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A DISCOURSE ON THE NATURE, CAUSES, and CURE OF CORPULENCY.

[Price One Shilling.]

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A DISCOURSE ON THE NATURE, CAUSES, and CURE OF CORPULENCY.

Illuſtrated by a REMARKABLE CASE, Read before the ROYAL SOCIETY, November 1757.

And Now firſt publiſhed, By MALCOLM FLEMYNG, M.D.

LONDON: Printed for L. DAVIS and C. REYMERS, Printers to the ROYAL SOCIETY, over-againſt Gray's-Inn, Holborn.

MDCCLX.

ADVERTISEMENT.

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THE AUTHOR of the following DISCOURSE had, above ten years ago, formed a reſolution of writing a full Treatiſe on Corpulency; both theoretical, and practical; with an appendix concerning its oppoſite extreme, thinneſs or leanneſs. And had accordingly not only drawn his plan, but began to raiſe part of the ſtructure in the year 1752, then living in London; but ſoon after returning into the country, at a great diſtance from well-furniſhed libraries, he could not come at the neceſſary books, for rendering his treatiſe as complete as he intended; eſpecially the foreign periodical literary tranſactions: which, he knew, furniſhed many obſervations relating to his ſubject. He was therefore obliged to lay aſide his intention. However, having ſucceeded in an extraordinary caſe of Corpulency, beyond his moſt ſanguine hopes; and that ſolely []by purſuing a method, which his own reflections had ſuggeſted, he drew up the following pages, in which the nature and cauſes of that burthenſome and dangerous ſtate of body, and the principal methods of cure indicated therein, are briefly, but he hopes clearly explained; and particularly the method which proved ſucceſsful, is fully deſcribed and accounted for. The paper was read in a meeting of the ROYAL SOCIETY, November 3, 1757. Though he had not obtained leave to mention in print, the perſon's name, upon whom the cure was made; yet he then produced authentic, and ſatisfactory vouchers for the truth of the facts; as the very learned and worthy ſecretary of the ſaid Soiety, Dr. BIRCH, will teſtify.

A DISCOURSE ON CORPULENCY.

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CORPULENCY, when in an extraordinary degree, may be reckoned a diſeaſe, as it in ſome meaſure obſtructs the free exerciſe of the animal functions; and hath a tendency to ſhorten life, by paving the way to dangerous diſtempers.

It is too great an accumulation of animal oil or fat, more or leſs over the whole body; but chiefly immediately under the ſkin, in the interſtices of the muſcles; and within the cavity of the abdomen or lower belly.

[2]

That Corpulency is cauſed by an increaſed quantity of fat, and not of blood, or any other ſubſtance whatſoever, is ſo clear and evident, that we may ſpare ourſelves the trouble of proving it. Butchers ſtalls ſufficiently evince it's truth, and the common ſenſe of mankind acquieſces in it; fat and corpulent being ſynonymous epithets in common converſation.

Till within a century ago, anatomiſts had a very imperfect notion of the manner, in which the fat is diſtributed, and lodged in the animal body; they imagined that it lies in confuſed cluſters or heaps, ſticking to the parts where it is found, without being contained in cells, or ſmall membranous cavities. But now it is generally and certainly known, that it is repoſited in the cells or veſicles of a certain web or texture, called membrana, or tela celluloſa; which is ſpread over the whole body, not only immediately under the ſkin, but penetrating likewiſe into it's inmoſt receſſes; and entering, more or leſs, into the compoſition of almoſt every part. The cells of this web [3]or tiſſue are ſo framed, as to communicate together all over. Where they are wideſt, they contain oil or fat. Where they are too minute for that purpoſe, they receive a fluid jelly or moiſt vapour.

The fat is a ſecretion from the blood, made by the moſt ſimple ſecretory apparatus, to wit, arteries bringing the blood, from which the fat is to be ſeparated; and lateral veſſels of a leſſer diameter ariſing from theſe arteries, which ſtrain off the fat or oil, and convey it to the cells or veſicles, where it is to be repoſited; while ſmall veins, continued with the arteries, return into the common channel of circulation that part of the blood, which hath paſſed by the mouths of the lateral ſecretory canals. The tumidity, with which the oil, when new ſeparated, abounds, is ſucked up by extremely ſmall tubules of the venous kind, opening into or communicating with the fatty cells, and ſo the fat or oil remains more pure or unmixed.

