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The CERTAIN METHOD to KNOW the DISEASE.

A LECTURE ADDRESS'D TO STUDENTS IN PHYSIC.

Medicus, ſi quidem ſuffecerit ad cognoſcendum; ſufficiet etiam ad ſanandum.

HIPPOCRATES de Arte.

LONDON: Printed for J. ROBERTS, near the Oxford-Arms in Warwick-Lane. MDCCXLII.

TO STUDENTS in Phyſic.

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GENTLEMEN,

IT is univerſally agreed, that among the ſeveral other Branches of Learning, neceſſary to the Accompliſhment of thoſe, who are Candidates in the Art of Healing; the judicious Inſtructions of an able, practical Phyſician, is a Qualification of the firſt Moment. The Reaſon of the preſent Conceſſion is very evident: Becauſe [ij]the Pupil, as the Reſult of ſuch an happy Inſtitution, according to the Standing of his Profeſſor, may, in a few Years, enter upon Buſineſs, with greater Advantage, than he could poſſibly do, in many, without ſuch Aſſiſtance. For myſelf, I own, I am too vain, not to account it a ſingular Felicity in my Life, that I have been bleſs'd with an Opportunity of attending Sir RICHARD MANNINGHAM'S Lectures in Midwifery and Phyſic.

I PAY a greater Deference to that GENTLEMAN'S good Senſe and diſtinguiſh'd Modeſty, than either to affront the one, or inſult the other, by attempting any thing, that might carry the Appearance of an Encomium, tho' religiouſly confined to his juſt Praiſe: Nevertheleſs, as every generous and honeſt Mind would be equally careful, neither to offend againſt the Laws of Gratitude to an ingenious Tutor, for the moſt inſtructive Dictates; nor thoſe of Juſtice and Zeal due to the Public, for whoſe Service, Gentlemen, you are preparing: [iij]I expect it be allowed me, on the preſent Occaſion, as a neceſſary Inſtance of Duty to Both; that I am at Liberty to declare, I want no Veneration for Sir RICHARD'S Whole Courſe.—It is compoſed, indeed, of Two grand Branches, which are thoſe of Midwifery and Phyſic. The former of theſe is by no means deſtitute of its Beauties: Such as the Improvements in the Apparatus itſelf; the Chaſtity of the Inſtitution; and the Excluſion of all Inſtruments.—For the firſt: The greater Machine is the moſt finiſh'd, in its way, that has, as yet, ever appeared, for conducting the different Kinds of Deliveries; while the Glaſs Machine gives ocular Proof of the Reaſon and Juſtneſs of the Rules to be obſerved in Operations on the Other; and, conſequently, in Genuine Labours.—For the next: It is not poſſible, by this Manner of Inſtruction, to give the leaſt Offence to the chaſteſt Mind, the moſt ſcrupulous Modeſty. — And with reſpect to the Affair of Inſtruments: It is evident [iv]to a Demonſtration, from this Method of Practice, that there is ſo little Occaſion for the preſent frequent Uſe of them, that excepting in a Caſe or two, which but rarely happen; the judicious Management of the Hand, is all that is required in the Art of Midwifery.

GENTLEMEN, I abhor Flattery and Oſtentation: And I cannot but perſuade myſelf, you will acquit me of Both, when I aſſure you, I ſhould, at no rate, have taken upon me to have been either ſo particular, or poſitive in the Articles above, if I were not very well acquainted, with the utmoſt, that has been done Abroad on the Subject of Midwifery. I ſtudied under Two Maſters, the late Meſſieurs GREGOIRE and DUSSÉ, at PARIS; and came from thence with no ſmall Freight of Self-ſufficiency and Confidence: Nor is it probable to me, I ſhould ever have been diſpoſſeſs'd of my perſonal Prejudices and dangerous Miſtakes (eſpecially in the Uſe of Inſtruments) had I not fell under Sir RICHARD's [v]Inſtitution, and formed myſelf on His Practice.

THESE things notwithſtanding: As I always thought the matter of Deliveries the leaſt Branch of the Man-Midwife's Character; and was aſſured, that He would ever have moſt Succeſs in Operations, who was beſt acquainted with the Structure of the Human Body: So I could not help being eſpecially charmed with thoſe Lectures in Sir RICHARD's Courſe, which properly belong to the latter Branch, the Head of Phyſic. The ſuperior Utility of the Subject will excuſe my paſſionate Regard on this Part: Since it is plain, that the Science, which leads to a general View of the animal Machine, and to a perfect Knowledge of all the Diſeaſes to which the whole Nature, in common, is incident; muſt be vaſtly preferable to all that is partial and confined, however exalted and worthy in itſelf.

WHAT was laſt obſerved, Gentlemen, you will pleaſe to remember, is deſigned, [vj]not only to account for the extraordinary Pains I was at in ſecuring this Lecture; but is alſo offered as a Reaſon, why you are to believe it tolerably correct. For the latter indeed, you have this additional Aſſurance, that I had not only ſeveral Opportunities of attending the Repetition of it; but was, moreover, allow'd the peculiar Indulgence of taking it in ſhort-hand, as delivered.

I CONFESS, it would give me no ſmall Pain, were I the leaſt apprehenſive, I was taking any Freedom, that might juſtly expoſe me to the Reſentment of Sir RICHARD MANNINGHAM: But, I flatter myſelf with leſs Danger in this Point, ſo far as concerns the preſent Publication, however; ſince, I am only indulging the Engliſh Reader with his excellent Method of Inveſtigating Diſeaſes, in the manner he explain'd it to Us, in his firſt Evening's Lecture in Phyſic; at the ſame time, that it is to be obſerved, he has already communicated the Method itſelf to the learned [vij]World in his Latin Compendium: Tho' ſome of the beſt Judges have acknowledged it's Claim to an higher Title.

