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A TREATISE OF Incurable Diſeaſes: CONTAINING

  • I. An ESSAY on the Proper Means to reduce the Number of INCURABLES.
  • II. An ATTEMPT to ſettle a juſt Notion of INCURABLE in Phyſick.
  • III. A SPECIMEN of a Rational Method to diſcover the Cures of reputed INCURABLE DISEASES.

By P. SHAW, M. D.

Neque igitur dubitabo inter Deſiderata reponere Opus aliquod de Curationibus morborum qui habentur pro Inſanabilibus; ut evocentur & excitentur Medici aliique egregii, & magnanimi, qui huic operi quantum largitur natura rerum incumbant; quando hoc ipſum, Iſtos morbos pronunciare Inſanabiles, neglectum & incuriam veluti lege ſanciat, & ignorantiam ab infamia eximat. Bac. de Aug. Scient. L. IV. C. II. p. 310.

LONDON: Printed for J. Roberts, near the Oxford-Arms in Warwick-lane, 1723. (Price One Shilling.)


TO THOMAS GUY, Eſq;

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SIR,

THOUGH the Subject of this Treatiſe, conſider'd as a Deſideratum in the Healing-Art, ſhould chance to have had no great Share in your Studies, yet have you a []Right to a Work of this kind, ſuperior to any ſuch Claim.

I will not ſay, had your benificent Diſpoſition never appeared in favour of the wretched Incurable, that I ſhould never have entertained any Thoughts on this Subject: But this I am obliged, in Juſtice, to acknowledge, that whilſt I was committing them to Paper, your excellent Deſign was ſo ſtrongly before me, that I found it abſolutely impoſſible to write regardleſs of it. Upon which Account, it is but Juſt that I make you a Tender of what was thus written.

I cannot indeed perſuade my ſelf, however mean the Performance may appear, that it will prove an unacceptable Preſent; ſince it attempts a farther Relief of thoſe deplorable Perſons, for whom you have already expreſſed ſo tender a Regard.

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And if by due Management, any of theſe ſhall happily find a Cure, where it might be leaſt expected, in an Hoſpital ſet apart for Incurables, it will not, I preſume, redound more to the Conſolation of the Patient, than to the Honour and Delight of him who not only generouſly founded, but liberally endowed it.

I am, With the higheſt Eſteem, Sir, Your moſt obedient Servant, PETER SHAW
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A TREATISE OF Incurable Diſeaſes, &c.

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I. Of the proper Means to reduce the Number of Incurables.

ALTHO' ſeveral cogent Reaſons, to demonſtrate the Feaſibility of the preſent Deſign, may be drawn from the Nature of Diſtempers, and the known Effects of Medicines; the common Occurrences of daily Practice, and the great Probability there is of bringing many unknown Remedies to Light; yet were it not for what ſo grave and approv'd an Author, as the great Lord-Chancellor Bacon, has recorded about incurable Diſeaſes, it would perhaps ſeem daring and preſumptuous to maintain the Poſſibility of leſſening [2]their Number, after ſo many Ages appear to have been unſucceſsfully ſpent in attempting it.

FOR, the Cure of Incurables does not only involve a Paradox in the Expreſſion, but in an Age ſo productive of new Diſcoveries, and ſo fertile in Improvements as the preſent, it generally paſſes for a deſperate Problem; and is apt to be rank'd in the ſame Claſs with the Quadrature of the Circle, the Perpetual Motion, and the Philoſopher's Stone.

BUT the moſt celebrated and judicious Author abovementioned, is clear and expreſs, that Phyſicians a ‘"In inquiſitione illorum de Morbis, inveniunt Morbos complures quos Inſanabiles decernunt, alios jam inde à principio Morborum, alios poſt talem quampiam periodum. Ita ut L. Scyllae & Trium-virorum Proſcriptiones, res nihili fuerint prae Medicorum Proſcriptionibus, per quas tot homines iniquiſſimis edictis morti dedunt; quorum tamen plurimi minore cum difficultate evadunt, quam illi olim inter Proſcriptiones Romanas. Neque igitur dubitabo (continues this great Author) inter Deſiderata reponere Opus aliquod de Curationibus Morborum, qui habentur pro Inſanabilibus; ut evocentur & excitentur Medici aliique egregii & magnanimi; qui huic operi, quantum largitur Natura rerum, incumbant; quando hoc ipſum, iſtos Morbos pronunciare Inſanabiles, neglectum & incuriam veluti lege ſanciat, & ignorantiam ab infamià eximat."’ de Aug. Scient. L. IV. Cap. II. p. 310.