The uſe of the fat is in general to lubricate the parts, that they may move and ſlip over one another eaſily, and therefore muſcles [4]are plentifully ſupplied with it; to prevent brittleneſs in the bones, which for that reaſon are furniſhed with marrow (for marrow and fat ſcarce differ at all from one another) to temper, and, as it were, ſheath acrimony; and laſtly, to fill up the chaſms and interſtices, which, without ſome ſuch contrivance, would be left between parts adjacent to each other, thus procuring a beautiful ſleekneſs to the ſkin. In particular we have good reaſon to believe, that the fat of the omentum or cawl, where it is always found in conſiderable quantity, if the ſubject is not very much emaciated, is ſubſervient to the functions of the liver, and contributes towards the matter of the bile. But I confine myſelf to the principal ſubject of this diſcourſe.

The efficient cauſes of Corpulency may be deduced to theſe following:

Firſt, the taking in of too large a quantity of food, eſpecially of the rich and oily kind, with a ſuitable digeſtion. Every thing that nouriſhes, contains oil more or leſs, which however ſcanty in proportion to the other conſtituent parts, is yet actually ſeparated [5]and extracted from them by the powers of the animal machine, and, as it were, treaſured up for it's proper uſes. Horſes, cows, ſheep, and many other animals, thrive and fatten upon graſs, hay, and even ſtraw, with water. But the pooreſt diet, that can nouriſh, and tolerably ſupport the human ſpecies, contains much more oil, than graſs or ſtraw. Oil may be preſſed out of the farinaceous grains in common uſe. Animals of every kind, however lean, yet contain ſome fat, and thoſe we daily feed on, a very great deal. Whoever, therefore, throws in a large quantity even of the plaineſt wholeſome food, at the ſame time lays in matter, out of which Corpulency is more likely to be produced, than out of a more ſparing meaſure thereof. And, beyond all doubt, that effect will more ſpeedily and certainly be brought about, if the aliment is oily and rich; provided it is rightly digeſted. Not that all corpulent perſons are great eaters; or all thin perſons ſpare feeders. We daily ſee inſtances of the contrary. Tho' a voracious appetite be one cauſe of Corpulency, it is not the only cauſe; and very often not even the conditio ſine qua non thereof.

[6]

Secondly, too lax a texture of the cellular or fatty membrane, we have already mentioned, whereby it's cells or veſicles are liable to be too eaſily diſtended; and therefore receive and retain too great a quantity of fat. And perhaps theſe cells may be originally of a larger ſize and capacity in ſome, than in others. This diſpoſition may be connected with a general laxity of the ſolids, but it may likewiſe be in a great meaſure local, and ſubſiſt by itſelf; there being no abſurdity in ſuppoſing one part or ſet of parts in the human frame to be over-relaxed, while the reſt continue in a laudable ſtate. This particular cauſe of Corpulency I incline to believe often runs in families. It may likewiſe be connate, that is, interwoven with the original ſtamina, and brought into the world by the infant, tho' it's parents and anceſtors had been otherwiſe conſtituted. But, no doubt, it is much ofter acquired by the manner of living of the corpulent perſons; ſuch as a plentiful, rich, relaxing diet; a ſedentary life; much ſleep; an indolent tranquillity of mind; warm bathing, &c.

[7]

Thirdly, ſuch a mixture or craſis of the blood and it's ſerum, as ſuffers the only parts to be too ſafely ſeparated from it's other principles, eſpecially it's aqueous vehicle; the whole being too weakly and imperfectly blended and united together. This fault may either depend upon the general inaction of the ſolids, whether conſtitutional or acquired; and the chief means of bringing it on are, as hath been ſaid, plentiful, luxurious diet, and want of exerciſe; or upon an over-proportion of oily particles in the blood, and it's ſerum; which may require a greater energy in the ſolids, though otherwiſe laudably conſtituted, than they can exert, in order to get the better of that exceſs, and complete the union of the heterogeneous parts.

