NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service ^$l^»S?S?I$8$i 3S2ffi5HHttf£2£< U I S S E R T A T I O ■ N ON THE GOUT, AND ALL C H R Q NIC DISEASES. \.M* tmmv®MW??$mm®mm® *. * A DISSERTATION ON THE ^ G O U T, A N-D ALL CHRONIC D I7S E A S E S, JOINTLY CONSIDERED, As proceeding from the {ame Cause*, What thofe Causes are ; AND -\ A rational and natural Method of Curs propofed. AddrefTed -to all Invalids. By WILLIAM CADOGAN, Fellow of the College of Physicians. THE TENTH EDITION. S(uod petit in te eft. LONDON; PRINTED. BOSTON, Re Piinted and Sold by Edes & Gill in Queen-Street \ M,DCC,LXXil. .i- t /x-*. II .. \ . . ftrc:- ; ' '*.** ;■« * P R E F A C E. TO enjoy good h ■ alth lsbtttcr-4-haii to cwitjianJ the ivorjj, fays a celebrated practical pbilojpher*', it ho under f-ad the ufe and value of life and health better then *'.'■'/ jneh ; ;-,r in exile, nvith a-final I income, and no very god c-jujht.itiou, he cultivated an uncommon let.gtb of days iiuo a i'atic?:*?' j: ries of pleafures ;*andn.Q'^at is vmch more, an htiinterrujltd ourfeofhappinefs. But, as far as 1 can find, he tvas almoji the only man that did fo. The generality of meK fee>H to me not to bejloiu a thought upon either, till it be too late to reap the benefit of their conviction ; fo that health, like titoe^ becomes valuable only twhe»*it is loft ; and ive can no longer think of it but 'with retrofpe.il and regret. That 7nsn in good health, the young and gay in their careert 'fhouldbe negligent of it, or abufe it, refufing to flop and lijlen to, or take nuaming from others, is no great ii>ohder \ but it is very furprifihg that mankind in general fhould be tirijiaken and mified for ever in the fame perpetual round of fruiilefs attempts to hepair and eflablifh it ; not the ignorant vulgar only, but the fenfible, the judicious, men of parts, & khoAulilg! in other things, in this cafe equally blind, fjyould ptiffue, with the fame vans hope, after repeated difappoiniment-., the thou* fand and ten thoufand idle arts and trick's of medication and quackery ; never once lifting thAr eyes up to Nature, of con-- fulling her book, open as it lies for theperafalj Conviction and benefit of all. * St. Ev ernond. *'///J3 vi PREFACE. Some induflrioux men. fancying that whatever is valuable Viufi lie deep, have, 'with the greatef alacrity in finking, plunged into the immertfe abyfi of ancient, Greek, Roman and Arabic learning, in hopes to find good precepts of health, and fure remedy for difeafe. But after all their pioneering into endlefs heaps of rubbif!?,< 'what have they found at laji hut this ? That in natural philofophy fome of the ancients >were very ingenious in gueftng -wrong ; for guefs was all they did ; they never fludied Nature at ail, they made no experiments, and therefore knew nothing of her ; but either blindly follow- ed or combated each other's opinions : fchool againfi fchool,and feci againfi fed, -.uaged equal and endlefs war. In the art of phyfic it was impoffi'ule for them to know much ; for before'our immortal Harv ey's difcovery of the circulation, there could be no fhyfiology at all, nor any knowledge either of the internal firuilure or aclion of any one part of the body. Before the juflly celebrated Asbllius and Pequet there could be no idea of nourifihmenj ; nor was it known how -our food pajfed into the blood, 'whether it went there or not, er what became of it. But now,fwce thefe lights have fhone in upon us, all the ancient conjeflures, reafanings, and fyfiems, mufi vanifh like morning clouds before the fun. Befides all this, there are fame of our difeafes which the ancitnts had not, nor have we all theirs : fome few, and very ufeful, difcoveries )hey made in medicine, which have defcended to us, and with fome late tricks in chemiflry are the chief foundation ofmodern quackery. Thus, have men of deep learning, if the know/edge of ancjettt •errors c-an be called fo, funk far out of fight tf truth, which in things of general ufe and necejfity, particularly the health tf mankind, lies mofi commonly upon the fur face. It has been cf great dijfervice, as well as difcredit to the art* of Phyfic, and every fair praclifer of it, that men's expeclati- MS ^ave been raifed by the ignorant and pre fuming, or the dif- henefl and artful, to hipe'for too much from it, more than it tverdid, or can do. Refpite and relief may be had in mofi chronic cafes ; remedy, I fear, but in very few, if it be ex- pecled from art alone. But a Jkilful and honefl .Phyftc'tan funicfs he be fent for too late and 4&fmije*d too ftn, which is generally the cafe) will employ thofe intervals of relief to in- troduce the powers of life and nature to aft for themfelves, and in fenfibly withdrawing all his medicines, and watching care- % fitfty over his patient's whole condufl, leave him