THERE is one Circumſtance, Gentlemen, of great Importance in the preſent Lecture, I mean: That the whole Argument is built on the moſt venerable Antiquity, and not on any precarious, modern Theories. I take the Liberty of inſerting this previous Hint; not but your own Attention in Reading would have excuſed me the Trouble; becauſe you will from hence immediately argue its intrinſic Value, and give more boldly into its Uſe.—The Hiſtories of Diſeaſes, originally put together by the moſt accurate Obſervations of HIPPOCRATES, and eſtabliſhed on the Authority of his Succeſſors, the moſt celebrated ancient Phyſicians, is here your Standard. Nature, ſince her various morbid Phaenomena were, in their manner, firſt reduced to any regular Syſtem, appears to have ſuffered no Deviation for ſome thouſand Years paſt; nor can, indeed, [viij]be capable of any, for the future, while the animal Oeconomy, and the Laws, under which the human Species continues to act, remain invariable.

I WISH nothing more ardently, than that, as the Subject, on which the Lecture before you is rais'd, is of general Uſe in itſelf; and it is hardly poſſible, every Student's Situation ſhould allow him an Opportunity of attending on the Spot: Thoſe, into whoſe Hands it may now fall, may find as much Pleaſure and Advantage in receiving it from the Preſs, as the Publiſher has perpetually retained, ſince he firſt took it from Sir RICHARD's own Mouth. I am,

GENTLEMEN, Your moſt Obedient, Humble Servant,SAYER RUDD, M.D. and MAN-MIDWIFE.

The CERTAIN METHOD to KNOW the DISEASE.

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IN the Courſe of our LECTURES in Phyſic, we propoſe, chiefly to confine ourſelves to the Diſeaſes of Children, from Infancy up to ripe Age; and to the Diſeaſes, peculiar to the Female Sex; thoſe eſpecially, belonging to Pregnancy and Childbed: Nevertheleſs, as Women are liable to all the Diſtempers incident to Men, beſides the many peculiar to their own Sex, as they are, by Nature, ordained for the Preſervation of Mankind; it will be neceſſary, in a great meaſure, to treat of Diſeaſes at large; and more particularly of Fevers, which, indeed, make up a very great Part of the Diſorders that afflict us, and do alſo aſſociate themſelves, with every other Diſeaſe: Febris, maxime communis Morbus, omnium aliorum Morborum, praecipue Inflammationis, comes eſt. HIPPOCRATES. The Truth of which we daily experience; and, moreover, often obſerve that, a [2] Fever ſhall even elude that Method of curing a Diſeaſe, which, without a Fever, has been generally found ſucceſsful; an Obſervation well worthy our particular Notice.

WOMEN with Child, and in Childbed, are often afflicted with Diſtempers, no ways cognate to Pregnancy or Childbed; eſpecially Fevers of all Kinds, whoſe Eſſence and Nature, indeed, differ nothing from other Fevers, and require a like Method of Cure; yet, by reaſon of their happening at the Times above-mentioned, are attended with greater Difficulties in Curing, and demand our greateſt Caution and Prudence, in the Adminiſtration of the proper Remedies for the Fever; the Phyſician at this time, not being at Liberty, ſo freely to make uſe of Bleeding, Vomiting, Bliſtring, Sweating, Purging, and Method of Diet: And during Pregnancy, our chief View muſt always be to prevent a Miſcarriage, or even the bringing on of Labour, whenever the Diſeaſe has no Affinity to Pregnancy. For tho' Diſeaſes, which are owing to Pregnancy, either decreaſe, or go off upon Delivery; yet, thoſe which are no ways cognate, are for the moſt part found to increaſe after the Delivery; and as HIPPOCRATES obſerves: Si mulier, Utero geſtans, morbum habuerit non cognatum, in Puerperii purgatione, perit.

WHEREFORE, as in all Diſeaſes not cognate to Pregnancy, our chief View, as I obſerved above, muſt be, to prevent Abortion and untimely Labour; ſo in all Diſeaſes happening in Childbed, [3]our principal Aim, muſt then be directed, to the due Regulation of the Lochia. Many, and great Difficulties ſurround us, in this dangerous and complicated Situation, which exact our moſt diligent Care and Attention: And, as it is oftentimes no eaſy Matter to diſtinguiſh between the cognate Diſtemper, and that which has no relation to Pregnancy or Childbed; and at all times, very difficult rightly and ſafely to conduct Affairs, in this nice and critical Situation; I ſhall therefore, in my ſubſequent Lectures, endeavour, to the beſt of my Judgment and Knowledge, to inform and direct you in each Particular, from the repeated Obſervations of the moſt approved Authors in Phyſic, both ancient and modern; and alſo from Experiences and Succeſſes, collected from my own Adverſaria, confirming their Doctrine; beſides which, I ſhall illuſtrate each Caſe, by the particular Application of the Method of Inveſtigating the Nature of all Diſeaſes.

IT is a Maxim univerſally received among Phyſicians: That Medicine ſhould begin, where Philoſophy ends. And as it is, undoubtedly, a neceſſary Qualification in a Phyſician to be knowing in Philoſophy; and the Animal Oeconomy is that Part of Philoſophy, which is more eſpecially conducive to the Knowledge of the Practice of Phyſic: I make no doubt, but you, Gentlemen, who have in this City the beſt Opportunities of being inſtructed in this Branch of Science; eſpecially by that moſt accurate, and excellent Anatomiſt and Phyſician, Dr. NICHOLLS; who, it muſt be confeſſed, is an Ornament [4]of our Profeſſion, and worthy of ſingular Praiſe: I ſay, I make no doubt, but with ſuch Advantages, you have already obtained a competent Knowledge in the Animal Oeconomy; and will, therefore, be enabled to make the beſt Uſe of our Lectures, and Method of Inveſtigating the Nature of Diſeaſes.

NOW, the human Body, we all know, may be properly conſidered, as a moſt perfect Machine; whoſe Parts are extremely well configurated and joined together; whoſe Symmetry is moſt beautiful; and whoſe Actions, reſulting from this admirable Compages, are reciprocally carried on by Solids and Fluids, of which it is made up. And as many of its Actions and Motions, are eaſily demonſtrated to be the neceſſary Conſequences of it's Structure; ſo its Diſeaſes, and all their Symptoms, are only the irregular Motions, or Diſorders of this very complicated Machine: Nor is the Caſe the leaſt altered, that we have a Principle within us, not ſubject, in itſelf, to the Laws of Motion.