Fourthly and laſtly, Corpulency is cauſed by a defective evacuation through the outlets of the body, of that fat or oil, which hath been already ſeparated from the blood, and repoſited in it's proper cells. As whatever is alimentary contains oil, if we did not daily expell part of it out of the body, we ſhould ſoon be buried under our own [8]fat. Thoſe, who keep up for a conſiderable number of years nearly the ſame weight of body, muſt diſcharge daily a quantity of oil or fat, nearly equal to what they take in. Sweat, urine, foeces, and no doubt inſenſible perſpiration likewiſe, all contain oil in an healthy ſtate; and therefore, if they are not in a pretty conſtant way ſufficiently charged therewith, to ballance the quantity conſtantly introduced with our meats and drinks, Corpulency muſt neceſſarily enſue. This deficiency is, I believe, moſt frequently occaſioned by a too ſedentary way of life. But it likewiſe may be influenced by the fat's not being ſo eaſily diſſolvible in, and remixed with the blood as it ſhould be, in order to be readily enough brought to the emunctories; and ſo may in ſome caſes be a conſequence of the cauſe deſcribed in the preceding paragraph. For, if the blood and it's ſerum hath already too eaſily parted with it's oily particles, that happened becauſe in them the oil was not ſtrongly enough united and blended with the other conſtituent principles, and therefore the ſame quality of the blood and juices will render them ſo much the more unfit to re-diſſolve, and ſweep it out of the cells, in which it is [9]laid up, back into the channels of circulation and excretion.

To recapitulate, Corpulency being an accumulation of too great a quantity of fat, or animal oil in the veſicles of the membrana celluloſa, wherever they are large enough to admit oily particles, it can be cauſed either by the introduction of too much oil into the habit, through the channels of nouriſhment, whereby there is ſo much the greater chance of it's being retained in too great a quantity—or by the over-laxity, or perhaps original over-largeneſs of the cells, in which it is repoſited, diſpoſing them to admit, and retain an over-proportion of it—Or by ſuch a craſis or temperament of the blood, as renders it liable to part too eaſily with it's oily particles, and let them be ſtrained off in too great plenty by the ſecretory veſſels—Or laſtly, by a deficient evacuation or expulſion of oil already taken in and ſeparated from the blood, and laid up in it's cells through the outlets of the body—By one, or more of theſe cauſes, or perhaps all of them concurring in the ſame conſtitution, and, I think, ſcarce by any [10]other of moment, can Corpulency be produced and eſtabliſhed.

Having enquired into the nature, ſeat, and efficient cauſes of Corpulency, we now proceed to lay down the rational methods of cure, founded on the reſult of this our enquiry. In the doing of which, we ſhall but briefly treat of ſuch things relating to the ſubject, as are commonly known and delivered in books; and be more full concerning the particular means we propoſe, in order to diminiſh and keep under this burthenſome ſtate of body, and prevent it's bad conſequences; to recommend and enforce the uſe of which, this paper is principally intended.

Diſeaſes, like other faults and imperfections, are, in a general way, to be attacked and conquered by remedies, oppoſite or contrary to the cauſes that brought them on; and that is exquiſitely the caſe with reſpect to Corpulency. We ſhall therefore, in delivering the method of cure, follow the order, in which we have treated of it's cauſes.

[11]

And firſt, the diet of corpulent perſons ought to be as moderate in quantity as prudence may direct, and one's patience can ſubmit to. Celſus adviſes ſuch to eat only one meal a-day. With us cutting off ſuppers may be ſubſtituted in the place of this rule. As to how much food is to be taken at one time, the beſt advice I can give is, after eating ſuch a quantity, as is known in a common way to ſupport perſons in health and ſtrength, to ſtop, as ſoon as the craving of the ſtomach will permit; and ſo riſe from table with an appetite. In ſome caſes it may be expedient to damp the ſtomach immediately before meals, by eating fruits or ſweetmeats; by drinking a glaſs of ſweet wine; or other ſuch ſafe means, as one's own experience will beſt direct. Variety of diſhes ſhould not be made free with; as they are apt to tempt one to tranſgreſs in quantity.