confirmed, fr&>n convifl'ton of their necejfity, in fueh good and falutary habits, as cannot fail to eflablifh his health for life. Pojlbljr, PREFACE. Pojpbly, if men wsre better informed of the real caufes of ■ their difeafes, they might be lefs unreafonabte in their demands, and learn to be contented with prefent relief; fubmitting Reader to confider as, what it really is, a hafiy V rxtratl of a much larger work, intend, d to take in the whole circle of Chronic Difeafes, here comprehended only in their re- prefentative the Gout. If what I have faid may feem to want ^ farther illujiration, or more demonjlrative proof, he will look upon it only as a /ketch to furnifh hints for "his own thoughts and reflections, either to improve mine or rejefl them en fir ly, cs may feem good unto him. If he thinks, from what I have faid here, or in the brochure itfelf 'bat I mean to impeach the prafiice of phyfic in general ; J fay, that it is not my in- tent r-n. I would decry all quacks, ftom JEfcuhpius to the prefent, either as ignorant fools, or filj convifred impoftv.s, advertizing daily lies ; whether mounted ci.fiagcs, or riding in chariots. But the art of phyftc fairly ,-ind hohdrly pr-^tifd Ihonour as the firfil of' profefions, comprcrrr-d'vigth'e v:oi> if»- /;/, the mofi extenfive and v.-:->erfal kno»y-i--dge-rf nattue ' / think a real Phyftcian th -,/J liberal cf chut afters vf-'.n earth; bywhic, I do nctn:,7r every Doftorjhat goes about iaii'.g guineas.. b.:t him who «,'..' neither Hatter th? great nor deceive the tgnoranty $■ d'wt.> wUd prefer the fails faflion of makingone invalid dh^lthy ,,an, /„ t'^ wealth of RaJcliff or the vogue o/Ward. But there is an e :/ hirif of quackery gone firth, that has poffstfed all orders %f<'-?n-n c:nr.-,--j us, ? would lay it, if I could, together with every ,■',:>. tt' ■: '■'" [■;'-:r- fiition, fraud, and error, and reflore the world to truth and' nature. > > George-Street, Hanover-fan are, Nov. 20, 177 1." *"V v* ■• X ♦I* 4* 4* 4*4* 4*4* 4* 4*4*4* 4* 4*4*4* 4* 4*4*4**!* 4* 4* 4* 4* 4* 4*4* 4* *tf frl-t>U frlftll/i >l< >L-^"-» *<+ ■ <'*"* >[<, >U»lt*|-ttl(i tlttll iL Jt -^ '' ''' *■* »1^aI^. i|< ||* DISSERTATION O N T H E G O U T, &c. OWEVER common it may be for men that fuffer to complain of the evils of life, as the unavoidable lot of humanity ; would they flop but for a moment to confider them in JoJfjL2?*rIB *&£ light of reafon and philofophy, they k a^^^CkL ^ would find little or no foundation for them «..J*jC j*IR-jfc jn na(:ure . fcut that every man was the real author of all or mod of his own miferies. Whatever doubts may be entertained of moral evils, the natural, for the moft part, fuch as kodily infirmity, ficknefs, and pain ; all that clafs of complaints which the learned call chronic difeafes, we moft undoubtedly bring upon ourfelves by own indigen- cies, exceffes, or miftaken habits of life ; or by fuffering our ill-conduced paffions to lead us aftray or difturb our peace of mind. Whatever notions men have been taught or have re- ceived of other caufes, fuch as accidental colds, or particu- larities of conft/tution, this or that thing difagreeing or fur* feiting, &c. thefe are too trifling to produce difeafes that commonly laft for life : there muft be fomething more fub- ftantial, fomething more conftant and permanent in our daily habits, to produce fuch inveterate evils. Though if you read authors or confult practitioners, what do you find, but that you have taken cold, though you know not how, or that your complaints are gouty, rheumatic, bilious, nervous, Sec. ? words that fatisfy, though they^give no kind of idea, and feem to have gained credit and affent only by the politenefs B of [ io ] of phyficians, who, while they are taking their patients mo- ney, are too- well bred to tell them difagreeable truths-, and that it is by their own faults they are ill. To enquire a lit- tk further into this matter may be well worth our trouble ; the tafk feems to have been left for me, and I will perform it moll fincerely. I have long had it in my mrrod to write upon chronic dif- eafes in general, in the hope of giving mankind, what moft affuredly they have never yet had, a few rational ideas about them; thinking that, if the true original caufes of them were fully and fairly fet forth, men could not be fo capitally mif- taken to impute them, as they do, to the falfe and imagina- ry, and therefore apply falfe .and imaginary remedies; nor think that the general health of mankind were to be ovcrfet by every trifle, and the recovery of it lay hid in a few drops or powders of any kind. Did they better underftand the na- ture of chronic difeafes in general, and whence they proceed* they could not be fo unreafonable to think they might live as they lift with impunity, expecting repeated remedy from art; or, did