AN ESSAY ON CUTANEOUS DISEASES, AND ALL IMPURITIES OF THE SKIN.
PROPOSING A SPECIFIC, AND, METHOD OF CURE.
BY JOHN GOWLAND, APOTHECARY TO HIS ROYAL HIGHNESS FREDERICK, LATE PRINCE OF WALES, THE PRINCESS DOWAGER OF WALES, AND ALSO TO HIS PRESENT MAJESTY.
LONDON: PRINTED FOR THE PROPRIETORS, NO. 55, LONG ACRE; AND SOLD BY MR. JOHNSON, ST. PAUL'S CHURCH-YARD, AND MR. MURRAY, IN FLEET-STREET.
[PRICE ONE SHILLING.]
(Entered at Stationers Hall.)
INTRODUCTION.
[]INNUMERABLE are the agents which diſturb our health, and make us liable to a wonderful variety of diſorders and diſeaſes; and it has ever been the buſineſs of the good Phyſician to exert his application, ſtudy, and diligence, in propor⯑tion to their danger and malignancy—Phyſicians, I ſay, whoſe lives are occupied in deſtroying the exiſting cauſes of the different maladies to which we are ſubject, and of re-eſtabliſhing the good order of the animal economy, are certainly the moſt noble portion of ſociety, the moſt uſeful, and (as Cicero has expreſſed himſelf) "Who neareſt approach the Divinity."
Cutaneous Eruptions, although an affection ſo very general, an affection, common to all ages, all conſtitutions, all cities and countries, have, from the enlightened, received little more than mere theoretical diſcuſſion; and thus, unhappily they are not even yet, advanced a long way in this branch of their art.
[4]The only reaſon of their not having made progreſs in this part of the ſcience, ariſes from an error, which, till lately, was univerſally adopt⯑ed concerning the ORIGIN of theſe diſeaſes.
Every one ſeemed ſure that a vice did exiſt in the blood, which when carried to the ſurface of the body, produced the different morbific appear⯑ances: and each, as vainly endeavoured to deter⯑mine the CHARACTER and QUALITIES of this imaginary vice; their labours were neceſſa⯑rily abortive, and, as will ever be the caſe where the criterion cannot be found, a variety of opinions neceſſarily aroſe.
From theſe erroneous and falſe principles they deduced their medical indications, or, in other terms, their method of cure; and theſe methods were not unique, but as numerous and as diffe⯑rent, as had been their particular opinions: con⯑ſequently, by purſuing the FALSE, the true means were neglected. This accounts for their back⯑wardneſs and univerſal want of ſucceſs in theſe complaints.
The caſe is now different; I ſay different, be⯑cauſe in thoſe latter times Phyſicians have known, that the diſeaſes of the ſkin, are a local affection, produced by a depraved and altered ſecretion of the extreme arterial veſſels, or, the cutaneous glands, which are in a PRETERNATURAL STATE: conſequently, this knowledge has led them to [5]attempt the cure, with topical, or external medi⯑cines. The effects have often correſponded with their expectation; but often alſo, their expecta⯑tions have been fruſtrated, for want of a SPE⯑CIFIC REMEDY.
Experience only could bring forward this ſpe⯑cific, which Phyſicians, by ſimple reaſoning alone, never could diſcover.
As all new doctrines in medicine amount to an impeachment of, and directly militate againſt, the judgment and practice of the day in which they are propoſed; they have therefore, not only men's prejudices to encounter, but alſo their pride; and frequently, nothing but the determination of the patients themſelvs can make their adoption general: this was particularly inſtanced in the in⯑troduction of the Bark, Inoculation, &c. &c.
The ſituation of Mr. Gowland, as Apothecary to the Three Royal Houſeholds, was particularly favourable, and gave more frequent occaſion to his experience in the complaints of which we are about to ſpeak, than moſt others; and he lau⯑dably availed himſelf at an early ſtage of this doctrine, with that alertneſs, and obſervation, which eventually produced the ſpecific in queſ⯑tion.
He had obſerved the treatment employed on Miſs Chudleigh, by the Phyſicians under whoſe care ſhe was, and the inefficacy, with which it was [6]attended; and although his Lotion was not admi⯑niſtered, until their efforts had failed of ſucceſs, its wonderful effects went beyond his own, or even his patient's hopes*. This fact alone, was not ſufficient to canonize the Lotion and en⯑ſure to it the reputation of SPECIFIC: but a long uſe, a ſcrutinizing and judicious obſerva⯑tion, was further neceſſary. The fact, how⯑ever, being known, a great number of afflicted perſons, the more readily concurred to try the remedy. This afforded him the opportunity of verifying and eſtabliſhing, the vaſt power of his Lotion, and at the ſame time, was the moſt complete defence of his doctrine and his repu⯑tation, againſt the invidious attacks of thoſe in⯑tereſted men of his time, whoſe practice it ſo di⯑rectly militated againſt.
This happy diſcovery of Mr. Gowland's has been much more intereſting, and more uſeful to mankind, than all the volumes written to this day upon Eruptions of the Skin, as they contain no⯑thing but Theories, and have always been defec⯑tive in the moſt eſſential part, namely, THE MAN⯑NER OF CURING, &c.
It is not enough to SPEAK well upon diſeaſes; the thing more important is to RELIEVE them.
[7]This recalls to my recollection, the hiſtory of thoſe two Greek ſculptors, who were called by the Senate, in order to learn from them, how they would execute a ſtatue which might be alluſive to an hero of Greece, and erect it to his glory. One of them made a long diſcourſe, which ſhowed him to have an exquiſite taſte, and proved, that he was completely maſter, at leaſt of the theory of his art: as he finiſhed, the opinion of the other was required; he anſwered in a few words, "I will DO what my colleague has SAID;" and he was choſen by the Senate, becauſe they deſired THE WORK, and not a diſſertation upon the work.
I have no doubt that many Phyſicians have ſpoken with more elegance and eloquence, upon the impurities of the ſkin than Mr. Gowland has done—but Mr. Gowland RELIEVED HIS PA⯑TIENTS.
Nor is this the only advantage enjoyed by him; it will appear, by this eſſay, that he was ac⯑quainted with the true cauſes of this diſeaſe.