With reſpect to quality, the food of the corpulent ſhould be lean and plain, rather than rich and palatable. Celſus enumerates amongſt the cauſes that fill or plump the [12]body. Aſſumpta per cibus aut potus maxime dulcia & pinguia. Courſe brown bread is here preferable to the white, finer ſort, as being more opening and leſs nouriſhing—Roots, greens, and other eſculent vegetables, with a ſparing quantity of butter, difpoſe leſs to Corpulency, than animal foods; as they contain leſs oil; yield juices leſs viſcid, and paſs more readily out of the body—Wines in a general way are leſs feeding than malt liquors; eſpecially ſuch as are thin, ſharp and old—Acids, and vinegar in particular, have a remarkably emaciating quality; but muſt be uſed ſparingly, and with caution.

The cauſe of Corpulency, mentioned in the ſecond place, being a flabby, relaxed ſtate of the membranous texture, in the cells of which the fat is collected, the indication of cure anſwering thereto, is to ſtrengthen that texture, ſo enabling it the better to reſiſt diſtenſion; and, by it's contractile power, to expel ſome part of it's contents. In order to anſwer this end the more effectually, it is requiſite, firſt to diminiſh, if we can, in a conſiderable degree, the quantity of fat already contained in [13]theſe cells, that they may be the more at liberty to contract themſelves; and afterwards remaining in a contracted ſtate, recover their tone. In the next place we muſt take care ſo to concert meaſures in order to ſtrengthen either the ſolids in general, or the cellular texture, where the fat is lodged, in particular, as neither to counteract the other methods directed againſt Corpulency, of which more in the ſequel; nor riſk hurting the particular conſtitution we are treating. Cold bathing (proper diet and exerciſe being ſuppoſed to go along) bids faireſt to anſwer the end we have in view. But it will be both ſafer and more effectual after the bulk is conſiderably diminiſhed than before. And it ought never to be uſed without great caution, leſt it ſhould prove hurtful in other reſpects; for I ſcarce know any remedy that is more generally, and more dangerouſly miſapplied, than cold bathing. As to ſtrengtheners taken inwardly, whether under the title of diet or medicines, they for the moſt part either whet the appetite, or render the body coſtive, both which are unfavourable to the cure of Corpulency; and upon that account they, as well as cold bathing, will come into uſe [14]with greater advantage, after the body is conſiderably reduced, than before.

The third cauſe of Corpulency being too eaſy a ſeparation of the oily particles of the blood from it's other contents, eſpecially the aqueous vehicle, ariſing from a weak and imperfect union of the different elements together, what occurs to me as moſt directly tending to it's removal, is,

Firſt, by a ſpare and plain diet to withhold, or at leaſt diminiſh the daily freſh ſupplies of oily matter to the blood; that the ſolids, by whoſe action and energy that union, and as it were coheſion of the principles of the blood effected, may not have more work, to do than enough: And,

Next to excite the action of the ſolids; which is to be done chiefly by exerciſe; under which, I comprehend friction or dry rubbing of the ſurface of the body, eſpecially the trunk, as a meterial article. And this kind of exerciſe is ſo much the more neceſſary to extremely corpulent perſons, that they can ſcarcely uſe any other with remarkable effect. Strengtheners, that heat moderately, [15]if judiciouſly choſen, may come in as auxiliaries.

The cauſe of Corpulency aſſigned in the fourth and laſt place, being a defective evacuation through the outlets of the body of the animal oil or fat already taken in, the curative indication naturally ariſing therefrom, is to promote and increaſe that diſcharge, by the ſafeſt and moſt effectual methods; that ſo the daily waſte of the oily parts being brought to exceed the conſtant ſupplies thereof, the quantity remaining within the habit may be properly diminiſhed. Now the common natural excretions, to wit, urine, foeces, ſweat, and inſenſible perſpiration being in a healthy ſtate, always more or leſs charged with animal oil, its expulſion is to be procured through theſe channels; and indeed it can ſcarce be brought about any other way, without violence to the conſtitution. If therefore, one or more of theſe excretions be increaſed with ſafety to the general health, and without leſſening proportionably the reſt, the quantity of fat in the body muſt in time be diminiſhed.