they know any thing of the nature of medicine, they would find that, though fits of pain have been relieved, or ficknefs cured by it tor a time, the eftablifhment of health is a very different thing, depending upon other powers and principles : the firft may be and often is done by medicine, the. other never. That their opinion ot medicine is vain and ridiculous rauft appear, I think, very evidently to any on« who recollects that the art of phyfic has now been pra&fed, more or Iefs regularly, above two thoufand years; and moft affuredly there is not yet difcovered any one certain remedy for any difeafe. Ought not this to make us fufpedt that there ts no fuch tiring ? How can it be, when different degrees of the very lame difeafe require various means and msthods, and the fame thing that in one degree would relieve, or per- haps cure, in another might kill ? It is by plan, by regimen, and fuccefiive intention, that difeafes muft be cured, when they are curable ; or relieved and palliated when they are not. The fkilful in medicine, and learned ia nature, know well that health is not to be eftabJifhed by medicine ; for it's effects are but momentary, and the frequent repetition of it destructive to the ftrongeft frames ; that if it is to be reftor- ed, it muft be by.gently calling forth the powers of the body to ad for themfelves, introducing gradually a little more and more activity,' chofen diet, and, above all, peace ot mind, changing intirely that courfe of life which firft brought on the difeafe : medicine a>operatiug a little. That this is [ » ] the truth, all who know any thing of nature or art muft know: and I may fafely take upon me to fay, that, though I firmly believe health may be reftored in moft cafes that are not ab- folutely mortal, I am very fure that no invalid was ever made a healthy man by the mere power of medicine. If this be the cafe, how muft the initiated, according as their humani- ty is touched, either laugh at or pity the poor foolifh world, furrendering at difctetion to the moft ignorant of quacks, pretending to infallible remedies which are .not in nature. But what is ftill more ridiculous, the patients themfelves are often fo a (Turned to own they have been deluded, that they favour the cheat, by pretending to relief which they never felt. I have collected a few materials for this work, which L intend to put in order, as foon as I can find time and induftry enough to fet about it in earneft ; and, if I can finifti it to my own fatisfaction, perhaps I may fome time or other trou- ble the work! with it. At prefent I think myfe'lf particu- larly called upon to fay fomething of the gout, as that dif- eafe was to make a confiderable part of my plan ; and, as I fee now fo many, and hear of more, who are throwing away, not only their money very foolifhly, but, as I verily believe, the future health of their lives alfo, in hopes of a medical cure for it, to fhew that fuch hopes are chimerical, and con- tradictory to every idea of true philofophy and common fenfe. I fhall therefore take a few extracts from this general plan, fufficient to fhew the real original caufes of aii chronic difeafes ; which, though they have been multiplied without end, and numberlefs caufes been affigned them, are certainly not many, and their firft caufes very few. I think they may very fairly be reduced to thefe three \ Indolence, Intempe- rance, and Vexation. From one or more of thefe three caufes, I have undertaken to prove that all or moft chronic difeafes are produced ; for different difeafes may have the fame original caufe, the dif- ference proceeding from the various degrees of ftrength and vigor in bodies ; fo that what would be gout in One, in ano- thermightbe rheumatifm, ftone, cholic, jaundice, palfy, &c. The gout is manifeftly.and I think confefledly, a difeafe of the befl confutation, and may therefore fairly ftand as a repre- fentative of all the reft : as fuch I fhall confider it for the prefent, and fpeak of thefe caufes in their order : but it mvty be neceifary to fay a word or two of the gout itfelf before we enquire into it's caufe. The gout is fo common a di&afe, that there is fcarcely a man in the world, whether he has had it or not, but thinks B 2 he E " } he knows perfectly what it is. So does a cook-maid think fee knows what fire is as well as Sir Ifaac Newton. It may therefore feem needlefs at prefent to trouble ourfelves about a definition, to fay what it is: but I will venture to fay what I am perfuaded it is not, though contrary to the general opi- nion. It is not hereditary, it is not periodical, and it is not incurable. If it were hereditary, it would be neceffarily tranfmitted from father to fon, and no man whofe father had it could poffibly be free from it : but this is not the cafe, there are many inftances