IT is, therefore, highly incumbent on every one, who would attain to the due Knowledge of the Art of Healing, that he make himſelf very well acquainted with this curious Machine: that knowing well the Parts, and the natural Actions, and Secretions of the human Body; he may be enabled to judge, when, and how, theſe natural Actions are perverted: all the Symptoms of Diſeaſes, being the neceſſary Conſequences of the Alteration of the Animal Oeconomy. It's Actions therefore being performed [5]by Fluids ſecerned from the Blood; without the Knowledge of Secretions, we cannot underſtand the Nature of Diſeaſes: Secretion being the Spring of all animal Functions. Wherefore, the greater our Knowledge is of the Animal Oeconomy, the more likely we ſhall be, to diſcover the Seat and Nature of its Diſeaſes; and of courſe be better enabled to rectify all its Diſorders.

EXPERIENCE is, no doubt, of great and neceſſary Uſe, in promoting the Art of curing Diſeaſes, if directed by a Knowledge in the Animal Oeconomy; foraſmuch as it is only by a juſt reaſoning on our Experiences, that we can come at the Knowledge of any Phaenomenon of Nature. So that Experience, or the Knowledge of the Hiſtories of Diſeaſes, added to that of the Animal Oeconomy, is what can only make a Phyſician; and, whereever the Hiſtory of a Diſeaſe is exactly known, if the right Method of curing it cannot be deduced, it muſt be, becauſe the Animal Oeconomy is not ſufficiently underſtood: For our Skill in curing Diſeaſes, whoſe Hiſtories are exactly known, is, for the moſt part, proportional to our Knowledge of the Animal Oeconomy. For in order to find out the Seat and Nature of a Diſtemper, and from them to deduce a right Method of Cure, it will be abſolutely neceſſary to reaſon on thoſe Hiſtories; which we cannot do, as we ought, if we are ignorant of the Structure of the Machine, we are about to rectify.

DESCRIPTIONS and Diagnoſtic Signs of Diſeaſes, are the proper Buſineſs of Obſervation [6]and Experience; but, Indications of Cure ariſe from our reaſoning upon thoſe Obſervations. Diagnoſtics are properly a Collection of particular Symptoms only; but Indications are thoſe Concluſions, which our Knowledge of the Animal Oeconomy enables us to make on theſe Obſervations, and Deſcriptions: So that the Hiſtories of Diſeaſes, and the Knowledge of the Animal Oeconomy, muſt always go hand in hand, in order to the obtaining the due Knowledge of the Practice of Phyſic. He therefore, who is ſufficiently knowing in Philoſophy and the Animal Oeconomy, and makes a proper Uſe of this Knowledge, by reaſoning on real Facts, grounded on repeated Experience and Obſervation, may juſtly be ſaid to uſe his Philoſophy aright; and may then reaſonably hope for Succeſs, in finding out the genuine Indications of Cure, in which, the Practice of Phyſic chiefly conſiſts: And without this Caution our Reaſonings will certainly be to very little purpoſe.

THE great HIPPOCRATES has this Aſſertion: That Nature cures Diſeaſes. The Truth of it we, of this Day, may experience, if we will carefully keep up to his excellent Directions, and Method: It being his only Aim to relieve Nature when oppreſſed, in the very Way, and Manner he obſerved her endeavouring to expel Diſeaſes. And it was by a conſtant Diligence of this Kind, joined with his wonderful Sagacity, that he arrived to that great Degree of Perfection in the Knowledge of Phyſic: Hence he perceived that, Nature herſelf judges Diſeaſes; and, indeed, does all, being properly aſſiſted; [7]nay, and, ſometimes, without any Aſſiſtance.

HIPPOCRATES alſo informs us, and our own Experience cannot but confirm it: That thoſe People who have Fevers, and are left to themſelves, and take no Medicines; if they do recover, get rid of their Fevers by Sweating, a Looſeneſs, an Haemorrhage, Diabetes, or the like: From whence HIPPOCRATES, and the ancient Practitioners in Phyſic, took their firſt Intimation to provoke Sweat and the other Evacuations. And from their repeated Obſervations and Succeſſes, they have formed for us, a moſt rational Method of Cure. And if we duly conſider, and attend to the different Ways by which Nature extricates herſelf from Diſeaſes, when left to herſelf; we ſhall ſoon be convinced, that they are not the confuſed and diſordered Effects of Nature, ill defending herſelf; but, in fact, the gradual, ſteady, and meaſured Operations of that exquiſite Mechaniſm, and innate, inceſſant Principle of Self-preſervation, with which Providence has been pleaſed to endow our Bodies: A very ſtrong Confirmation of the Neceſſity of a careful and diligent Obſervance of the Tendencies of Nature, in all her Diſorders; and the Method ſhe takes to get rid of Diſeaſes, when left to herſelf: And alſo, a very good Caution to us all, not to be over haſty, or too buſy in the Adminiſtration of our Remedies; leſt we ſhould be found to ruffle and diſturb, rather than aſſiſt Nature, with the untimely Uſe, or Multitude of our Medicines. And really, the Ne quid nimis, in the Practice of Phyſic, [8]is a Matter of no ſmall Conſequence. He therefore, in my Opinion, is moſt likely to prove the beſt, moſt prudent, and rational Phyſician, who moſt diligently obſerves, and conſtantly follows, the Motions, and Dictates of Nature herſelf.