The many reaſons and proofs, which both de⯑monſtrate his knowledge, and the truth of the doctrine, have received additional weight, from having ſince appeared, in the works of the moſt enlightened Phyſicians of the preſent day, and which prove incontrovertibly, that the cutaneous affections are mere LOCAL affections.
It is to be lamented that medical works are [8]chiefly confined to the readings of medical men; and of courſe, however indiſpenſable and whole⯑ſome, the doctrine may be, are therefore never thoroughly diſſeminated, eſpecially, when re⯑pugnant to the general conſumption of medi⯑cine. How far that has been the caſe in what has formerly been written on this ſubject, is left to the diſcernment of the reader. This remark, however, may be made, that, the uſe of a Topical Remedy, in cutaneous diſeaſes, muſt entirely ſu⯑perſede the uſe of internal medicine for theſe complaints; from its pleaſantneſs, eaſe, and cer⯑tainty of cure. Hence ſome oppoſition may be expected from the ſelfiſh as well as the ignorant: characters unhappily too common, even in this profeſſion—characters, on whom the remark of CICERO ſhould be reverſed*.
[9]In the courſe of this eſſay the term SECRE⯑TION is of neceſſity often uſed:—on a thorough knowledge, and indeed, intimate acquaintance with this term, and the exact meaning of it in its fulleſt extent, depends all the information the reader can gain; and in proportion to his ac⯑quaintance therewith, will be his information, and acquaintance with the ſubject.
By the term ſecretion people generally under⯑ſtand no more than certain ſecreted fluids, or mat⯑ters; without conſidering AT ALL, the organs that produce them, or the power of thoſe organs, to alter their properties, from a natural ſtate, and according to the circumſtances, impreſs them with new characters, and frequently characters of diſeaſe.
By the term SECRETION, phyſiologiſts under⯑ſtand a particular operation, performed by the extremities of arterial veſſels, from which reſults a new animal product, or in other terms, a fluid which is furniſhed with new characters and pro⯑perties, ("ſui generis") and of their own diſtinct kind: for inſtance, the bile is elaborated in the liver, and is not in the blood, nor are its cha⯑racters to be found in any other part of the hu⯑man body. Again, the fat is not in the blood, [10]but the arteries, which terminate in the cellular membrane, elaborate and compoſe it by a ſecret and inimitable combination of principles: the poiſon of vipers is not found in the maſs of their fluids, (on the contrary they are very innocent) but it is created by particular organs endowed with that power.
The ſame obſervation applies to all the ſecre⯑tions, particularly that which takes place and is performed in the ſkin, or ſurface of the body, CALLED PERSPIRATION.
Theſe operations are themſelves very ſurpriſ⯑ing and difficult to be underſtood, it is however, enough to know the effects, and theſe effects are, as has been obſerved, generally, of their own pro⯑per and natural kind.
Nor is this doctrine confined to animals alone, it is the ſame in greens, plants, and flowers them⯑ſelves; their different colours, ſmell, taſte, &c. are from a ſpecific combination of parts, the con⯑ſequence of different ſecretions.
Since then the EARTH, from which they have their nouriſhment, has not in itſelf, ALL the dif⯑ferent principles, qualities, ſalts, and juices, which they themſelves poſſeſs, ſo it is neceſſary to al⯑low, that this combination, is the reſult of the veſ⯑ſels of thoſe vegetables, adapted to an inherent power in them, the ſame as the ſecretions of ani⯑mals: and if it is abſurd to aſſert (as it certainly [11]is) that theſe different products and matters exiſt READY PERFORMED in the earth; ſo it ſhould be equally abſurd to think that the different ſecreted fluids in animals exiſt READY PERFORMED, or that their characters, are in the BLOOD.
In the peruſal of this little work, the intelli⯑gent reader, it is preſumed, will find reaſoning and fact founded on reflection and experiment, agreeing with the trueſt principles of the art, and not on ſimple ſpeculation: nor is it doubted but the truth and candour of Mr. Gowland's Eſſay will entitle his Specific to that confidence which the experience of fifty years, and the teſtimony of thouſands, in the firſt ranks of ſociety, have proved it to deſerve.
THAT the following Pages had been intended for Pub⯑lication by Mr. GOWLAND in his life-time, is evident:— why it did not take place, we are at a loſs to ſurmiſe. They were found among other MS. papers after his death, and have been ſubmitted in that manuſcript to a Gentleman, who, from his philanthropy and medical talents, is an orna⯑ment and a bleſſing to the Country in which he lives. The truth of the doctrine, he declared was ſuch, and withal ſo little known, that he ſhould regret extremely if it was with⯑held. This obſervation determined the preſent Proprietors of his ſpecific, on its publication, and they conceive they are doing no more than their duty, to the public, and to them⯑ſelves, in demonſtrating alſo, that this remedy has not ſuf⯑fered any diminution, or loſt any of its virtues, in its miſſion from the inventor's hand to their's; in proof of which, they here adduce the following general teſtimony:
CERTIFICATE OF THE EFFICACY OF THE GENUINE GOWLAND's LOTION, PREPARED BY ROBERT DICKINSON, UNDER THE INSPECTION OF HIS FATHER-IN-LAW, THOMAS VINCENT.
[12]We whoſe names are hereunto ſubſcribed, being well ſatisfied that the uſe of the Genuine Gowland's Lotion is calculated, and adequate to cure the moſt violent eruptions of the face, &c. and alſo to cleanſe and clear the ſkin in general, We ſeel, as if promoting a general benefit, in permit⯑ting the Proprietors, to refer any perſon to us who may deſire ſuch ſatiſ⯑faction, and alſo, in authoriſing them thus publicly to uſe our names.
- A. CRUGER, ſon to the Member of Parliament for Briſtol.
- THO. MAYER, of Queen-ſquare, Weſtminſter, and Malton, in Yorkſhire.
- RICHARD BETHEL COX, Craig's-court, Charing-croſs.
- THO. HOLLOWAY, Chancery-lane.
- PETER CRAWFORD, York Houſe, Albemarl-ſtreet.
- JAMES BAILY, York Houſe, Albemarl-ſtreet.
- JAMES FOZARD, Park-lane,
- ALEX. WEATHERLEY, Crown-and-ſcepter-court, St. James's. ſtreet.
- FRANCIS UNDERWOOD, No. 228, High Holborn.