to the contrary : it is therefore: not necSfTari- ly fo ; but the father's having it inclines or difpofes the fon to it. This is the caufa proegutnenaov pradifponent of the learned, which of itfelf never produced any effect at all; there imuft be joined the caufa procatarflica, or active efficient caufe, that is, our own intemperance or miftaken habit of life, to produce it ; and accordingly, as this operates more or lefs, fo will the gout be. Our parents undoubtedly give us con- ftitutions fimjlar to their own, and, if we live in the fame manner they did, we flxall very probably be troubled with * the &me difeafes j but this by no means proves them to be hereditai-y : it is what we do ourfelves that will either briag them on, or keep us free. ■.. , If it were hereditary, it would appear in infancy and iri women, which in general it does not. I may be told of fome women who have had it. I believe never very young, nor till they had contributed to it themfelves ; for women, as well as men, may abufe a good conftitution. I have heard likewife a boy or two out ot a million that had it, or fomething like it ; but thefe boys had been fuffered to fip wine very early, and been fed and indulged every way moft unwholefbmely. Thofe, who infift that the gout is hereditary, becaufe they think they fee itfo fometimes, muft argue very inconclufive- ly ; for if, we compute the number of children who have it not, and women who have it not, together with all,thofe active and temperate men who are free from it, though bosn of gouty parents ; the proportion will be found at leaft a hundred to one againft that opinion. And furely I have a greater right from all thefe inftances to fay that it is not hereditary, than they have from a few to contend that it is. What is all this, but to pronounce a difeafe hereditary, and prove it by faying that it is fometimes fo, but oftner not fo i Can there be a greater abiurdity ! ' Some [ '3 ] , Some men qbferving, in the circle of their acquaintance, the children of gouty parents afflicted with the gout, and often very early in life* though they are what they call tem- perate, conclude, not unnaturally,, that the difeafe muft be parental, and unavoidably transfufed into their conftitutions. If this were the cafe, it muft be for ever incurable, and the fins of the father vifited upon the children not only of three or four but endlefs generations to come. Difeafes really hereditary, I fear, are never cured by any art or method whatever, as is but too true in the cafes of fcrophula and madnefs, and difeafes of taint or infection, and malforma- tion. But here lies the error, their idea of temperance ip by no means juft*: for fome man require a greater degree, a ftricter mode of it than others, to be kept in good health,. I make no doubt but if the lives thefe gouty defcendants lead were clofely inquired into by real phyficians, they would be found to commit many errors, and to Jin often againft na- ture's law of temperance, or to want that conftant peace of mind or regular activity p£ body which are as neceffary as temperance, not only to keep off the gout, but to preferve health in general ; and thus it will appear at laft that they have contributed to it more than their parents. If the gout be a difeafe of" indigeftion, and therefore of our own acquiring, we muft reafou very ill, or rather not reafon atall, when we fey it is hereditary; for furely no man wili fay that indigeftion is hereditary, any more than intemperance. There are whole nations of active people knowing no luxury, who for ages have been free from it, but have it now fince the Europeans have brought them wine and fpicits. If the govt be thought hereditary becaufe it is incurable by medicine, the fame may be faid of every other chronic difeafe, none of which ever are cured by it, I mean, fo as not to return again. When was there a man who, having had one fit of rheumatifm, ftone, colic,, &c. however happily re- lieved by art for a time, had it not again and again, or fomething worfe in the place or it ; till he became a con- firmed invalid, & died long before his time ; unlefs fomeYery remarkable alteration took place in the courfe of his life to confirm his health ? So it is in the gout .