[16]

Inſenſible perſpiration, in our climate can carry off but little oil, eſpecially in corpulent perſons, where the extraordinary accumulation of fat under the ſkin muſt compreſs the arteries that go to it; through the ſmall excretory veſſels, that ariſe from which, the matter of perſpiration paſſes, and is conveyed off; and therefore no mighty ſtreſs is to be laid upon promoting that diſcharge, more than what friction may effect.

Frequent purging, if it could be ſafely brought on, would no doubt be a ſpeedy and effectual means of reducing Corpulency. We ſee often in practice what vaſt quantities of animal juices, all which contain oil more or leſs, are evacuated per annum, in a diarrhaea or cholera morbus; and how much the patient is emaciated thereby in not many hours. But it is dangerous to proceed far this way by art. Purgatives often exhibited, beſides weakening the general habit by carrying off the nutritive ſerum, hurt the ſtomach through which they muſt paſs; and the inteſtines ſtill more, where they exert their principal efficacy, and muſt remain longer; they may bring on dyſenteries and [17]ulcerations of the guts, with all their direful train of ſymptoms, by abating the natural mucus of the parts, dyſenteries, hemorrhoids, &c. What therefore is moſt adviſeable to be done by the corpulent perſon in this reſpect is, to uſe ſuch a diet and manner of living, as may prevent coſtiveneſs; and occaſionally take ſafe openers in ſmall doſes, and no oftner than is neceſſary to remove it. Aloetic medicines are here preferable to rhubarb (except where piles are troubleſome) as they are leſs apt to leave a binding quality after their operation is over, walking, in a general way, promotes the evacuation per anum. Riding, as well as a ſedetary life, encourages coſtiveneſs.

Sweat ſeems to contain more oil than the other fluid excretions; and therefore promoting it often, if it could be done ſafely and conveniently, might no doubt be of the higheſt efficacy in reducing a corpulent habit—The ſafeſt way of raiſing ſweat is by encreaſed muſcular motion, as walking hard, playing at tennis, exerciſing ſome laborious mechanic employment, or the like. The next ſafeſt way in my opinion, is by moiſt heat; as in a bagnio. Medicines given to ſweat [18]upon, beſides the uncertainty of their operation, may do hurt by overheating and by changing the craſis of the blood and juices, for the worſe, if they are frequently adminiſtred.

The laſt of the natural excretions, by which animal oil is carried out of the body, is urine. The urine of a ſound perſon, made after a due concoction of the aliments and chyle, contains an animal oil exalted by repeated circulations, and the heat of the body, and tending ſomewhat to the volatile and putrid, as all chymiſts of note agree. Now, as the excretion of urine may be promoted by a variety of diuretics, with leſs ſhock to the conſtitution, than that by ſweat, or ſtools; and with tolerable certainty too, where there is no morbid obſtruction of the paſſages; it would appear highly reaſonable to conclude, that animal oil may both more ſafely, and more effectually in the end, be diſcharged out of the body through the channels of urine, than by any of the other ways already treated of; as the increaſing of that evacuation can be brought about more conſtantly and uniformly; and longer perſiſted in, becauſe attended with leſs danger or inconveniency. [19]But that diureticts may be employed to the beſt advantage, in order to diſcharge the animal oil, and by that means reduce Corpulency, it is requiſite to chooſe out of that extenſive claſs of medicines, ſuch as, beſides increaſing the quantity of urine, may at the ſame time render the animal oil more mixible with the watry vehicle of the blood, than otherwiſe it would be. Urine, beſides water, which conſtitutes much the greateſt part of it, contains oil, as hath been already ſaid, an eſſential ſalt peculiar to itſelf, reſembling ſal armoniac in many reſpects, but differing from it in ſome material properties; and a fine ſubtiliſed earth abraded from the veſſels, by the conſtant motion of the liquids through them. But 'tis the increaſe of the evacuation of the oil only, that can diminiſh Corpulency; and therefore it is evident that ſuch diuretics, as are endowed with the property above-mentioned, are to have the preference here.