A letter from Mrs. Jane Fountain, of High-ſtreet, Mary⯑le-bone, has in it alſo this very remarkable paſſage:
‘"I have recommended the Lotion for upwards of thirty years to all my female acquaintance, as a general cleanſer and clearer of the ſkin, and have as conſtantly received the thanks of thoſe who have uſed it."’
Mrs. Patterſon Anſtruther, of Ely Houſe, Fifeſhire, and ſiſter-in-law to the Member of Parliament, has ſavoured the Proprietors with this very expreſſive declaration:
‘"I have found it [...] a great cleanſer, and clearer of the ſkin, though at firſt it occaſioned rather an alarming ſcurf. A. P. W. ANSTRUTHER."’
The reſpectability of thoſe teſtimonies is ſuch as muſt ſu⯑perſede the neceſſity of all further remark.
PRELIMINARY OBSERVATIONS.
[]AMONG the Chronical Diſeaſes, the Eruption of the Skin is one affection, the moſt common, and, at the ſame time the leaſt dangerous: it is not preceded by any cauſes, capable of inducing a diſorder in the animal economy, and thoſe who are thus afflicted always enjoy the beſt ſtate of health. This excludes the idea of that humoral vice, to which ſome Phyſicians, aſcribe every diſorder, when the cauſe thereof is unknown to them. Some learned Engliſh Phyſicians, how⯑ever, of the preſent day, have taken away the veil to this ſpecies of impoſture, and have brought to light the vacuum that did exiſt in the hy⯑potheſis of humours; and yet, notwithſtanding their efforts, the ſame prejudices nevertheleſs exiſt, and indeed, are almoſt general, from their works having been chiefly confined to the read⯑ing of medical men. The humouriſts have ne⯑ver been able to ſupport their opinion beyond the moſt ſimple conjecture, the ſtrongeſt of which is, that the work of Chylification and Sanguifica⯑tion, or of Chyle and Blood, is often ill perform⯑ed, [14]and conſequently the fluids remove more or leſs from their natural ſtate. One might anſwer theſe gentlemen, that if the aliments are not all converted into chyle, the lymphatics or lacteal veſſels of the inteſtines do not abſorb the remain⯑der, and that they refuſe admiſſion to all matters which have either an acid or alkaline quality; that is, theſe veſſels have a power of attracting what is proper for them, and of repelling what is not: thus their mouths become ſhut the inſtant their outer extremities are approached by theſe ſubſtances, and except to ſome violent medicines, open only to what is neutraliſed and fit for nu⯑trition. In order to demonſtrate this, we need but obſerve, that there are always matters in the inteſtinal canal, which are naturally in a cor⯑rupted ſtate, namely the reſidium of the chylifi⯑cation or excrements, and which, are refuſed upon the ſame principle.
There is alſo in the inteſtines a quantity of gaz really mixed with the aliments and chyle; but this is never abſorbed by the lymphatics in the pure ſtate of gaz; I ſay never, becauſe if it ſhould happen, immediate death would be the certain conſequence of ſuch abſorption: in fact, when this gaz, or ethereal fluid are injected into the cellular of the ſkin, or into the veſſels of any animal, the moſt dreadful diſorders enſue, and, in general, death itſelf. This has been demonſtrated by the experiments of the Abbe Vaſſalli. And, [15]as to the ſanguification, it is demonſtrated, that the atmoſphere makes this admirable proceſs,—changes and converts the fluids into animal ſub⯑ſtances, and renders them proper for nutrition: it is for this reaſon, that in individuals who have a bad temperament or conſtitution, the blood is as good, as in the moſt robuſt, and healthy. This fine and precious obſervation, is made by Dr. Ballonius, the Hyppocrates of France.
There are alſo poſitive vital powers, in the life of the animal, which prevent the degenera⯑tion of humours, as is demonſtrated by experi⯑ments and facts; from which it reſults, that the circulating fluids, though they are not refreſhed by new aliments, preſerve themſelves innocent. V. Haller Phyſiolog:—Tit de fame et Siti, &c. And laſtly, many organs exiſt in the animal body, which continually purge and purify the maſs of blood, if by any accident heterogeneous matter ſhould intermix therewith: but without ſtopping any longer on this queſtion, I return to my ſub⯑ject.
I have ſaid that the Cutaneous Eruptions do not originate by any acrimony of the fluids: their proximate cauſe is an altered ſecretion, which takes place in the ſkin.
That the perſpiration be a ſecretion, ſui gene⯑ris, is a fact which wants no proof, and it would be ridiculous to doubt, and queſtion, upon any phy⯑ſiological [16]point ſo evident as this is. That every ſecretion is liable to be changed, and more or leſs altered, by a variety of circumſtances, there are many inſtances. Individuals who are ſea⯑ſick, often bring up a great quantity of bile, which is black and corroſive, and is very far from being in a natural ſtate. It alſo happens frequently that children when cutting their teeth have very fetid Diarrhoea, from the ſtimulus of the gums communicating with the inteſtines. It is an obſervation of Sydenham, that hyſterical women ſometimes vomit bilious and depraved matters, which did not exiſt before the paroxiſm in the ſtomach nor in the bowels, but which had been ſeparated during the paroxiſm itſelf.
In the ſame women, as well as in the hy⯑pochondriacal, when afflicted by their mala⯑dies, a very copious quantity of urine is in⯑ſtantaneouſly ſeparated, and it is as limpid and clear, as ſpring water. This ſecretion is the ſure, or as Phyſicians ſay, the pathognomonicon ſign of this diſorder. Sometimes fear alone will ſud⯑denly arreſt the menſtrua; ſometimes anger will provoke an hemorrhage of the uterus. Grief and ſorrow conſtantly occaſion a greater ſecre⯑tion of bile, and this fluid is ſometimes ſo acrid as to produce convulſions, or the more dreadful effects of melancholy, or pains in the inteſtines, or colick; and if it be by any accident abſorbed [17]and brought into circulation, excites ſome ſe⯑rious or fatal diſorders. The ſecretion of the milk, by violent pathemata, or paſſions of the mind, has been on ſeveral occaſions ſtopped, and it often happens that its qualities are changed and vitiated: in the laſt caſe the child is violently purged, or affected with convulſion-fits, and other indiſpoſitions and diſorders. In a word, every organ, which nature has deſtined to perform any ſecretion, is ſubjected to the influence of the nerves, and as a certain conſequence receives and partakes of all the affections of this ſyſtem.