• a man gets a fit of it, and by abftinence, patience, time, and nature, the crude acrimony producing it is fubdued and exhaufted, and he is relieved for that time j (he might be fo much fooner, and very fafely too, by the afuftance of art judicioufly employed) $ he • See Chapter of Inltrriperanee, p. 41. [ H 1 he recovers however, and in a few months is taken again. Why ? Not from any thing inherent is his conftitution, but becaufe he returned to his former habjj: of life that produ- ced it at firft.and will for ever produce it, while the ftrength of his body lafts. s . The truth is, we breed it at firft, we renew it again and again, and bring it on ourfelves by our own roiltakes or faults, which we would fain excufe by throwing them back upon our parents, that our complaints may be more juftiy founded. And as bankrupts, undone by idlenefs and ex- travagance, forever plead loffes and misfcrtunes ; 10 do we inheritance, to exculpate ourfelves. It is natural enough for thofe who believe the gout here- ditary to think italfo periodical, as if fomething innate and inherent in our conftitutions produced it at certain times : but this is a great miftake ; for, if it were periodical, it muft be regularly fo. The only periodical difeafe I know is the intermittent fever, which, till it be difturbed by the bark or any other febrifuge, is as regular as a good clock. The returns ot the gout are always very uncertain, according to the quantity or quality of accumulated indigeftion within, and the ftrength of our bodies. I come now to fhew that the gout is not incurable. If by the cure of it be meant the adminiftering a pill or a powder, or medicine of any kind to do it, I fear it is and ever will be incurable. It has been long and often attempted in vain, from the origin of phyfic to this day, from the firft quack to the prefent. Indeed there is a moft glaring abfurdity at firft fight, that muft ftop any man of common fenfe, who has the leaft infight into nature, or knowledge of the human frame t for, if the gout be the neceffary effect of intempe- rance, as I hope to fhew very evidently that it is, a medicine to cure it muft be fomething that will enable a man to bear the daily intemperance of his future life unhurt by the gout or any other difeafe ; that is, fomething given now that will take away the effeet of a future caufe. As well might a me- dicine be given now to prevent a man's breaking his leg or his neck feven years hence. One would think the utmoft that any rational man could expect from medicine was, that it fhould have power to relieve and remove prefent diforders^, leaving the body quite free, without pretending to infure it from future injuries. Here lies the error : men think the gout to be fomething latent in the body now, which, once well eradicated, would never return ; not fufpecting it to be «o more than each day's indigeftion accumulated to a cer- tain E is ] tain pitch, that, as long as the vigor of life lafts, always brings on every fit, which once well over, the man has no more gout, nor feeds of gout in him, than he who never had it; and, if he did not breed it again, moft certainly would ne- ver have it again. A proof of this, is, that the gout has been often cured by a milk diet, which, as long as it lafted, has generally kept the patient free. But this method ot cure I cannot approve, becaufe it relaxes and enervates the man. and does not fufficiently fupport the health and vigour of his bod/. Though I think the gout incurable by medicine, it is fo far from being incurable in its nature, that I am firmly per- fuaded it may be more eafily and more perfectly cured than almoft any other chronic difeafe ; and this is another ftrong argument that proves it not hereditary. My reafon is, that it is confeffedly a difeafe of the ftrongeft and beft conftitutioa relieving itfelf by throwing off harm and bad humors from the vitals and out of the blood upon the extremities, where they do leaft harm to the powers and principles of life and health ; and as thefe humors can be nothing more than the daily accumulations of indigeftion,if a man can live withont breed- ing constantly this indigefted acrimony, he may moft undoubt- edly live free, not only from the gout, but every other chro- nic difeafe alfo. And that h« may live fo, not in a perpetual ftate of mortification and felf-denial, but with great eafe and comfort to himfelf, in the trueft, moft philofophic luxury, I fhall endeavour to prove, I hope to the fatisfaction of all thinking, reafonable men. I have faid, that Indolence, Intemperence, and Vexation, are the original caufes of all or moft of our chronic difeafes : perhaps a few accidents muft be excepted, to which the ftrongeft and healthieft are moft liable ; and the effects of fe- vers not happily ended ; and which I expect, to obviate all cavil and difpute with the men of art. I believe, to every confiderate man, whofe eyes have been opened fo as to give him the leaft infight into nature, the truth of this propor- tion will be fo felf-evident, that he muft inftantty perceive it ; and every invalid that will be candid enough to do it, may fairly trace all his co/nplaints up to^me or other of thefe caufes. But it may require fome explanation to the genera- lity of men, who atre fo fhort-fighted as never to look back or forward far beyond the ken of their nofe, and therefore never fee either