Now we are ſo happy as to be in poſſeſſion of a diuretic medicine, which hath that quality in a ſingularly eminent degree; and is withal ſo ſafe, as that it may be taken in large quantities every day for years together, without remarkably impairing the general health: [20]that medicine is ſoap, which we ſhall here endeavour to prove, both by reaſon and obſervation, to be exquiſitely proper for reducing Corpulency, in the ſafeſt and moſt effectual manner; in a word, its true remedy where it is curable.

Soap in general (for there is a variety of ſoaps) is a compoſition conſiſting of a vegetable, fixt, alcaline ſalt, made by incineration, and oil or fat, whether animal or vegetable, with the addition of quick-lime, in ſome form or other, intimately and inſeparably incorporated together, by boiling according to art. Quick-lime, by the aſſiſtance of boiling, hath been found by experience to be the fitteſt bond of union between theſe two ſo different and repugnant ſubſtances, without which it cannot be completely effected, at leaſt not ſo eaſily and commodiouſly. Soap, as is well known, is entirely diſſolvable in ſoft water; and that ſolution aſſiſted by heat, agitation and friction, diſſolves, beſides gums and reſins, likewiſe oil, and animal fat, incorporating them with itſelf, thus fitting them to be ſcoured and waſhed off from the ſubſtances they adhere to. And therefore its general, as well as its original uſe, is to clean cloaths, eſpecially [21]linnen, when ſoiled with animal filth, in which oil is the predominant ingredient, as being both moſt penetrating, and adhering moſt obſtinately; at the ſame time cementing with itſelf other ſoiling particles of whatever kind. And yet, by the means of ſoap, they are eaſily reſtored to cleanneſs, ſweetneſs, and whiteneſs.

It is leſs to be wondered that ſoap ſhould have been introduced into the regular practice of phyſic, as an inward medicine, conſidering its wonderful diſſolving virtue; than that it was introduced ſo late. In Lemery's Dictionaire des Drogues, firſt publiſhed at Paris, in 1694, the fulleſt and moſt noted book of its kind in the hands of the public at that time, and for ſome years after, there is no mention made of the internal uſe of ſoap. It hath been much uſed inwardly ſince, and deſervedly held in great eſteem as a reſolvent, detergent, and deobſtruent; and of late as a lithontriptic. It is found to be a diuretic of the milder ſort. The great run of Mrs. Stephen's medicines, both as publiſhed by herſelf, and as ſince new modeled and amended, not to mention numberleſs caſes well known to the public, in [22]which ſoap hath been given for the ſtone either by itſelf or with lime water, ſufficiently evince its ſafety, whole ounces having been exhibited every day for years together, without remarkably injuring the conſtitution.

As therefore ſoap is diuretic; hath a ſingular power of rendering oil or fat mixible with water; and withall is ſo fafe, as that it may be given in large quantities, and its uſe long continued, we may fairly conclude, that it is a moſt effectual, harmleſs and eaſy remedy for reducing Corpulency; and, to ſum up all, more to be depended upon than any other yet propoſed. This will farther appear from the following conſiderations. Perſons inclined to Corpulency ſeldom think on reducing their ſize, till they grow very bulky; and then they ſcarce can, or will uſe exerciſe enough to be remarkably ſerviceable. It becomes a great trouble to them: Indolence uſually gets the better of reſolution, and feeds the growing evil, until what was at firſt only diſagreeable and difficult, becomes at length impracticable—Where a rich and plentiful diet is one principal cauſe of Corpulency, as it often is, the habits of good eating and [23]drinking becomes ſo deeply rivetted, as ſcarce to be conquered. A luxurious table, a keen appetite, and good company are temptations to exceed often too ſtrong for human nature to reſiſt. Sweating and purging for the increaſe of inſenſible perſpiration, as hath been already obſerved, is herein inſignificant, though very proper now and then, yet cannot be uſed with ſafety frequently and conſtantly enough to do the buſineſs by itſelf, and atone for errors in point of regimen—whereas ſoap may be ſafely uſed in large quantities every day for years together.