Now nothing is more certain, than that thoſe organs, which are ſupplied with the greateſt ſhare of ſenſibility, and which have a more intimate connection (let me ſay) with the nervous ſyſtem, will ſuffer more than other parts in exact propor⯑tion to the cloſeneſs of that connection. I will now aſk what part in the animal body, has ſo much connection with, or dependence on the nerves, as the ſkin? Certainly none. It is from the in⯑numerable quantity of nerves which are inter⯑ſperſed throughout, and actually terminate in the ſkin*, that this dependence and connection ex⯑iſts, and thus it is that the anxieties, emotions, and troubles of the mind,—the morbific ſtate of the viſ⯑cera, the tooth-ach, a bad digeſtion, and a hundred [18]other CAUSES, are capable of influencing the tranſpiration, and thereby materially affecting the health of the ſkin; beſides, that the action of the atmoſphere muſt be calculated, and conſidered, as one of the moſt obvious, and powerful agents.
The cauſes laſt ſpoken of, do not always act; for inſtance, they do not act when the tone of the Cutaneous veſſels is above the irritability of the muſcular fibre; and ſometimes, although an im⯑preſſion be made upon thoſe veſſels, nevertheleſs no eruption takes place, becauſe in this caſe, the other ſecretions are augmented, in the ſame pro⯑portion, as the cutaneous ſecretion is diminiſhed: This is eſpecially obſervable in cold weather*. Hyppocrates ſays—Cutis denſitas ventris laxitas. It is not only by the belly that this compenſation of ſecretion is executed, but the Reins are alſo ano⯑ther Canal, by which the ſuperfluous fluids are commonly evacuated.
Perſons of an irritable temper, a great mobi⯑lity, a fine a delicate ſkin, and a diſpoſition to the cutaneous eruptions, ſuffer very much from the humidity and viciſſitudes of the air, and every kind of irritation. The animal powers in ſuch individuals are very often inſufficient to prevent the diſorders in queſtion.
One reflection ought here to be made; it is, [19]that a great number of perſons are ignorant of the cauſe of their complaint, although it really exiſts in themſelves; but where the cauſes are ſo extremely numerous, it cannot be expected I ſhould enumerate them all: yet in order to be underſtood, I ſhall inſtance a few facts, and at the ſame time obſerve, that the effects frequently remain, when the primary cauſe has ceaſed.
There are many women, who, in certain deli⯑cate circumſtances, are frequently troubled with effloreſcences, pimples, &c. in their faces, hands, legs, &c. but who, not perceiving any ſenſible unuſual trouble, or inconvenience, do not im⯑mediately think of the ſtimulus that exiſts in the internal organs, and are therefore far from con⯑ceiving it to be the cauſe of the preſent cuta⯑neous affection.
A great eater, who vigorouſly executes all the functions of life, and is perfectly well, never ſuſ⯑pects that his ſtomach is ſtimulated by the far⯑rago of aliments, with which it is continually aſ⯑ſailed; but ſeeing the ſurface of his body covered with eruptions, is diſpoſed to attribute them to any cauſe rather than the true one. But there is a variety of ſtimulus, of which our internal organs are ſenſible, that we do not perceive; thus, we have no ſenſe of the ſtimulus excited by the blood circulating in the heart, nor of that which the juices of the ſtomach occaſion [20]in its nervous membrane, and which the bile and other juices, occaſion in the inteſtines, &c. &c.
If theſe different ſtimulus, and many others, I do not ſpeak of, are increaſed, and become violent, then not only the proper organ where the ſpecific fluids are ſeparated and collected, but other parts, are, by ſympathy, ſenſible thereof, without any knowledge or conſciouſneſs of the mind. It is from effects that a knowledge of the wonderful laws of the animal economy is obtained; and in order to prevent mankind's being any longer miſtaken, as to the real ſources of cutaneous eruptions, I have endeavoured to explain them the more fully, that they may be the better underſtood.
I have ſaid, that the ſenſibility and mobi⯑lity of the arterial veſſels are ſo very great*, that they ſympathize, extremely, with all the ner⯑vous ſyſtem, but, particularly with the ſtomach, the inteſtines, and the womb, &c. and alſo, of the peculiar influence, which, the paſſions of the mind, affecting the nerves, have upon the ſkin; nor, muſt we forget what is ſtill greater, the action of the atmoſphere, to which the face, particularly, is always expoſed. Since then, there are ſo many [21]agents to diſturb the functions of the ſkin, it is not extraordinary to ſee the ſurface of the body, and particularly the face, ſo often affected with lumps, blotches, pimples, effloreſcence, herpeys, &c. &c.—indeed, it would be more extraordi⯑nary if it was otherwiſe.
The action of ſtimulus, directed now to one part, and now to another, gives occaſion to par⯑tial eruption, and the character of this eruption differs, according to the nature of the ſtimulus, its duration, and, of the ſenſibility of the perſon affected.
Theſe appearances, ſometimes, reſemble ſcor⯑butic ſpots, and the practitioner, not well in⯑ſtructed, often confounds the one with the other, but without reaſon; becauſe the real ſymptoms of ſcurvy, never attend the affections we are ſpeaking of.
It is truly important to determine the true cauſe of this diſorder, for, from hence, one ought to deduce the medical indications; and I have endeavoured, in my little work, to fix this point, aſſiſted by reaſon, experience, and authority.
In order then, to demonſtrate the ſevere con⯑ſequences which obtain, by a wrong and falſe principle, we need but reflect upon the ordinary method of humouriſts in the caſe in queſtion; they always begin by purging and bleeding, and [22]ſo prepare the body to the uſe of remedies, which they call ſweeteners and balſamicks.
This plan is as infamous as their theory, as it ſerves merely to weaken more and more the con⯑ſtitution, and, from hence, the cutaneous affec⯑tions take a greater extent, and its character be⯑comes more hurtful, ſevere, and uneaſy. Ex⯑perience ſo fatal ought to teach them to re⯑nounce a practice which is always uſeleſs, and frequently dangerous.