AFTER ſuch a Declaration from ſo great a Man, it will not, I hope, appear either aſſuming or ridiculous to attempt a Diſcovery of the Cures [3]of ſuch deſperate or inveterate Diſeaſes as may chance unjuſtly to paſs for Incurable. Such a Deſign, at leaſt, ought not to be thought aſſuming, if it be enter'd upon according to his Lordſhip's Direction, ‘"To the end that the more able Phyſicians, and Perſons of Eminence and Reſolution, may be encouraged and excited to a thorough purſuit of this Matter;"’ which is the main View in publiſhing this Treatiſe.

And if an Indulgence be granted to any thing that may ſeem to carry an Air of Preſumption or Aſſurance in ſuch an Undertaking, I am perſuaded there are few will think an attempt of this Nature, Ridiculous or Impracticable, after ſo very grave and diſcerning an Author has laid it down for juſt and reaſonable.

Some there are, however, who will be apt to ſay, granting many Diſeaſes were an hundred Years agoe, unwarrantably call'd Incurable; and allowing the Phyſicians of that time to have, in this Reſpect, been no leſs unjuſt than rigid and ſevere; yet after ſo many great Improvements, and uſeful Diſcoveries made in Medicine of late, 'tis impoſſible the Cenſures of the preſent Phyſicians ſhould be equally unjuſt, or equally ſevere with thoſe at the time when this great Author wrote. Others will go ſtill farther and cry, can it be imagin'd, when by a grand Increaſe of Learning, a through Reformation in Philoſophy, a prodigious Number of uſeful Experiments, and happy Diſcoveries in Mechanicks, Anatomy, Chyrurgery, Chymiſtry, Pharmacy, and Botany, a noble Addition to the Materia Medica, and the Introduction of a Mechanical Syſtem of Phyſic; can it be imagined will ſome ſay, when by theſe large Acquiſitions the Art of Healing ſeems rais'd to its Achme, its Pinnacle of Perfection, that the Cenſures of Phyſicians are not extreamly juſt and utterly Irreverſible; and the Number of Incurables already ſhrunk and contracted within the narroweſt Bounds human Means can reduce them?

Indeed, it may very well appear Surprizing, if with theſe accumulated Advantages the Art of Healing be not vaſtly improv'd, and the Number of reputed incurable Diſeaſes leſſen'd; and yet alas! the thing it ſelf will ſpeak and tell us, that Incurables were never more common, and that they are ſo far from diminiſhing, that they rather ſeem to grow upon us daily, [4]inſomuch, that 'tis become neceſſary to provide for the meaner Sort of them by a new and an extraordinary Kind of Bounty.

Beſides, as 'twere folly to endeavour to palliate the Matter, the common Practice of every Place will, at this Day, afford a ſufficient Proof both of the great Number of Incurables, and the raſh Cenſures of Phyſicians. For not to mention that we daily ſee Perſons who were given over by ſome Phyſicians, recover'd by others, what Numbers after having been declared Incurable by very eminent Men, and ſuch as were well verſed in phyſical Practice, have not found a Cure by Accident, the Kindneſs of Nature, the Obſervation of a Regimen, the Uſe of ſlight Medicines, a Courſe of Phyſic, or by venturing upon ſome deſperate Means? Inſtances of all theſe are every where ſo Numerous, that 'tis in vain to go about to conceal the Thing, or its pernicious Conſequences: Moſt Perſons are now appriz'd, that Incurable in Phyſic has had a like Effect with Occult Quality in Philoſophy, a Term which manag'd with Addreſs, amus'd the Multitude, and kept up a Veneration for an Appearance of Learning, but at the ſame time prov'd a very great Obſtacle to farther improvement in uſeful Knowledge.

