
accurate biographical account already pre- 
fented to the world. Many acknowledgments 
are due from the public at large, and par- 
ticularly from this refpedable fociety, to the 
founder of the prefent inftitution. He has 
raifed a monument to gratitude and friend- 
fhip on the broad bafis of public benefit. 
May fo benevolent and fcientific an attempt 
profper, and may the author receive, as part 
□f his reward, the fatisfadion of feeing nu- 
merous profefibrs of the healing art, and the 
members of this fociety in particular, ftimu- 
lated by this honourable diftindion to emu- 
late with greater ardor, the medical virtues, 
as well as knowledge, of Dr. Fothergill. 
FINIS. This Day is publifhed, Price 6s. in Boards, 
By C. Dilly,> in the Poultry; and J. Phillips, 
George-Yard, Lombard-Street. 
"fc/TEMOIRS of the Medical Society of London, 
Vol. I. containing 35 original Effays, viz. 
Art. I. On the character of TEfculapius, commu- 
nicated by Dr. Lettfom. II. Cafe of gangrene, by 
Mr. Luttrell. III. On the caufe and cure of teta- 
nus, by Dr. Rujh. IV. On palpitation of the heart, 
by Dr. Lettfom. V. Obfervations on deafnefs, by 
Dr. James Sims. VI. Cafe of retention of urine, by 
Mr. Norris. VII. Some remarks on the effects of 
quaffia, by Dr. Lettfom. VIII. Of the hydrocepha- 
lus internus, by Mr. Hooper. IX. On the hydroce- 
phalus internus, by Dr. Lettfom. X. Some account 
of an unufual exfoliation of the cranium, by Sir Tho. 
Gery Bart. XI. Of a fingular enlargement 
of the heart, by Mr. Ogle. XII. Of a morbid en- 
largement of the proftate gland, by Dr. Fothergill. 
XIII. An extraordinary cafe of delivery, by Mr. Shaw. 
XIV. Of the bronchocele, by Mr. Lane. XV. Cafe 
of rheumatifm, by Mr. Sherjon. XVI. A cafe of the 
itone in the urinarv bladder, fuccefsfully treated, by 
Mr. Harrifon. XVII. A cafe of hydrops ovarii and 
afeites, by Mr. French. XVIII. A cafe of angina 
peifforis, by Mr. Hooper. XIX. Cafes of hydropho- 
bia, by Dr. JohnJlone. XX. General remarks and 
cautions refpeiting fome cafes in furgery, by Mr. 
Wathen. XXL A cafe of head-ach, attended with 
uncommon fymptoms, by Mr. Henry. XXII. Cafe 
of angina pectoris, by Dr. Edward JohnJlone. XXIII. 
On the efficacy of the hyofeyamus, or henbane, in 
certain cafes of infanity, by Dr. Fothergill. XXIV. 
The cafe of a burn, and another of {tones in the kid- 
nies, by Mr. Lowdell. XXV. Cafe of a young lady, 
who fwallowed a knife, by Mr. Wheeler. XXVI. 
Cafe of a fpafmodic affection of the eyes, bv Mr. Say. 
XXVII. Of a difeafe, fucceeding the trarifplanting of 
teeth, by Dr. Lettfom. XXVIII. Remarkable effects 
of of cantharides in paralytic affections, by Dr. Vaughan. 
XXIX. Of an injury in the hand fuccefsfully removed, 
by Thomas Pole. XXX. Cafe of a biliary calculus, 
by Dr. Lettfom. XXXI. Cafe of an angina pectoris, 
by Dr. fohn/lone. XXXII. Of the fcarlatina angi- 
nofa of 1786, by Dr. Sims. XXXIII. Hiftory of a 
gangrene of tbe fcrotum, by Dr. Hubbard. XXXIV. 
A large exfoliation of the tibia removed, by Mr. 
IVhately. XXXV. Memoirs of Jacques Barbeu Du- 
bourg, by Dr. Lettfom. 
In the Prefs, and fhortly will be publiihed, 
MEMOIRS of the Medical Society of London, 
Vol. 2. 
The Society propofe to give the Gold or Fother- 
gillian medal of ten guineas value, to the beft Effays 
in anfwer to the following queftions. 
How is the human body, in health, and in a dlfeafed 
Jlate, affected by different kinds of air ? 
For the YEAR 1788. 
The above queflion flood propofed as the fubject of 
the Differtations for the prize medal of the prefent 
year, which was to have been adjudged on the 8th of 
March lafl ; but notwithflanding the ingenuity of the 
candidates, in explaining the nature and effects of 
different kinds of artificial air; the effects of atmofpheric 
air in different fituations and climates, fc. mountain 
air-marfli air-fea air-the air oi different cities, 
and different parts of the fame city-to which the en- 
quiries of the Society were meant to be principally 
directed, were not fufficiently inveftigated, nor any 
fatisfatory account given of this part of the fubjet; 
the adjudication of the medal of this year is therefore 
poftponed until the next anniverfary, on which day 
will alfo be adjudged the gold medal, 
For For the YEAR 1789. 
What circumfances accelerate, retard, or prevent the 
progrefs of infedion ? 
For the YEAR 1790. 
The gold medal will be adjudged to the author of 
the belt Diflertation on Cutaneous Dfeafes. 
They like wife propofe to give a filver medal to the 
beft original Eflay, communicated to the Society by 
any Fellow of it, within the year 1788. 
And another filver medal to the beft original Eflay 
communicated to the Society by any perfon, not &■ 
member of it, within the year 1788. 
The filver medals for the year 1 787, were adjudged 
to Dr. Wai er, phyfician to the General Infirmary 
at Leeds, for his Eflay on the Atrophia Ladfantium. 
And to Mr. Sherwin, of Enfield, Surgeon, for his 
Efiays ; on the fchirro-contradfed redtum ; on the 
external application of emetic tartar ; and on the ex- 
ternal application of arfenic.