Another remark muſt be made on the method of humoriſts; it is, that they attempt to cure in the ſame manner all the unhappy perſons which fall into their hands, however various may have been the cauſe. If in their opinion an acrimony does exiſt, it cannot be the ſame in all individuals; nay, it muſt extremely differ from one another from their tempers, conſtitution, age, cuſtoms, and paſſions, and, to be corrected, its nature ſhould be known, &c. It is another argument of the abſurdity of the treatment employed by the hu⯑moriſts, and is alſo, equally a proof, that they have not an idea, nor juſt nor falſe, of the acri⯑mony which they undertake, and pretend to deſ⯑troy, and, that they exerciſe the art blindly.
The good practitioners, inſtead of occupying themſelves, to correct an imaginary vice of the blood, direct their thoughts to the ſkin, as there is the focus and ſeat of the diſorder.
[23]The qualities of the eruption are not always the ſame, nay, they differ materially, not only in different ſubjects, but alſo in the ſame in⯑dividual; for a perſon may have ſpots, her⯑peys, blotches, &c. &c. all at the ſame time, which could not happen if the vice was in the blood, for then they would be all of the ſame ſpecies of eruption, which is not here neceſſary, as it proceeds from an altered ſecretion, and this ſecretion is not every where the ſame, but changes in different parts in the ſame body, be⯑cauſe every part, nay, every point of the body, is furniſhed with ITS OWN ſenſibility, and as the phyſiologiſts ſay, "Sua fruntur vita."
It might ſeem contradictory and paradoxical, that we ſhould propoſe one remedy as the ſpecific in all theſe caſes; but it is not ſo, for we are NOT intending by THIS remedy to attack the bad qualities of the matters which occaſion the local diſorder, becauſe we know not their intrinſic na⯑ture; there is another way for us to take that is more ſhort, eaſy, and at the ſame time ſure; it is to alter the action of the veſſels which prepare it improperly,— IT IS TO CHANGE THE CUTA⯑NEOUS SECRETION, by applying to the veſ⯑ſels themſelves. The ſmall arteries which fil⯑trate the perſpirable matter, are affected with ſpaſm; I ſay, with ſpaſm, for I ſee that the re⯑mote cauſes of the eruption act upon the ſkin [24]as ſtimulants; and I obſerve, that, if the ſtimulus be momentary, the eruptions almoſt always diſ⯑appear ſpontaneouſly, with ſwiftneſs and faci⯑lity. When the ſtimulus has been of long con⯑tinuation, the ſpaſm continues though the ſtimu⯑lus has ſubſided, and EXISTS NO MORE.
From the foregoing reflections, it is eaſy to perceive, that the principal indication in the cutaneous affections is TO RESOLVE THE SPASM, from which the preternatural ſecretion depends, and to give a bland tone to the cutaneous veſ⯑ſels.
The Lotion produces this effect, by calming the ſpaſmodic contraction, and reſtoring the tone of the excretories, and the cutaneous veſ⯑ſels.
It often happens, that in the firſt moments, the uſe of the Lotion increaſes the eruption, be⯑cauſe the action of the ſkin becomes more eaſy and natural: this ſymptom, beſides being de⯑monſtrative and ſatisfactory, announces always a very quick recovery.
Generally the recovery is not rapid, but comes on ſlowly, and in proportion as the veſſels ap⯑proach their former ſtate, and uſual manner of acting.
THE ANATOMY OF THE SKIN.
ITS IMPURITIES, AND THE CAUSES THEREOF.
[]NATURE has been no leſs bountiful and attentive to the ſtructure of the external covering, than to the more noble parts of our frame; it is no leſs remarkable for its general uſe, than for its beauty; it is compoſed of two parts, viz. the epidermis, or ſcarf-ſkin, which is the external, and the cu⯑tis, or true ſkin, which is underneath: the firſt is inorganic; the other is, what anatomiſts call highly organized, being made up of arteries, veins, and nerves, and exquiſitely formed to convey to the mind, the various impreſſions we receive, which impreſſions, we call feeling.
It is beſet with many ſmall glands, for ſeparating the per⯑ſpirable matter, and with others alſo, which furniſh a dif⯑ferent and a more mucilaginous fluid, contained in a fine reticular, or network ſubſtance, between the outward and inward ſkins, to ſheath the nerves from injury, and regu⯑late the ſenſe of feeling, which would, without ſuch pro⯑tection, be too exquiſite. The internal ſurface becomes in⯑ſenſibly of a leſs firm texture, and at length degenerates into the cellular membrane; a great number of arteries, and ſtill greater number of veins, extend themſelves within its ſub⯑ſtance; the lymphatics diſtributed upon it, are alſo very numerous, as well as the nerves, the extremities of which evade the obſervation of the moſt diſcerning anatomiſts.
[26]The ſcarf, or outward ſkin, is a very fine tranſparent membrane, in the compoſition of which, neither veſſels or fibres are obſervable; it is, in itſelf, not endued with a ſenſe of feeling,—eaſily ſeparated from the parts beneath,—is renewable when it peels off, or is deſtroyed by any accident; —it is pierced by an infinite number of pores, which afford a paſſage to the hairs, and in which, terminate, the lympha⯑tics and excretory ducts of the ſebaceous glands; it is pre⯑ſerved ſoft and ſupple, by the mucus ſecretion below it, and by the perſpirable matter opening on it, through thoſe in⯑numerable pores. It is generally imagined by anatomiſts, that, this membrane is formed by the condenſation of a fluid, furniſhed by the extremities of the capillary arteries.
Under the true ſkin, and over the muſcles, Nature has placed another covering, called the membrana cellularis, or cellular membrane; between this membrane and the true ſkin, lie a number of ſmall glands, called ſebaceous glands: theſe glands have one or more excretory ducts, every where opening on the ſurface of the ſkin, through which is tranſmitted the fluid the glands ſecrete, to lubricate the ſkin, and keep it lax, and a very important office they do per⯑form. Other glands ſeparate a fatty matter of the ſkin, of the nature of ſuet, and theſe are found, in thoſe parts of the body, which are moſt expoſed to the action of the air; in other parts it does not contain any.