'Tis well known alſo, that every Age has had its particular Kind of Practice, which was always adequate to the Diſcoveries of the Time, and regulated by the prevailing Philoſophy of the Place; ſo that this Practice in the Infancy of the Art, muſt neceſſarily have been proportion'd to an infant Knowledge of Diſeaſes and Remedies. 'Tis leſs to be wonder'd at therefore if the puny Phyſicians of the earlieſt Ages ſhifted the obſtinate Caſes from one to another, and were pleas'd to denounce all the Diſeaſes incurable which baffled their ſlender Skill. This Procedure, however we laugh at in them, but are our ſelves perhaps no leſs Ridiculous; for we alſo turn off our deſperate Patients, when our Remedies fail us, and term that an incurable Diſeaſe which obſtinately reſiſts the faſhionable Practice of our Age and Country.

But is a Diſtemper therefore really Incurable, becauſe I, a ſecond, or a third Perſon cannot cure it? Or can this Term with any Propriety, be applied [5]to a Caſe which has only eluded the prevailing or current Practice of our Time, without giving any evident Tokens, that 'tis abſolutely, and in every reſpect Incurable? If this be ſufficient to denominate a Diſeaſe incurable, then numberleſs Diſeaſes, which have been cured, were incurable.

Doubtleſs this Term ought to be uſed with great caution, becauſe when miſapplied, it not only abuſes the Patient, but diſgraces the Profeſſion, and brings a Scandal on its Profeſſors, at the ſame time that it prevents an Improvement of the Art of Healing. But we of this Age ought more than thoſe of any precedent one, to demur in the Uſe of the Word, when the Caſe is not very plain and evident; we who are well acquainted with the Structure of the human Body, and ſeveral grand Remedies which were unknown to former Ages; we who are Maſters of all the Experience of the Ancients, and have ſeen their Weakneſs and Errors, as well as our own, in calling ſome Diſeaſes incurable; we who cannot but own Poſterity may improve in their Knowledge of theſe Things, and be able to cure Diſeaſes reputed by us Incurable, as we have happily cured ſome that were ſo reputed by Antiquity. Are not we alſo ſenſible that Phyſicians generally go in the ſame beaten Track, and that tho' they differ in Forms, yet uſually agree to exhibit the ſame Medicines in like Caſes? Thus all now preſcribe Mercury in the Venereal Lues, and Cortex in Intermittents; and if theſe happen to fail, the modiſh Practice of our days is ſuppos'd to be exhauſted, and without farther trouble, the Caſe is adjudg'd Incurable. But as this Sentence is frequently revers'd either by Nature, Accident, or Art, it is, by no means, of it ſelf ſufficient to denominate a Perſon properly Incurable, that his Caſe has been unſucceſsfully preſcrib'd to by a few Phyſicians.

How it comes to paſs that Incurables are ſo numerous at this time, and that whilſt other Arts and Sciences appear in a flouriſhing Condition, and even Medicine it ſelf is greatly improv'd in its Theory, yet the Art of Healing, the practical Part, the moſt valuable Branch of Phyſic, and ultimate End which all the other Branches are deſtin'd to promote and centre in, ſhou'd not be equally advanced, is a Speculation that wou'd carry us beyond the Bounds of the preſent Deſign. And as it is of far greater Conſequence [6]to know how to remedy this Defect in the Art of Healing, and thereby diminiſh, if poſſible, the Number of Incurables, than to account for the ſlow Progreſs of the phyſical Practice; I ſhall here confine my ſelf to the former Conſideration, and endeavour to ſhew what is the moſt proper Method of proceeding in order to diſcover the Cures of ſuch Diſtempers as obſtinately reſiſt the preſent Form of Practice, at the ſame Time that they give no other Signs of their being abſolutely and properly Incurable.

The Method that I wou'd offer at in this caſe, is founded on a proper Uſe of our natural Faculties. If we will but open our Eyes, allow a freedom of Reaſoning, and not be ſlow in reducing its Dictates to Action, there are good grounds to hope that the Number of reputed Incurables will ſoon be leſſen'd, or at leaſt their increaſe be prevented; and a more accurate diſtinction of Diſeaſes for the future be introduced.