IF an altogether new Diſtemper ſhould at any time ariſe among us, the only Way of getting into the Nature of ſuch new Diſeaſe, would be to copy HIPPOCRATES's Example; I mean, his Method of obſerving, joined to the Rule of finding out the Nature of Diſeaſes: For we muſt, firſt, be led by Symptoms to find a Diſeaſe; after that it's Nature, and from thence the Method of Cure. And here it may be proper to obſerve, that there are ſeveral Seaſons, which have Diſeaſes peculiar to themſelves; and may, in ſome meaſure, indeed, be called new Diſeaſes: It will therefore be neceſſary to know, and carefully obſerve the Seaſons, as HIPPOCRATES, and, our renowned Countryman, SYDENHAM adviſe; wherein ſuch Diſeaſes are wont to appear; otherwiſe we ſhall be unſucceſsful in curing the Diſeaſes peculiar to thoſe different Seaſons. It muſt alſo be obſerved, that theſe Diſeaſes are generally ſtated, and regular in each Conſtitution, and have an Affinity to each other: He therefore, who is able to come at the Nature and Cure of one Epidemical Diſtemper, in any Conſtitution, hath an Advantage in the Cure of all the other. For tho' they may differ in ſeveral reſpects, yet they require ſomething common in their Cure, as proceeding from a common Cauſe. And a few Caſes diligently enquired into, by recollecting and [9]carefully examining their Symptoms, as directed by our Method of diſcovering the Nature of Diſeaſes; will be ſufficient to give us the Nature, Cauſes, and Method of Cure, of the Diſeaſe of every Conſtitution whatever. Here we can by no means omit a pertinent Obſervation of CELSUS: Quod ſi jam incidat Mali genus aliquod ignotum, non ideo tamen fore Medico de rebus cogitandum obſcuris; ſed eum protinus viſurum, cui morbo id proximum ſit; tentaturum (que) remedia fimilia illis, quae vicino malo ſaepe ſuccurrerint, & per ejus ſimilitudinem opem reperturum.

THE many accurate and charming Deſcriptions of Diſtempers, delivered down to us by HIPPOCRATES in his Hiſtories of Diſeaſes; wherein the Phaenomena of each Diſtemper, even in its minuteſt Circumſtances, are obſerved; preſent us with a moſt exquiſite Delineation of Nature: and if duly attended, will always be found, of the greateſt Service for advancing our Progreſs in the Art of Healing. Becauſe, from his Diagnoſtics in particular, and others of the Antients, and ſuch among the Moderns, who have cloſely copied after His manner; we readily diſcover the Nature of the Diſeaſe. And as, whenever we arrive at the true and exact Hiſtory of any Diſtemper, whether from Books, or our own careful Obſervations; we may, at all times, by the right and diligent Application of the Method of Inveſtigation, moſt aſſuredly diſcover the immediate and conjunct Cauſe; ſo may we likewiſe, on thoſe Principles, eaſily come at the Nature of the Diſeaſe; when, having that [10]given, it will be no difficult matter to find out Remedies to Cure, in all curable Caſes; and to adminiſter Relief, even in thoſe, which are incurable.

THIS unwearied Diligence in Obſervation, and cloſe Attendance on Nature in that ſagacious, great Man HIPPOCARTES, and others of the Antients; might probably be heightened in them, from the Scantineſs of their Materia Medica, and the exceeding Harſhneſs of the then known Remedies; however, much to our Benefit: ſince the excellent Deſcriptions of Diſeaſes they have given us, can not only never be exceeded, but will always remain invariably true, while Human Nature continues the ſame. And had thoſe of later Ages, who have been ſo happily provided with a more copious and ſalutary Materia Medica; and who, it muſt be allowed, have been greatly improved in the Knowledge of the Animal Oeconomy: had theſe, I ſay, conſtantly perſevered in the Uſe of HIPPOCRATES'S great Diligence and Manner of obſerving; they might, doubtleſs, long ago, have brought the Practice of Phyſic to a conſiderable Degree of Perfection; tho' they had not been bleſs'd with his extraordinary Sagacity: For that, indeed, is a peculiar Happineſs, and the Lot of a very few; in which Particular, I believe, we may ſay of the Phyſician, as is commonly done of the Poet: Naſcitur, non fit.

Now, ſhould we of this Age, fluſhed with our ſuperior Knowledge in the Animal Oeconomy, and the Variety of our Materia Medica; neglect to [11]make uſe of that Prudence and Diligence, which is neceſſary in attending the Motions and Intentions of Nature; and, inſtead of endeavouring to aſſiſt her on theſe Principles, when oppreſs'd, become too precipitate and officious, in the Adminiſtration of our Medicines; the Conſequence will inevitably be, that we ſhall only obſcure the Diſeaſe, by multiplying, rather than taking off the Symptoms; and this to our own perſonal Confuſion, the manifeſt Injury of our Patients, and the great Diſrepute of our Profeſſion. Whereas, would we conſult the true and proper Uſe of the many happy Improvements of our own Age, I think, it cannot be done more effectually, than by keeping cloſe to our moſt ſkilful Leader, HIPPOCRATES; together with the ancient Practitioners in Phyſick, in their Manner of obſerving, and in their Method of healing; founded upon the Knowledge of the conjunct Cauſes of Diſtempers, from whence alone, the curative Indications are to be taken: agreeable to the Method here mentioned, and HIPPOCRATES'S Manner of obſerving. And by a careful Perſeverance in theſe Methods, I imagine, we may reaſonably hope for the greateſt Succeſs; and may, perhaps, in a few Ages, arrive at the higheſt Perfection in the Practice of Phyſic, that human Nature is capable of attaining.

FROM what I have already advanced, you will naturally conclude, that it is no eaſy Matter to become a prudent and ſkilful Phyſician: Much Reading, much Thought and Pains will really be required; many Things are neceſſary to be learnt [12]much Diligence in Inquiry, much Aſſiduity in Obſervation is to be uſed, before we can be duly qualified, either with Peace of Mind to ourſelves, or Relief to our Patients, to undertake a Truſt, in which the Lives of our Fellow-creatures are ſo nearly concerned.