The ſkin is capable of being diſtended, and of contracting itſelf to a ſurpriſing degree; it has a variety of uſes; but we ſhall confine ourſelves to that one only, which is moſt parti⯑cularly intereſting to our ſubject, namely, the ſecretion of the matter of perſpiration. I muſt not here be underſtood as ſpeaking of a fluid floating in, and circulating with the blood, but, of a fluid which the veſſels and glands them⯑ſelves prepare and elaborate, upon which, they impreſs characters of a greater, or leſſer, degree of malignity, accord⯑ing [27]to the degree of ſtimulus with which they are oppreſſed. This matter, in its natural ſtate, is only a watery fluid, but when by any exciting cauſe, its quantity is increaſed, its na⯑ture is changed, and it immediately appears to contain a ſa⯑line principle, along with a certain quantity of inflammable air.
In acute diſeaſes, convulſions, and epilepſy, its altera⯑tions are frequently very remarkable, ſo that its ſmell be⯑comes diſguſting and intolerable. From numberleſs other cauſes, it frequently happens, that this ſecretion is won⯑derfully changed, ſo that the matter furniſhed by it, ad⯑heres to, and corrodes the ſkin, and forms a chronic cu⯑taneous diſeaſe.
This laſt ſubject, is meant to be inveſtigated in this Trea⯑tiſe.
OF CUTANEOUS ERUPTIONS.
THE appearance, of cutaneous eruptions, varies conſide⯑rably, either on account of the different ſenſibility of the perſons affected, or, of the different character of the ſecreted fluid.
Sometimes they preſent themſelves, as a red effloreſcence, under which a white powder is formed, which, after ſome time, falls off, and leaves the ſkin apparently healthy; the effloreſcence, however, again makes its appearance, and again goes off in the ſame way. Theſe alterations continue for life, unleſs cured by a topical remedy.
At other times, there are very ſmall puſtules or pimples, like millet-ſeed, filled with a tranſparent water, which when ſhed, condenſes and forms cruſts or ſcabs; theſe detach themſelves, but the ſkin underneath being inflamed, pours [28]out freſh matter, which undergoes the ſame change as the firſt.
Sometimes, likewiſe, there are puſtules, containing ſerum, which at firſt is white, then becomes yellow, excudes, and is converted into cruſts; at other times the diſeaſe puts on the appearance and ſymptoms of the itch. What is called black worms frequently appear on the noſe, the chin, the cheek bones, &c. this is the ſebaceous matter of the glands, obſtructed and lodging in the ducts, which when ſqueezed out, have the appearance of worms; the black⯑neſs at the outward extremity is dirt, too much inſinuated to waſh off; and the reaſon they infeſt theſe parts particu⯑larly, is owing to the ducts being larger on thoſe extremities than in other parts.
And laſtly, in other inſtances, there is only a redneſs in the ſkin, or ſpots, which prove extremely troubleſome, from the itching which attends them. Senſations of prick⯑ing and itching almoſt conſtantly attend diſeaſes of this na⯑ture, and it ſcarcely ever happens, that they go off of them⯑ſelves.
That theſe diſeaſes of the ſkin, are, in general, ſimply local affections, was an opinion entertained by Dr. Cullen, one of the moſt enlightened Phyſicians of the preſent age; and from the numerous remote cauſes, it evidently appears, that a DEPRAVED SECRETION, in the cutaneous capillary arte⯑ries, and the vicious elaborated matter, by the cutaneous glands, are the proximate cauſe of the diſeaſe.
I. This acrid and corroſive matter, could not exiſt in the maſs of blood, without exciting grievous diſorders in the animal economy; but, as the latter does not exiſt, there is not any reaſon for ſuppoſing the exiſtence of the former.
II. Thoſe perſons who are ſubject to eruption, generally enjoy good health, and execute their functions without in⯑convenience.
[29]III. Thoſe who have a bad conſtitution, and in whom one might, with ſome appearance of probability, ſuppoſe an acrimony exiſting in their fluids, are leaſt of all ſubject to eruptions. They are never met with in caſes of chloro⯑ſis and cachexy.
IV. The eruption is generally confined to ſome one par⯑ticular part; as to the noſe, the cheeks, the breaſt, or the ex⯑tremities, but almoſt, always, to the face alone.
If it were true, that the arteries received from the blood, the matter which occaſioned the eruption, and that they diſcharge it upon the ſurface of the body, why do they not diſcharge it in equal proportion upon every part of it? Would it not be abſurd to ſuppoſe, that the artery A, or the artery B alone, ſhould have a power of ſelecting, every thing viciated, from the general maſs, whilſt all the other veſſels of the ſyſtem receive their blood from the ſame ſource?
V. Cutaneous diſorders, are not peculiar to any particular claſs of individuals, but attack all without diſtinction.
Thus, we meet with them alike, in the voluptuary, and the aſcetic; in thoſe who are little ſenſible to the allure⯑ments of wine, or the ſtill ſofter ones of love; in thoſe who do not work, as in thoſe who do: in a word, the diſeaſe at⯑tacks perſons of all temperaments, characters, and paſſions. This, precludes every ſuſpicion of a ſpecific acrimony of the humours, as it could not be found in the midſt of circum⯑ſtances ſo oppoſite to each other.
VI. And laſtly, if there really exiſted a diſeaſe in the fluids, ſome advantage might be derived from the uſe of thoſe means, which Phyſicians have characteriſed under the titles of edulcorants, refrigerants, balſamic and antiſceptic me⯑dicines; but, on the contrary, experience has unfortunately ſhewn, that inſtead of the patients receiving benefit from their employment, the diſeaſe is uniformly exaſperated, and [30]becomes worſe and worſe: for confirmation of this fact I have only to appeal to the tribunal of thoſe who have been the victims of their credulity. The ſkin is therefore the ſource of the eruption.
M. Lorry, a very ingenious French Phyſician, who has written a very voluminous work upon cutaneous diſeaſes, adduces many inſtances of perſons, who the inſtant after having eaten of certain kinds of aliment, or taken certain liquids, had the face, or ſome other part of the body covered with pimples, which diſappeared as ſoon as the irritation of the ſtomach had ſubſided.
Eruptions, alſo, frequently appear, in a very remarkable ſhort time after drinking cold liquors, particularly cyder, when heated; this is one eruption which often finally be⯑comes a real chronical cutaneous diſeaſe.
Riverious Hoffman, and all eminent practitioners, have remarked, that, the ſaburra of the alimentary canal, frequent⯑ly occaſions eryſipelatous affections, which go off as ſoon as the ſaburra is evacuated.