As by a reputed incurable Diſeaſe, I always mean ſuch an one as proves too ſtrong for ordinary Treatment, without affording any farther reaſon to perſuade us, that the Cure of the ſame Caſe is utterly impoſſible to be effected hereafter, to attempt the Cure of a reputed incurable Diſeaſe, is in no wiſe Wild or Romantick. But the Way to diſcover ſuch a Cure, is not to ſtop ſhort where the common Medicines fail, lazily term the Caſe Incurable, and then ſit down contented, and applaud our ſelves for having got to the extent of our Tether: On the contrary, if we wou'd in carneſt endeavour to benefit Mankind, by improving the Art of Healing, from an accurate Obſervation of the Phaenomena of Diſeaſes, we ſhould proceed to deduce their immediate Cauſes, and find out what kind of Remedies are wanting to remove them; and then by the proper Experiments obtain theſe Deſiderata, or at leaſt in defect of them, contrive to raiſe the known Remedies to their utmoſt Power, in order to ſee whether they will not then reach the more ſtubborn Caſes.

It is ſuch a Kind of Geometrical Method, which appears to me the moſt proper to be obſerv'd in this Purſuit; that way of Reaſoning from Data to Quaeſita, which has done Wonders in Philoſophy, Aſtronomy, and Mechanicks. But it happens moſt unfortunately, that inſtead of encouraging and purſuing this noble Method in Phyſic, we ſeem almoſt entirely to [7]diſcountenance and contemn it; inſtead of endeavouring by this means to cultivate the moſt momentous Art on Earth, we are too often amuſing our ſelves with what is Trifling, when ſet in Competition with it; and inſtead of endeavouring to leſſen the Number of Incurables, or eaſe their Tortures, we are either wrapt up in the Clouds, and contemplating the Stars, or groveling on the Ground in queſt of Pebbles. Not that I would Reflect on any part of Knowledge, though ever ſo little uſeful; but ſurely thoſe who have attach'd themſelves to Phyſick, and make Profeſſion of its Practice, are inexcuſable, if this has no ſhare in their Studies. Some excurſions out of this Province are perhaps allowable, but we ſhould not methinks always content ourſelves with ſearching after Things which are utterly foreign to Phyſic. The Theory of Phyſic, indeed, no one can deny to be uſeful, ſo far as it brings Advantage to the Practice; but who does not ſee that 'tis Prepoſterous to ſpend Time in computing the abſolute force of the Muſcles, the weight of the Air upon the Lungs, the juſt Momentum of the FLuids, and a thouſand other Things; whilſt there remain ſo many inquiries of infinitely greater Importance to be made, and which might even diſcover the cure of ſuch Diſeaſes as we now miſcall Incurable?

Is it not ſhocking to ſee what Pains and Application are beſtow'd in promoting other Arts and Sciences, whilſt Phyſick alone is abandon'd, and ſeems to be almoſt the only Art that is not cultivated among us? Thus in Aſtronomy, a glorious Science indeed, and tho' not unworthy of the Eſteem it meets with, is yet infinitely leſs conducive to the Well-being of Mankind than the Practice of Phyſick; what immenſe Labour and Aſſiduity are employ'd? With what diligent attendance and watching is a new Star added to the Catalogue, or another Satellite to the train of a Planet? What Drudgery is not gladly undergone, to determine the Magnitudes, Diſtances, Periods of Revolution, Gravities and Denſities of the remote planetary and cometary World? But if any profeſs'd Phyſicians, leaving their own Art to the improvement of others, ſhall give themſelves up to the cultivation of this, they may pleaſe to conſider that ſuch procedure will afford little Conſolation to a Man under the raging torture of the Gout or Stone, or to thoſe doom'd to languiſh under the hard Sentence of Incurable. [8]What will it avail ſuch as theſe, to be told the exact Minute of an Eclipſe, or other Reſults of numerous Obſervations, and laborious Calculations? And yet theſe Things which concern us ſo little are highly priz'd, at the Expence of Medicine; and the Knowledge of them obtain'd with the moſt vigorous Reſolution and aſſiduous Application. How we can anſwer the not taking equal Pains to diſcover new Remedies, improve the old ones, and advance the Art of Healing, when the Lives of Mankind are immediately concern'd in it, I am at a loſs to know. But to return.