IF this be a juſt State of the Caſe, what ſhall we ſay of thoſe Perſons, who boldly take upon them the Practice of Phyſic, without the leaſt previous Knowledge of the Requiſites abſolutely neceſſary for the regular Diſcharge of this important Office? Certainly it can be no other than the greateſt Folly, and the higheſt Preſumption, for Thoſe to expect Succeſs, or hope for a Bleſſing on their Endeavours; who are altogether ignorant of the Province in which they engage: And would ſuch Perſons but give themſelves Time to reflect, and ſeriouſly conſider, the great Conſequence of Phyſic, in the practical Part of it; where Life itſelf is ſo immediately at ſtake: I am perſuaded, they would not thus raſhly venture to adminiſter Medicines, before they had acquired the proper and neceſſary Qualifications.

IT is a mighty Miſtake, that has ſeized ſome of our young Candidates in Phyſic, who are not much addicted to Study or Pains-taking, to imagine: That, if they are but well furniſhed with Books of Recipes, they have every Qualification ſufficient to commence Doctor upon; becauſe in thoſe Books, as they think, agreeable to the common Saying, they are ſure to find a Salve for every [13]Sore. But, alas! theſe baſe, empirical Books, the Peſt of the preſent Age, will greatly deceive them. They are by no means to be confided in; but, on the contrary, are rather to be looked upon as very injurious: Foraſmuch as they only furniſh all Sorts of People, with great Opportunities of deſtroying each other's Health. And ſhould any Perſon pretend to ſet up to practiſe Phyſic on this deceitful Foundation, He would ſoon find himſelf miſerably miſled; to the great and manifeſt Injury of Himſelf, as well as his Patients. For it is moſt certain, that every Medicine, be it never ſo good, muſt always be adminiſter'd in the moſt proper Doſe, and at the moſt proper Times of the Diſeaſe, to make it of any Advantage to the Patient; but the Chance of the Miſchief ariſing from the contrary Practice, no one, I think, would covet: Yet this Knowledge can no otherwiſe be come at, than in the arduous and diligent Manner of ſtudying above-mention'd; join'd with the Method of Inveſtigating the Nature of Diſeaſes. Not that this is the only Advantage, which follows on our Doctrine of Inveſtigation; fince it not only leads us into the true Nature of the Diſeaſe, and the certain Method of Cure; but alſo, at the ſame time, into the very Nature and Power of Medicines themſelves, if rightly attended to and applied. And were it poſſible, even to find out an Univerſal Remedy for all Diſtempers; it muſt ſtill be ſubject to the due Timeing and Doſing; the accurate Knowledge of which, can no otherwiſe be obtained, than by the Manner and Method already laid down. And this, indeed, is the only real and true Arcanum, [14]in the Practice of Phyſic. All your Panaceas, Noſtrums, Specifics, and the like; without this perfect Knowledge of adminiſtring them, in the moſt proper Doſe, and at the moſt proper Times of the Diſeaſe, will, for the moſt part, prove very miſchievous. And here the Opinion of the late learned Profeſſor BOERHAAVE concurs with us: Nec ſpecioſos Medicamentorum titulos Morbis addidi. Cur? Nihil Arti exitiale magis novi; neque verò ipſe ullum cognoſco, quin ſolo tempeſtivo Uſu tale fiat. * And theſe Remedies can only, by the greateſt Hazard and Chance imaginable, ever prove of good Effect, in any Diſeaſe of Conſequence: Tho' we all know, indeed, that, in many Caſes, let the Medicine given be ever ſo improper in itſelf, or ever ſo unſeaſonably adminiſter'd; the Strength of Nature may ſometimes get the better of both. But this is by no means Curing; nor can it be any Excuſe for our Ignorance.

HAVING thus prepared you for the Method to be obſerved in finding out the Diſtemper; I ſhall now proceed to give it you, in the plaineſt, and moſt methodical Manner, I am able.

I CANNOT introduce, what I have to offer on this Head, with greater Advantage, than by laying before you, the following practical Obſervation of SCHEFFLER: Ut Rationalis Medicus curativis Scopis ſatisfacere, Materias Medicas invenire, inventis rectè uti valeat: non ſatis erit, Vires cuſtodire, & morbificas Cauſas amovere; ſed & Morbi Speciem, [15]& Locum affectum exquiſitè cognitum habeat, neceſſè eſt.

AGREEABLE with this, you will obſerve that, in order to Cure any Diſeaſe, it is neceſſary to have a thorough Knowledge of the Diſeaſe itſelf, and of the Remedy peculiarly adapted to it; it being impoſſible to cure a Diſeaſe according to Art, if the Nature of the Diſeaſe be hid from the Artiſt: And for want of this Knowledge, the Care and Pains of many Phyſicians have proved ineffectual. For theſe Phyſicians, for the moſt part, making little other Uſe of the Diagnoſtic Symptoms, than the mere naming the Diſtemper only; have, very injudiciouſly, taken their Indications of Cure, from ſecondary and caſual Symptoms: Whereas the true Nature of a Diſeaſe is ever beſt found out, from the Diagnoſtic Signs or Marks alone; and from thence alſo, the true Indications of Cure, muſt always be drawn, in order to the beſt and moſt effectual Method of curing the Diſeaſe. And as theſe Indications wholly ariſe from our Reaſoning upon the Obſervations of the Phaenomena of Nature; therefore, the greater our Knowledge of the Animal Oeconomy is, the better we ſhall be enabled to find out the Nature of the Diſeaſe. For 'tis the Animal Oeconomy alone, which muſt enable us, by reaſoning upon the Cauſes, Signs, and Symptoms of Diſeaſes, to find out their Natures, and to deduce true and juſt Indications of Cure.

THIS, however, in general; more expreſsly: To come at the true Method of inveſtigating all Diſeaſes, [16]incident to the Human Body; and from thence proceed to the moſt effectual Methods of treating and curing them; the ſolid Knowledge of the following Particulars is abſolutely required, viz.

  • 1. The next, and ever-concomitant Cauſe of the Diſeaſe.
  • 2. The Seat and Part affected.
  • 3. The Ways and Paſſages, thro' which the Evil takes its Courſe.
  • 4. The inſeparable Signs of the Diſtemper.
  • 5. The Symptoms, which commonly accompany the Diſeaſe; and
  • 6. That we be careful the Symptoms of the Diſeaſe are rightly diſtinguiſhed.