It is no ſmall additional recommendation in favour of this remedy, that it is highly proper for relieving complaints, and curing diſeaſes ariſing from Corpulency, even independently on diminiſhing it, ſuch as amongſt the chronic tribe, ſhort windedneſs; lethargy, &c. of the acute kind, baſtard peripneumonics, which are more difficult to cure in very ſat perſons than others: and in general whatever diſorders may be owing to viſcidity of juices, a never failing attendant on plenitude, and defect of motion. But to proſecute this head farther, would lead us beyond [24]the bounds we have at preſent preſcribed to ourſelves.

We now proceed to take into conſideration the manner of exhibiting ſoap, with a view to reduce Corpulency. And firſt let us chooſe the fitteſt kind for that purpoſe. Spaniſh ſoap, particularly that from Alicant, is at preſent moſt eſteemed for inward uſe. And although in the obſervation I am going to relate, the common home made Caſtile ſoap was uſed, yet, I heſitate not to give the preference to that from Alicant. It is not only a more cleanly and leſs diſagreeable medicine, but is much more eaſily diſſolved in water; and therefore muſt anſwer better in every intention where ſoap is required.

As to the manner of exhibiting it, I think once a-day may be ſufficient. And I apprehend the propereſt time is at night when going to bed. A drachm (the eighth part of an ounce) may be tried for the firſt four or five days: and if that creates no remarkable diſorder in the ſtomach or bowels, the quantity ſhould be increaſed to two, three, and in very ſtubborn caſes, to four drachms; which laſt doſe, I think, needs not in any [25]caſe to be exceeded. It may be taken either ſliced down ſmall, and made into the form of a bolus or electuary, with any palatable ſyrup, as that made with orange or citron peel; or it may be ſwallowed in the ſhape of pills; or it may be diſſolved in a gill or more of ſoft water, and ſo drank.

This courſe ſhould be continued at leaſt three months, in order to give it a fair trial; in which time, without great errors on the corpulent perſon's ſide, I think it highly probable, that remarkable benefit will be felt in a common way. If good ſervice is really done, the patient will, at leaſt ought to be, encouraged to go on. If his patience ſhould ſometimes be tired out, he may intermit the uſe of the remedy for ſome days; and afterwards reſume it for three or four months longer; and ſo on, dropping or renewing the courſe, as his own direction, or ſkilful advice may beſt direct.

The following caſe, will, I hope, greatly both illuſtrate and confirm what hath been hitherto ſaid. A worthy acquaintance of mine, a judicious and experienced phyſician, in his younger days had been very active, [26]and uſed much exerciſe, both on foot and on horſeback; and for many years ſeemed as little liable to extreme Corpulency as moſt people. By inſenſible degrees, as he diminiſhed his daily labours, ſatneſs ſtole upon him, and kept increaſing; inſomuch that, when I met with him about ſix years ago, I found him in the greateſt diſtreſs through mere Corpulency, of any perſon not exceeding middle age, I ever knew. He was then about forty-five. He was obliged to ride from houſe to houſe to viſit his patients in the town where he practiſed, being quite unable to walk an hundred yards at a ſtretch; and was in no ſmall degree lethargic. In other reſpects, he ſeemed pretty clear of any remarkable diſeaſe, except gout, of which he had felt ſome, not very violent, attacks. I warmly recommended the inward uſe of ſoap, in order to reduce his Corpulency, as the only ſafe and effectual remedy in his caſe, and a remedy which he might continue to uſe the longeſt; I enforced my advice by the reaſonings above urged, of which he was too good a judge not to perceive their full cogency. Accordingly, he began to take it July, 1754, at which time he weighed twenty ſtone and eleven pounds, [27]jockey weight, a vaſt load for him to bear, who is little above middle ſtature, and withal ſmall boned. He took every night at bed-time, a quarter of an ounce of common home-made caſtile ſoap, diſſolved in a quarter of a pint of ſoft water. In about two or three months time, he began to feel more freedom, and an increaſe of activity, which encouraged him to perſevere. And that he did with ſuch ſucceſs, that in Auguſt, 1756, (as he informs me in a letter now lying before me) his bulk was reduced two whole ſtone weight; and he could walk a mile with pleaſure. He had continued the uſe of the ſoap all the time between June, 1754, and Auguſt, 1756, with very ſhort interruptions, in the manner and quantity above mentioned; it operated remarkably by urine, without ever producing the leaſt troubleſome effect. And now, while I am ſending theſe pages to the preſs, (April 1760) I am certainly informed that he is hearty, and well.