diftant caufes or effects ; and when they are fick feldona enquire more than for fome cold or forfeit of ye- fterday, and to fome fuch trifling caufe impute difeafes that laft [ I< ] laft for life, An accidental cold or even debauch that hap- pens but feldom can have no fuch effect ; and men other- wife healthy, living in good habits, foon get rid of both. It is the conltant courfe of life we lead, what we do. or neg- lect to do. habitually every day, that if right eftabhfhes our health, if wrong, make us invalids for life. Men ignorant of the ways of nature in the produtfion and fupport of animals, not knowing what fhe requires to preferve them in health & vigour to their utmoft period, have conceived very ftrange and meft affuredly very falfe ideas of difeafes in general, & feem to think every difeafe a diftinct kind of be- ing or thing, and that there are medicines oppofed to each, that will certainly remove and cure it. This makes them fo folicitous to know the name of their complaint, which once afcertained, they think the remedy not far off. Poor men ! Is not the gout fufficicntly diftinguifhed ? But where is the remedy ? Certainly not In the precarious fkill of pre- ferring doctors, or the fecret of ignorant and enterprizing quacks. They fancy too that there is great variety of con- fiiiution, with difeafes unavoidably peculiar to eagh :^ that certain times of life muft produce many, and that it is Im- poffible to grow old without ficknefs of fome kind or other. There is certainly no foundation in nature for any of thefe opinions, nor is there any real effenti&l difference of conftitu- lion, but offlrongor weak, and this is produced more by habit than nature. The ftrong by bad habits will become weaker, and by good the weakftronger. But the moft deli- cate frames may be as healthy as the ftrongeft, for the fame reafon that a fquirrel may be as healthy as an elephant. There is no difeafe neceffarily peculiar to any time of life, the changes into the different ftages of it may affect the va- letudinary. And it is poflible for men to live to great age without any difeafe at all, for many have lived to upwards of an hundred with uninterrupted health. Not from the natural defects of our conftitutions therefore, but the abufe of them, proceed all our chronic difeafes. That is, from Indolence, Intemperance, or Vexation. Let us now proceed to enquire what muft be the neceflary effect of one or more of thefe caufes acting datiy upon the body ; whether in the ftrongeft and moft vigorous frames it muft not be the gout : in weaker, rheumatifm, colic, ftone, palfy, &c. or any, or all of the nervous and byfterical clafs. Firft, of Indolence, by which I do not mean infenfibility, but an inactive habit of life, taking the word in tb,e general common fenfe it is now ttfed. Of [ '7 ] Of Indolence. IT feems to have been the defign of Providence that all men fhould labor, every one for himfelf. That fome are rich enough to purchafe the ftrength and activity of others is a mere accident with regard to individuals, in which the care of Providenee appears to be no otherwife concerned, than having unequally diftributed thofe powers and abilities by which active and fiery fpirits rife uppermoft to preferve the harmony of fubordination, without which fociety could never exift. The rich and great have fo far forgot this firft principle of nature, that they renounce all bodily labor as unworthy their condition, and are either too lazy or too in- attentive to fubftitute exercife inftead of it : thus facrificing health to indulgence and dignity, they do not enjoy thofe ad- vantages their fuperior Rations and fortunes give them ; but in happinefs fall often below the laboring hind. I remem- ber to have feen a very ingenious little book upon the origin of evil, in which labor is confidered as a great evil. The a- greeable author muft furely mean when it is exceflive, and ur- ged on to the wearing and wafting the body ; for in general it is the firft principle of good to mankind, and to none more than the laborious themfelves. Does he mean that it would be better for us all, did the earth fpontaneoufly bring forth her fruits in fuch abundance, that we fhould no more labor or contend for them than we do for the air, and have no- thing to do but bafk in eafe, and riot in enjoyment ? If fo, I can by no means agree with him ; for foon, very foon, in fuch a (late of things, there would not be one healthy man upon the earth, and the whole race muft quickly perifh. In- deed, I am afraid, notwithftanding all our unreafonable and unphilofophical complainings, the utmoft wit of man cannot remove the leaft evil out of nature, without taking with it all the good. But begging pardon for this little digreffion, and to come back to my own purpofe, I think he had been nearer the