IF we err not in theſe main Points, we are in the right Way of arriving to an happy Cure of the Diſeaſe.

IT is very neceſſary at all times, carefully to diſtinguiſh between the Diſeaſe itſelf, and the Symptom; the want of which has been the Stumblingſtone of ſome, even very learned Men, in all Ages: Since it is to be imputed to the want of this Diſtinction, as a principal, if not the only Obſtacle; that Phyſicians have been ſo much at a Loſs, for the true Cauſe of the Diſeaſe, and have therefore ſo often taken the Symptom for the Diſeaſe itſelf; not rightly diſtinguiſhing the next, and immediate conjunct Cauſe, from its Symptoms or Accidents; which [17]may not be occaſion'd by the next, and always accompanying Cauſe of the Diſeaſe, but by ſome other Symptom; and what is ſo far from being the Mark of the Diſeaſe, that it is a Symptom of a Symptom only.

IN the Tooth-ach, for Example, when it does not proceed from a Caries; the genuine Eſſence of this Diſeaſe, is the violent Diſtenſion or Stretching of the Perioſtium, by ſome ſort of Humour; by which means this Membrane, being forc'd out of its natural Form and Situation, excites a moſt exquiſite Pain; which Pain is not the Diſeaſe, but the true Mark of the Diſeaſe; and the Humour occaſioning this Pain, the Cauſe of the Diſeaſe. The Inflammation, Fever, ſwelled Face, &c. which may ſucceed, are neither of them the true Mark; but proceed from the Pain, which is the true Diagnoſtic Sign or Mark of the Diſeaſe; each of the above-mentioned being the Symptom of a Symptom only.

Of the DIAGNOSTICS or SIGNS of a Diſeaſe.

THE true Marks or Signs of a Diſeaſe are ſuch, which are preſent from the Beginning, and, as it were, born with the Diſeaſe; they grow up with the Diſtemper to it's height; abate alſo, and vaniſh with the Diſeaſe. Theſe are the only ſure Marks or Signs: other Signs or Symptoms, which do not immediately follow the Diſeaſe, nor any proper Effects [18]of it; and which do not always appear in the Diſeaſe, are therefore deceitful Signs, and not to be truſted to; tho' ſuch as have, inadvertently, miſled ſome, even ſagacious Men.

NOW, theſe deceitful Signs are not to be reckoned among the proper Symptoms of the Diſeaſe; being only ſuch as proceed from ſome proper Symptom of the Diſeaſe; and are, indeed, Symptoms of Symptoms only. For the true, and proper Diagnoſtic Marks or Signs of the Diſeaſe, muſt always begin, grow up, decline and vaniſh with the Diſeaſe itſelf; and, from ſuch Marks only, we muſt ever draw our Indications of Cure.

Of the SYMPTOMS of a Diſeaſe.

AS to the Symptoms of any Diſeaſe, the firſt Buſineſs is to diſtinguiſh the Symptoms in general, from the Diſeaſe itſelf; and then to make a Diſtinction between the Symptoms themſelves: That is, the Symptoms which ariſe and vaniſh with the Diſeaſe, are to be diſtinguiſh'd from thoſe, which are bred, not from the Diſeaſe itſelf, but from the Symptoms of the Diſeaſe: And the Symptoms, as we before obſerved, which immediately accompany the Diſeaſe, and are born and die with it; are the only ſure Marks or Signs of the Diſeaſe.

TO illuſtrate this by our former familiar Inſtance of the Tooth-ach: Here the Pain is the chief and moſt grievous Symptom, but is neither the Diſeaſe itſelf, [19]nor the Cauſe of the Diſeaſe; nor, yet, is it a ſimple Symptom only, foraſmuch as it is the Cauſe of other Symptoms, which ſucceed; as the Fever, Inflammation, ſwelled Face, &c. eſpecially when the Pain is violent. Thoſe ſeveral Accidents, now mentioned, are cauſed only by the raging Pain of the Tooth-ach (the true Mark of the Diſeaſe) and are Symptoms of a Symptom only. And farther, theſe Accidents of Fever, Inflammation, ſwelled Face, &c. are neither in whole, nor in part, the Cauſe of the Tooth-ach; neither are they inſeparable Companions of the Tooth-ach; for the Tooth-ach may be, and often is, without them. And the ſwelled Face, in particular, does not begin, nor end with the Diſeaſe; nor does it always accompany it; nor is it of the ſame Nature with the Humour, occaſioning that violent Pain, but is a Symptom only of the Tooth-ach; being raiſed by the Pain, and bred by Conſent of Parts from an Afflux of Humours.

THUS you ſee plainly the Method of inveſtigating the Nature and Cauſes of a Diſeaſe; it's Seat and Part affected; it's Diagnoſtic Symptoms; and the Neceſſity of diſtinguiſhing theſe latter, not only from the Diſeaſe itſelf, but alſo from one another: All which will make way to judge the better of a fit Remedy to cure the Diſeaſe; for we cannot reaſonably hope for a Cure, before the Diſeaſe be thoroughly underſtood. And in this manner we muſt come at the Nature, Cauſe, and Cure of all Diſeaſes whatever. — And, indeed, Diſeaſes have that ſurprizing Analogy to one another, that we [20]cannot find the Nature of any one Diſeaſe; but the Nature of ſeveral other will, by the ſame means, become manifeſt to us. So that a general Knowledge ariſes from a particular Inquiry; and we are inſtructed from the Diſcovery of any one, into the Nature of many other Diſeaſes, and the moſt perfect Practice in Curing them.