Theſe facts are well known all over the town, where my friend reſides, and it's neighbourhood; and it is the general opinion, that, had it not been for the relief [28]that was then given him, he muſt have been in his grave long before now. Let me add, that he uſed no other method or medicine all the while, to which the extraordinary change in his favour, can with any colour of reaſon be imputed.

I have taken opportunities of recommending the ſame remedy to others, in ſimilar circumſtances; but have not been as yet informed of any caſe, in which a thorough trial thereof was made. However, as it proved ſo ſignally ſerviceable in the inſtance above-mentioned, under ſuch diſadvantages, I hope it may be fairly concluded it may prove uſeful in a general way, at leaſt in caſes leſs ſtubborn: which conſideration is ſufficient to recommend it to the attention of phyſicians, and the public.

FINIS.

Appendix A This Day is publiſh'd,
[Price One Shilling,]

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A DISSERTATION on Dr. JAMES'S FEVER POWDER, in which the Different Circumſtances, wherein that Remedy may prove beneficial or hurtful, are conſidered and diſtinguiſhed, according to Obſervation and Reaſon.

By MALCOLM FLEMYNG, M.D.

Printed for L. DAVIS and C. REYMERS, Printers to the ROYAL SOCIETY, over-againſt Gray's-Inn, Holborn.

Appendix A.1 Lately publiſhed by L. DAVIS and C. REYMERS, Printers to the ROYAL SOCIETY,

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  • I. A Treatiſe on the Diſorders of the Teeth; in which the ſeveral Operations on the Teeth are conſidered; and ſuch Things as are found deſtructive to them particularly pointed out. By Fred. Hoffman, M.D. Phyſician to his prefent Majeſty, the King of Pruſſia, price 1s.
  • II. An Account of the Sore Throat attended with Ulcers. By John Fothergill, M.D. pr. 1s.
  • III. Doctor Warren's Treatiſe on the malignant Fever in Barbadoes, and the neighbouring Iſlands, in a Letter to Dr. Mead, pr. 1s.
  • IV. Clifton Wintringham's Medical Works, 2 Vol. pr. 6s.
  • V. Dr. Malcolm Flemyng's Diſſertation on Dr. James's Fever Powder; in which the different Circumſtances, wherein that Remedy may prove beneficial or hurtful, are conſidered and diſtinguiſhed, according to Obſervation and Reaſon, pr. 1s.
  • VI. Dr. Parſon's Analogy between the Propagation of Animals and that of Vegetables, pr. 4s.
  • VII. The Hiſtory of England, as it relates to Religion and the Church, from the earlieſt Accounts to the preſent Century. By F. Warner, L. L. D. Chaplain to the Right Hon. the Lord Keeper, 2 Vol. Folio, pr. 1l. 16s. half bound.
  • VIII. Lord Somers's Tracts; the laſt Eight Vol. being the third and fourth Collections. Three Guineas will be allowed for the firſt Eight Volumes to any Gentleman that may be inclined to part with them.
  • IX. Travels in Egyt and Nubia, by Frederick Lewis Norden, F. R. S. Elegantly printed in Two Vol. Fol. with near 200 very fine Copper Plates.
  • X. The ſame Work in Octavo, with Plates, pr. 6s.
  • XI. The learned Mr. Chiſhull's Travels in Turky, and back to England, by Dr. Mead, 14s.
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Zitationsvorschlag für dieses Objekt
TextGrid Repository (2020). TEI. 5615 A discourse on the nature causes and cure of corpulency Illustrated by a remarkable case read before the Royal Society November 1757 And now first published by Malcolm Flemyng M D. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5D73-B