Pechlin, quotes examples, of inſtantaneous eruptions, produced by violent emotions of the mind, and the hiſtory of medicine teems with ſimilar examples.
A woman, Hyppocrates tells us, had, during pregnancy, an exanthematous affection of the face, which went off im⯑mediately after delivery.
There are many women, as M. Lory has obſerved, who in certain delicate circumſtances, have eruptions which laſt as long as their cauſe continues to exiſt, and no longer.
From theſe obſervations, it is evident, that the ſkin has a conſent or ſympathy with every part of the nervous ſyſtem, —that every impreſſion, whether phyſical or moral, may eaſily become an indirect ſtimulus to the ſkin, and, that this ſtimulus is capable of altering its functions in ſuch a way, as to give riſe to a ſecretion of an acrid matter, and conſequent eruption.
[31]Since we are here in poſſeſſion of cauſes which explain, in the moſt ſatisfactory manner, the origin of cutaneous diſ⯑eaſes, it is by no means neceſſary to ſeek for another in the blood, and gratuitouſly ſuppoſe the exiſtence of an univerſal acrimony.
The term acrimony, is, in its application, extremely ana⯑logous, to the occult qualities ſo much in uſe, among the an⯑cients; that is to ſay, a term void of ſenſe, a term, to which Phyſicians only aſſociate falſe and arbitrary ideas.
The acrimony which is generally accuſed, is that of the ſcurvy.
It is commonly the want of ſound freſh animal food, with the want of vegetables, which gives riſe to the ſcurvy; but, in London, neither of theſe is wanting: we are provided with excellent fermented malt liquors, as beer and porter, with brandy, rum, and other ſpirits, and foreign wines, which may all be conſidered as ſo many antiſcorbutics*. We are not in the neighbourhood of marſhes; ſalted or ſmoak-dryed fleſh or fiſh do not conſtitute any conſiderable part of our food, neither do we drink putrid or ſtagnated water, which give the diſpoſition to ſcurvy. In a word, however it may have ſuited the intereſt of regulars or irregulars to inſiſt upon it, our mode of living, and our ſituation, are by no means, favourable to its production.
Scurvy is preceded or accompanied by ſymptoms, which are never met with in the cutaneous affections of which we are ſpeaking. In fact, the ſcurvy begins by a ſpontaneous weakneſs, or ſenſe of weight in the whole body, pain in the muſcles, inability to walk, a difficult and laborious reſ⯑piration. The colour of the face of ſcorbutic patients, is pale and ſallow, the mouth exhales a fetid ſmell, the gums become red, painful, and flabby, and liable to bleed upon the ſlighteſt preſſure, the teeth fall out, flying pains are felt in [32]different parts of the body, bleedings come on, and laſtly, (and not till then) ulcerations make their appearance, parti⯑cularly in the legs, and the ſkin becomes covered with an itchy eruption, puſtules, and cruſts.
The matter which produces the eruption is ſo acrid as to corrode the ſkin, and its ſmell is highly diſguſting and alka⯑line. This ſhort ſketch evinces the enormous difference, which obtains between ſimple affections of the ſkin, and the real ſcurvy.
Thoſe who confound them together, either are unac⯑quainted with the cauſes, and nature of theſe diſeaſes, or they abuſe the confidence which the world, without ſuffi⯑cient examination, may repoſe upon their talents or integrity.
Having laid down theſe principles, which are ſupported both by reaſoning and facts, I may advance, without running a riſk of being accuſed of temerity, that, cutaneous affections, being a local diſeaſe, require a local treatment.
(NOTE.) The ſingle authority of Mr. Gowland upon this point, may not, perhaps, be of ſufficient weight to carry along with it conviction and perſuaſion, but, the world, ſurely, will not refuſe to accord its confidence to that of men of ſcience. The Proprietors, therefore, take the liberty of adducing the authority, of one of the moſt reſpectable ſurgeons, this, or any other country can boaſt of, and, whoſe works are known in every part of Europe; we mean the Profeſſor Bell, of the Univerſity of Edinburgh.
"It was" ſays he, "till lately believed, that eruptive diſeaſes of this nature (herpetic) could never appear but in conſequence of ſome general morbid affection of the ſyſtem, and, accordingly, a great variety of internal remedies have been recommended, by almoſt every author who has written upon the ſubject. It has even been commonly conſidered, as an unſafe and dangerous practice, to attempt the cure of [33]ſuch eruptions in any other way, than by correcting the fluids which at firſt were ſuppoſed to have produced them: it is ſomewhat ſingular, however, that the opinion ſhould have remained ſo long uncontroverted by regular practitioners; as, from the writings of many old authors it appears, that complaints of this kind were conſtantly and eaſily cured, as they ſtill are, by every itinerant, with local external ap⯑plication only.
"This, we ſhould imagine, ought, very ſoon, to have over⯑turned the general notion, which prevailed with reſpect to the nature of thoſe diſorders, and which ſeemed, all along, to have no other foundation than antiquity for its ſupport. Modern practitioners, however, not being ſhackled by ſuch authority, have, in many inſtances, ventured to diſpute, and boldly to deviate from, the opinions of their predeceſſors, and the improvements which have univerſally reſulted from ſuch a free ſpirit of enquiry, have never yet given them rea⯑ſon to repent their having done ſo.
"This, in no inſtance, has been more remarkable, nor at⯑tended with better effects, than in the treatment of cuta⯑neous diſorders, which, from having been very perplexed, and intricate, will ſoon, it is hoped, become a very ſimple, and eaſy part of the practitioner's employment.
"Inſtead of the tedious, and debilitating courſes of medi⯑cines, which patients went through formerly, and which, perhaps, they are ſtill too frequently obliged to undergo, it is now found, that the greateſt number of theſe complaints, are more certainly, and ſpeedily removed, by the uſe of local remedies merely, than they ever were by a contrary courſe."
BELL, on the Theory and Management of Ulcers.
Sect. ix, page 336.*
[34]Bell became convinced, by long experience, that the ex⯑ternal application of medicaments, rarely diſappoint the ex⯑pectations of the Phyſician and Patient. He enumerates ſe⯑veral of thoſe employed, as well by him as others, and ob⯑ſerves, that the principle dependence, is to be placed upon thoſe which are of an aſtringent and drying quality.