truth, had he put Indolence in its ftead, which is a fource of great evil. Nothing undermines the foundation of all our happinefs, the health and vigor of the body, like it, or lays fuch a train of difeafes to come. But I muft endea- vour to fhew in what manner. It is upon the minuteft and alrooft invifible parts of the body, our beft health, ftrength, and fpirits depend : thefe fine parts.commonly called capillaries,are little pipes or tubes, the extended continuations of the larger blood-veffels, thro* C which [ i8 ]. which the fiueft parts of the blood muft conftantly pafs, not only to keep thefe very fmall channels always free and open, but alfothat the particles of the blood m*y in their paffage be attenuated, broken.and rubbed into globules perfectly fmooth and round, and eafily divifible into flill lefs and lefs.till they efcape the fight affifted even by the microfcope ; which gives ocular demonftration of this moft amazingly minute circula- tion. I have obferved myfelf, and any curious patient man may fee with a good microfcope, in the pellucid membrane of any living animal, thhrfecpriring minutenefs. He may fefefland obferve onefingleveflel, the fmalleft of thofe that convey red blood, many of which would not equal the fmall- eft hah- in fixe, through which the blood may be feen pafiing;, not like a fluid, but a number of little red foKd balls pufhing one another on till they come to the'extremity or ramification of the veffel where it divides into two ftill lefs. There the firft globule, flopping a little, and recoiling, is pufhed on a- gain till it divides into two, and, lofing its red colour, panes on in the fmaller pipes fitted only to receive the ferum ; which undergoes the fame circulation till it be refined intc* lymph, and this into ftrll finer fluids ; which, being thus pre- pared, efcape into a fnbtilty beyond all poffible obfervation. Now the ftrength of the heart and arteries alone, in a feden- tary courfe of life, is by no means fufficient to keep up and perpetuate this motion through theft capillaries,but require* the affiftance and joint force of all the mufcles of the bod; to act by intervals, cbmprefs the veins, propyl and accelerate the circulation of the whole mafs of blood, in order to force and clear thefs pipes, and to triturate, cribrate, and purify the fluid paffing through, forming every particle of it into a perfedt globule, which is the form all the atoms of matter muft take from much agitation. Without this extraordinary occafionalaid, the little veiTels would, by. their natural clafticl- ty, clofe up into fibres, or be obftructed by rough angular particles flicking in them, and flopping all* paffage. Nura- berlefs evils of the chronic kind, efpeciolly all nervous difea- fes, owe their origin to this caufe alone. Accordingly we fee moft of thofe who lived for any time in a ftate of indolence, grow emaciated and pale by the drying up of thefe fine vef- ftls ; or, it they happen to be of a lax. habit, having a good appetite, and nothing to vex them, they may be loaded with fat.; but they grow pale withal, many of thofe fine pipes being neverthelefs elofed up ; fo that they appear bloated, and their fat unwholfome, having much lefs blood in their veins than thinner people. Hence we may learn why thefe languid I ip. 3 h^fSirlt PZC°tt? uP°n -the ,caft motion ***** ^int and fEl 5 IS'i^ebl00dhJttr!:y,ng l^ough the larger veffels yet free and, like a crowd obftructing its own patage.caufiag a dang^usfuffocat.on Or, if they have not blen long in this Kate, nor the capillaries quite clofed, they glow, efbeci- ally young women, with a momentary red, the fine veffels SSJrlth.at tim^ landed. Thus inactivity firft forms obaructtons in thefe exqu.fitely fine parts, upon which the health and v.gor both ofbodyand mind depend cntirely.and lays the foundation of many difeafes to come ; which other concomitant: ch-cumftances, fuch as a violent cold, excefs of Ifl^'A ^fr9m without. or * particular difpcfuion llfr J5 7iTl !?' ™>V>ften fatal to many in this habit of lite; aad-which the induftrious and active never feel rflN?W * Jonld afe any reafonable perfon, capable'of con- tiering this operation of nature with the leaft glimmerinjr of P^fophy, or even the attention of common fenfe, anl HZ1^J^r"concerns every man to confider it well, Whether he can conceive it poffible to fubftitute any medicine to be fwallowed, that fhall a# upon the blood and veffehi like the joint force of aU the mufcles of the body, arting and reading occafionally in a regular courfe of moderat? daily labor or exercife. Unlets this can be done, I will ven- ture to pronounce that there is no fuch thing as a laffing •cure'either for the gout or any other chronic difeafe. Yes, &ir, fays a common practitioner, cordials, volatiles, bracers. f^ngthene«will do this, will keep up an increafed clrcu- !lT' Jfib]y fhey ?