FROM this Method alſo of finding out the Diſtemper, is diſcovered, at the ſame time, the only Way of making a right and true Prognoſtic; which is only a Declaration of a Phyſician's Expectation in curing a ſick Perſon. And this Expectation can no otherwiſe be truly framed, than from the Nature of the Diſeaſe; the Quantity and Intenſeneſs of it; the natural Strength of the Sick; and the Power of Medicines conjunctly. The Knowledge therefore of Prognoſtics is not otherwiſe to be acquired, than by rightly inveſtigating the Diagnoſtic Marks of a Diſeaſe, whereby it's Nature is diſcovered; with that the Quantity of the Diſeaſe, and the Strength of the Sick, at the ſame time. And as by this Method, we are alſo led into the Nature, and Power of Medicines themſelves; ſo here again, the very Medicine reflects Light, and, in ſome meaſure, confirms the Knowledge of the Diſeaſe; as HIPPOCRATES well obſerves: The Medicine declares the Diſeaſe.

THIS then is the Method, by which the Nature of all Diſeaſes, to which human Bodies are, or may be liable, is diſcovered. And ſhould ever any altogether new, and unheard of Diſeaſe, at any time, [21]appear amongſt us; this will be found the ſure way of coming at it's Nature: by only thus carefully recollecting, and examining its Symptoms. Again, this will of Conſequence direct to the moſt proper Method of Curing; the Knowledge of a Diſeaſe being the firſt Step towards its Cure.

‘"ALL the Difficulty of Philoſophy," ſays the great Sir ISAAC NEWTON, "ſeems to conſiſt in this: From the Phaenomena of Motions to inveſtigate the Forces of Nature; and then, from theſe Forces, to demonſtrate the other Phaenomena."

AGREEABLE to which, we obſerve: That the Symptoms of any Diſeaſe being given, it's Nature may readily be diſcovered.

NOW the Method of curing Diſeaſes, by drawing Indications from the evident and conjunct Cauſes, has been moſt approved of by the beſt and Generality of Phyſicians. To this purpoſe CELSUS: Rationalem quidem puto Medicinam eſſe debere: inſtrui vero ab evidentibus Cauſis; obſcuris omnibus, non à Cogitatione Artificis, ſed ab ipſa Arte rejectis. As to the Knowledge of theſe Cauſes, it is allowed, they can only be attained by a cloſe and aſſiduous Obſervation of all the Appearances in the ſeveral Stages of the Diſtemper: Whoever therefore is Maſter of an exact Knowledge in the Hiſtories of Diſeaſes, having alſo due Regard to the Diagnoſtics, as by our Method directed; may readily inveſtigate their Nature. Natural Philoſophy and the Hiſtory of Diſeaſes, as we obſerved before, muſt [22]ever go hand in hand in improving the Art of Healing; it not being poſſible to make any great Uſe of the latter, without ſome Degree of Knowledge in the former: and the greater our Knowledge is in the Animal Oeconomy, the better the Nature of Diſeaſes will be known.

I HAVE always found, the keeping cloſe to this Method of inveſtigating the Nature of Diſeaſes, of the greateſt Uſe to me in the Courſe of my Practice. For having long ſince drawn up our Method from the moſt approved Authors in Phyſic, Ancient and Modern; I have conſtantly apply'd it, not only to all thoſe Hiſtories of Diſeaſes, which I read in Authors, whoſe Deſcriptions of evident Cauſes, Signs, and Symptoms are juſt; where the ſeveral Species of the ſame Diſeaſe are judiciouſly diſtinguiſhed; but alſo to all thoſe Diſeaſes, together with their ſeveral Appearances, I have at any time met with among my Patients. And I am verily perſuaded, that you, Gentlemen, will likewiſe reap the ſame Advantage, by the Uſe and Application of our Method, if duly attended, in your future Practice; as well to the great Relief of your Patients, as the abundant Satisfaction of your own Minds.

NOW, in order the more ſtrongly to inculcate on your Minds this moſt neceſſary and uſeful Method of inveſtigating, we will here again give it you in a cloſer Manner, and in a ſomewhat different Light; ſetting out with an Obſervation of LOMMIUS: Noſcere Morbum proximus eſt ad Sanitatem Gradus: Nemo ſane hanc aut praeſagire, aut reddere [23]affectis rectè poteſt, qui non animadvertere Genus Aegritudinis, quod ſit; non ejus Eventum omnem praenunciare, certis Indiciis norit.

WE ſaid before, that the Symptoms of any Diſeaſe being given, it's Nature may be diſcovered.

NOW, the Symptoms of every Diſeaſe are no other than the Effects of ſome Cauſe, or ſome Number of Cauſes, which pervert and overturn the natural Actions of one or more Parts; for which reaſon by explaining theſe Symptoms, we become appriſed of the perverted Action, or diſcover the Diſeaſe: for nothing can be the Cauſe of a Diſeaſe, that does not produce the Symptoms, in which the Nature of the Diſeaſe conſiſts.

WHEREFORE, the Symptoms of any Diſeaſe being given, it's Nature may thence be diſcovered: And the Nature of a Diſeaſe being aſſigned, we have alſo the Methods of curing it. Farther, having the Nature and Cauſes of any Diſeaſe, we ſhall be able to determine how far the Diſeaſe is curable or incurable; the Probabilities of curing any Diſtemper; and the moſt proper Methods of attempting it.

NOW the Ancients, as we have already obſerved, having accurately deſcrib'd the Diagnoſtic Signs or Marks of Diſeaſes, together with their moſt natural and ſimple Appearances; whoever is thoroughly acquainted with the Hiſtories, as delivered down to us by them, and is accurate, or well [24]verſed in the Structure and Nature of the Fluids and Solids of the Human Body; may, from their Diagnoſtic Signs, in particular, be able to diſcover the Nature and Seat of the Diſeaſe, and the Way it is produced. By the ſame means alſo, he will have it in his Power to ſhew in what manner, the Symptoms attending the Diſeaſe do flow from it's Nature, thus found out from it's Symptoms; and likewiſe be capable of perceiving how thoſe Symptoms give way, or are cured, by changing the diſtempered Condition of the Parts affected.

IN this Examination of the Nature of the Diſeaſe from it's Symptoms, we muſt be moſt careful, that every caſual and foreign Symptom be ſeparated from the conſtant and permanent, in the manner the Method, more at large, directs; it being eaſy by obſerving the Rule there laid down, to diſtinguiſh the conſtant and inſeparable Symptoms from thoſe, which are merely caſual and ſecondary.