I have been able to diſcover a remedy which I may with the greateſt propriety ſtile "the Specific for Cutaneous Diſ⯑eaſes;" it has a great advantage over thoſe which have gene⯑rally been employed, namely, that ſo far from poſſeſſing any the ſlighteſt repellant quality, it is the very reverſe, and acts in a mode diametrically oppoſite thereto. Its operation con⯑fiſts in taking off the ſpaſm of the extremities of the capillary arteries, removing the inflammation where it exiſts, and gradually bringing back the excretorious veſſels to the diſ⯑charge of their natural functions.
Some days after its employment, the inflammation diſap⯑pears, and conſequently the tranſudation; after which, the ſkin reſumes its natural ſtate and complection. If there are any puſtules, they become in the firſt place leſs troubleſome, which ſhew that the lymph they contain has loſt ſomewhat of its malignant properties.
Laſtly, they diſappear altogether, and never appear again in any part of the body, except ſome new cauſe ariſes, or that the natural texture of the ſkin ſhould be inadequate to reſiſt the power of the external air, in which caſe its appli⯑cation ſhould be ſometimes repeated.
In thoſe caſes, which, actually owe their riſe to ſome ſpe⯑cific virus, as the ſcrofulus, venereal, &c. even though the morbific cauſe be deſtroyed, the local diſeaſe of the ſkin is incapable of curing itſelf. Veſſels which have been in the habit of making, a depraved ſecretion, do not of themſelves, change this diſpoſition, although the maſs of [35]blood and the conſtitution be in a healthy and natural ſtate. Van Swieten, when ſpeaking of venereal ulcers, has made this obſervation: Here the neceſſity of a topical treatment becomes particularly evident; that is, the application, of a remedy, to the part affected. Thus, the Lotion is productive of the greateſt advantage, even in ſcrofulus, and ſcorbutic caſes.
We have ſaid, that there are ſebaceous glands in the ſkin, the excretory ducts of which, throw out a ſuetty matter, and that there is likewiſe a great number of excretory veſſels, which are, a continuation of the capillary arteries.
Theſe ducts and veſſels, are frequently, conſtricted by ſud⯑den cold, ſo, that the matter which ought to be exhaled, is pent up, and if not evacuated by the inteſtines or kidneys, it forms tubercles, or hard knots, and ſmall viſſicles, as has been obſerved, by the celebrated Ludwig.
The face, is the moſt common ſeat of the eruption of which we are ſpeaking, on account of its being expoſed more than any other part of the body, to the action of the air. Eruptions will ſometimes frequently remain, after the cauſe has ceaſed; for, nature is not always equal, by its own pow⯑er, of reeſtabliſhing theſe minute organs in their natural functions; in conſequence of which, the ſkin remains dis⯑figured, not only by a partial redneſs, but by ſcabious irre⯑gularities on its ſurface, and even by matter contained in puſtules, and by cruſts, which ariſe from the condenſation of the lymph, eſcaping from the veſicles.
If this affection be unfortunately neglected on its firſt ap⯑pearance, it ſoon overleaps its firſt limits, extends its ſphere of action, and every day gives additional force to its malig⯑nity. This diſeaſe, commits horrid ravages on thoſe perſons whoſe general ſyſtem is in a ſtate of debility.
The female ſex, the endearing bond of ſociety, when once attacked by theſe diſorders, ſuffer more from them than men, on account of their ſkin being poſſeſſed of a far greater degree of delicacy and ſenſibility.
[36]How diſtreſſing muſt it not be to a fine woman, to the perfecting of whoſe face nature has lavished all her power, to find the beauteous fabric ſpotted and diſcoloured with diſguſting pimples, which deſtroy the effect of all her charms? It is in this caſe, that the imagination, whoſe in⯑fluence on the ſofter ſex is ſo very extenſive, takes the lead, exaſperates the diſeaſe, and renders it a thouſand times more obſtinate: and yet I can aſſure my readers, from long and aſſiduous obſervation, drawn from the experience of many years, that theſe impurities, ariſing from obſtructed perſpiration, are the eaſieſt of all others to overcome. The veſſels, when once freed from the matter contained in them, and which has become foreign and vitiated by ſtagnation, readily reſume the tone and energy neceſſary for cutaneous ſecretion.
The Lotion, conſtantly produces this effect; it waſhes and cleanſes the ſurface, and, by penetrating within the ſmall, obſtructed veſſels, diſſolves the condenſed fluids contained in them, and facilitates their expuiſion.
When this is executed, the ſkin reſumes its natural ſtate, becomes ſmooth and poliſhed, and, exhibits that brilliancy of tint which depends upon the free circulation of the fluids in the cutaneous arteries, and, the continual afflux of thoſe, furniſhed by the different glands and veſſels, which are found in the ſkin.
In addreſſing my reflections to the public, I have ad⯑vanced, that ſimple cutaneous diſeaſes, are local affections only, and I have given proofs of the truth of this aſſertion; I have ſaid, that, the mode of treating them, ought to be local; and, both authority, facts, and reaſoning, have confirmed what I have advanced.
I have aſſerted, that my Lotion, is a Specific for theſe Eruptions; and I appeal to thoſe who have experienced its efficacy, after they had been diſappointed by internal means: [37]thus, the goodneſs and infallibility of my Specific, is a ſuffi⯑cient anſwer to, and compleatly confutes the invidious at⯑tacks that have been made againſt me, for its introduction.
The only place in which the term is generally properly underſtood is when we ſpeak of the humidity of the weather, meaning a dampneſs in the air: here the idea is juſt, ſee any dictionary. "HUMOUR, Wet, Moiſt, Watery.—HUMIDITY, Moiſture.—HUMID, Moiſture, Wa⯑tery, &c." And thus the ignorance of charlatans; I ſay the ignorance of ſome, and the wickedneſs of others, in diſtorting this ſenſeleſs term merely to frighten or alarm us thereby into a courſe of uſeleſs internal medicine, and inſtead of forwarding, to deter us from the only means of cure: falls beneath our pity, and are deſervedly objects of our abhor⯑rence and contempt.
- Zitationsvorschlag für dieses Objekt
- TextGrid Repository (2020). TEI. 5618 An essay on cutaneous diseases and all impurities of the skin Proposing a specific and method of cure By John Gowland. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5C18-3