*? for a few hours- bX do\ng mifchief fcrtnany days : but their aftion foon fubfides, and the fti- mufus ceafes ; they muft therefore be repeated and repeated for life. Woe be to him that takes them, and to* him that wSti »ff\°nlfefs k be d°ne with great judgment. While they aft they coagulate the juices and corrupt the *no!e mafs of blood; and whenomitted.the patient muft feel atTthe languors & horrors of a crapulary fever after repeated debauch ; and muft have recourfe to them again and again, like a dram-drinker, who cannot bear his exiftence but in a Uate of intoxication. No, art can never come up to nature m this moft falmaxy of all her operations. But thefe obflructions from crude particles of the blood, and this inanition of the capillaries, are not all the evils pro- duced by indolence That fprightly vigor and alacrity of health which we feel and enjoy in an active courfe of life, that zeft in appetite, and refrefhment after eating, which fated luxury feeks in vain from art, is owing wholly to new c 2 blood [ 20 ] Wood made every day from frefh food prepared and diftri- buted by the joint aetion of all the parts ot the body. No man can have thefe delightful fenfatians who lives two days with the fameblooi but muft be languid and fpiritlefs. To introduce new juices the old muft be firft thrown off, or there will be no room, there will be too great a plethora or ful- nefs ; the firft caufe of difeafe in many cafes. In a ftate of inactivity the old humors pafs off fo flowly, the infenfible perforation is fo inconfiderable, that there is no void to be filled ; confequently by degrees the appetite, which is the laft thing that decays, that is, the defire of fupply, muft daily dimiriifb, and at laft be totally loft. Here art can do wonders ; it can procure evacuations ; we can bleed, purge, and vomit ; but then, to do any good by thefe, the cafe muft be recent, before the humors are vitiated by tpo long a ftay in the body, which will be the cafe very foon, for they are all in a perifhable ftate, which makes their daily re- newal fo effentially neceffary to health : but then thefe ar- tificial evacuations difcharge all alike ; the new, the middle, and the old juices ; that is, the chyle, the blood, the ferum, and lymph ; and by this indifcriminate action make ftrange confufion in thofe that remain : whereas in nature's courfe there is a conftant regular tranfmutation and fucceffion from one ftate to another ; that is, from chyle into blood, and blood into ferum, ferum into lymph, and fo on, till they are all in their turn, hiving done their office in various fhapes, elaborated and ground to fuch a minute fubtility and fine- nefs, that, like wave impelling wave, they fuccefuvely pafs off in the vapor of infenfible perforation. In a ftate of indo- lence they do not pafs off either fo foon or fo regularly as they ought, becaufe there is not motion, nor confequently heat enough to throw off the vapor : they lodge in the body too long, grow putrid, acrimonious, and hurtful many ways, like the matter formed in an ulcer, which, while it is yet fweet, is more healing than ^ny balfam the furgeon can apply ; but, when confined, it foon becomes corrofive, and like a cauftic eats it's way all round in fiftulas to find vent. This thews the virulent acrimony of thefe confined and ftagnating humors : hence the breath-and perfpiration, what there is of it occafionally, of indolent people is never fweet; and henc** in jails, where thefe noxious vapors are collected and condenfed from crouded wretches languifhing in indo- lence, very malignant and peftilential fevers arife. Perpetual blifters have been often thought, and fometimes found, to be ferviceable in draining off fome of thefe fuper- fluous [ « ] fluous juices before they are much corrupted, and making, by a taint refemblance of nature's action, a little more room for new ; and it is for this reafon they do any good at all, by increafing the general circulation, and forcing off a few of thofe humours that had circulated too long in the body, and were becoming acid : for the quantity they difcharge is fo trifling, that there could be no phyfiology, nor even common fenfe, in fuppofing the evacuation to be the benefit ♦ procured. By a vomit or a purge the difcharge is a hun- dred fold more, but tne good obtained not always fo great, becaufe by thefe the humors are indifcriminately thrown off, and much more of the new than the old. Many have ufed frequent bleeding to renew their blood, and I have known it anfwer very well to fome, efpecially old people who had been long accudomed to it, whom it preferved to great age : but then it muft be begun in time, before the whole mafs of hu- 'gaors be vitiated, and continued for life. Is it not ftrange