THE principal Symptoms are, for the moſt part, caſy to be explained; the falſe Symptoms are moſt commonly found among the ſecondary Sort, and are the Symptoms of Symptoms only; for which reaſon they ought to be rejected from the Number of Symptoms properly belonging to the Diſeaſe.

INDICATIONS of Cure muſt be drawn from the Nature of the Diſeaſe, and not from their precarious and ſuppoſed Cauſes; nor from their adventitious and caſual Symptoms: And there muſt run an uninterrupted Chain, from the Diagnoſtic Signs [25]of the Diſeaſe, through it's Nature and Cauſes, 'till it ends in a rational and evident Method of Cure.

THUS we ſee that, in order to cure any Diſeaſe, the moſt natural, eaſy, and practical Way, is firſt, to collect the moſt conſtant Symptoms and Effects of the Diſeaſe. But in doing this, we muſt always remember; that our utmoſt Diligence will be abſolutely neceſſary, rightly to diſtinguiſh the Symptoms: That in our collecting the genuine Diagnoſtic Signs of any Diſeaſe, we never ſuffer the ſecondary Signs, or Symptoms of Symptoms, to creep into the Number of the genuine Diagnoſtic Signs. For, if we do, we ſhall certainly render our Inquiries into the true Nature of the Diſeaſe, almoſt fruitleſs and impracticable. But, by ſtrictly obſerving this Caution, we ſhall readily diſcover the Diſeaſe, and it's Symptoms; together with the Cauſes of Both. And if we can come at the Nature of the Diſeaſe, we are about to Cure; there remains no Difficulty as to the Way of curing, be the Appearances of the Symptoms ever ſo various or complicated.

THE direct Method of Cure being thus obvious, the Probabilities of Succeſs muſt be, as the Nature of the Diſtemper we come to Cure, and the Force and Efficacy of the Medicines we adminiſter, reſpectively: And if we already know, or can diſcover by Practice, the peculiar Ways, in which the Medicines, we make uſe of, will act; we ſhall be thereby inſtructed, when one Method, or any one [26]Medicine, is moſt properly adminiſtered; and why it muſt be continued, or laid aſide: which is the Sum and Subſtance of Phyſic.

THE MATERIALS, which compoſe the Method of Inveſtigating, and finding out the Nature of Diſeaſes, having been only diſperſed in ſeveral Parts of the Works of HIPPOCRATES, CELSUS, and other moſt approved Authors in Phyſic, both ancient and modern; and having never yet, as I know of, been thoroughly collected and digeſted into a regular Form: As it may, to this Day, be juſtly ſuppoſed one great Reaſon, why thoſe excellent Hints and Admonitions have not, always, been ſo duly regarded and attended to, as they certainly deſerve; ſo was it, long ago, an Incentive to me to throw them together, with ſome Care and Pains, in the Method, in which I have now delivered them. And I have, for many Years, with much Satiſfaction and Succeſs, experienced the great Benefit and Uſefulneſs of ſo good a Monitor in my own Practice; and I flatter myſelf, it may become equally ſerviceable to others of my Profeſſion, if rightly made uſe of: It being the whole Buſineſs of the Phyſician to find out the Diſtemper, and from that to draw the Method of Cure; and to know the Power and Efficacy of his Medicines, together with the true and exact Manner of Timeing and Doſing them, in each particular Diſeaſe, and its Variations.

THIS METHOD, therefore, of inveſtigating the Nature of all Diſeaſes, being the moſt natural, moſt rational, and certain Way of attaining that [27] compleat Knowledge; I think, it may not improperly be eſteemed the very Maſter-Key to the Knowledge of the Practice of Phyſic: And I imagine, if thoroughly underſtood, and then properly apply'd, it will moſt ſafely conduct us, from the very Threſhold of Phyſic even to its Conſummation; and that, with much greater Expedition and Succeſs, than any other, hitherto known, Method. And, as it will be of very great Service to the Beginner; ſo likewiſe, will it continue to be the moſt uſeful and neceſſary Companion, we can aſſociate withal, through the whole Courſe of our Practice. Wherefore, that I might make this Method familiar to you, I have gradually opened it in the Beginning of this Lecture, and have through the whole variouſly repreſented it: More particularly, I have given it you in two different Views; that I might the more ſtrongly inculcate, and impreſs it on your Minds. And, that nothing may be wanting to it's compleat Uſe; I ſhall endeavour, in my ſubſequent Lectures, not only to make it ſtill more familiar, but alſo as ſerviceable as poſſibly may be, both to yourſelves and Patients; by illuſtrating it with frequent Examples, and the conſtant Application of it to the ſeveral Diſorders, we ſhall hereafter be obliged to treat of. By this means, Gentlemen, I hope, you will be altogether Maſters of the right Uſe of our Method of Inveſtigation, and the Application of it in all the Diſeaſes, and the Varieties of them, you may either meet with in Authors, or obſerve in your own future Practice.

[28]

FOR the reſt: I ſhall take care to direct you, how to judge of the Efficacy and Powers of Medicines, with their peculiar Way of acting: How to adminiſter each Medicine in the moſt proper Doſe, and moſt proper Time of the Diſeaſe: When it may be neceſſary to alter, entirely change, or continue the Methods and Medicines: When, and how, properly to Bleed, and apply Bliſters, in the ſeveral Stages and Complications of a Diſtemper. I ſhall, beſides, furniſh you with a ſelect Materia Medica, and Methodus Praeſcribendi, ſuitable to each Diſeaſe. This introductory Knowledge, joined to your own neceſſary Diligence and conſtant Attention; will, I apprehend, moſt effectually qualify you, to practiſe with Succeſs, in every Diſorder, we ſhall have occaſion to lay before you in this Part of our Courſe.

FINIS.
Notes
*
BOERHAAVE in Epiſtola Aphoriſmis praefixa.
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TextGrid Repository (2020). TEI. 5616 The certain method to know the disease A lecture address d to students in physic. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5F95-2