The Method I would recommend to find the Cures of reputed incurable Diſeaſes, will be beſt underſtood by the Specimen annext; where I aim to proceed intirely upon rational Grounds. I muſt therefore take leave to obſerve, that the free uſe of our Reaſon is the beſt Guide we can make choice of to lead us to this Diſcovery. By the uſe of Reaſon I wou'd be underſtood to mean the exerciſe of that Faculty upon Subjects relating to Diſeaſes, in order to find a deſirable and promiſing Method of Cure for an inveterate Caſe, when the current Practice has proved unſucceſsful; that is, ſuch a Method as ſhall, before it be try'd, appear likely to ſucceed, when conſider'd by a rational Phyſician, and is more eligible to the Patient, than the Diſtemper 'tis intended to rid him of, or at leaſt to palliate. Such a Method of Cure as this, is, in my Opinion, unexceptionable, in reputed incurable Caſes; and ought without ſcruple to be put in Practice by a reputed incurable Patient; becauſe ſuch a Patient can have no hopes of a Recovery, but either from meer Chance or Empiriciſm, or elſe from the tryal of ſuch a rational Means as is here propos'd: But any rational Perſon will ſurely rather rely on Reaſon, than Chance for a Cure. Moreover, true reaſoning from the requiſite Data, brings us to abſolute certainty; and is always preferable to Belief, Tradition, caſual Experience, or any other Aſſiſtance rely'd on in phyſical Practice: a general and rational Phyſician therefore, who is never unprovided of Data to Reaſon from, cannot do better than thus to apply this Faculty. And if the reſult of this Application be the diſcovery of a deſirable and promiſing Method of Cure, he cannot do better, in the way of his Profeſſion, than to recommend it.

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This method of Procedure will be readily acquieſc'd in by thoſe who are unacquainted with the general fate of Phyſick. Such Perſons are ant to imagine, that this is the common foot upon which all rational Phyſicians proceed in their daily Practice, and that no other tolerable Method can be eſtabliſh'd. But theſe Perſons are not aware how extreamly cautious and ſparing Phyſicians have formerly been in the uſe of their Reaſon. That Body of Men have all along had ſo tender a Regard to their fellow-Creatures, that they thought their utmoſt care was neceſſary in the Application of Remedies; and therefore rarely ventured to truſt ſo dangerous a Thing as Reaſon in the uſe of 'em. And ſo Experience, ſafe Experience, came to be wiſely ſubſtituted in its ſtead: this was the Oracle, this alone was extoll'd, and Reaſon, fallacious Reaſon was decry'd and contemn'd, as having little to do in the Practice of Phyſick. Hence they proceeded to ſettle Rules, and eſtabliſh Forms from Experience, chuſing always to uſe the Remedies which had been uſed before, and to preſcribe over again what they had already experienc'd. To ſwerve from the eſtabliſh'd Method, or prevailing Practice of the Age, was commonly thought bold and dangerous; and to try a new Remedy, tho' it might promiſe ever ſo fair, was look'd upon as hazardous and preſumptuous. The practice of Phyſick being thus curb'd in, and reſtrain'd, has advanced by very ſlow Paces; and all this for want of a ſound Philoſophy, and a larger ſtock of Data. For certainly there can be no other Pretence, why this beſt of Faculties ſhould be thrown aſide as uſeleſs, or diſadvantagious in Phyſick, rather than in Philoſophy, or any of the Arts and Sciences. But now as the caſe is otherwiſe, as our Data are more numerous, and the way of reaſoning from them is improv'd; as our preſent Syſtem of Philoſophy is ſolid and extenſive, and the Subject of Phyſick, the animal Structure, is vaſtly better defin'd and underſtood; 'twould be highly abſurd to pretend, that this grand Talent ought not to be applied to diſcover the cures of, at leaſt, the reputed incurable Diſeaſes among us. For in theſe Caſes, our preſent ſtock of Experience is confeſſedly of no Service, and new random Trials might be juſtly deem'd raſh and Preſumptuous: An attempt therefore to form a method of Cure, by arguing from the nature of the Diſeaſe, to the diſcovery of more powerful [10]Remedies, is here the only rational and promiſing means we have left.

It will ſurely be granted, that the preſent practice of Phyſick is improveable, if it be conſider'd, that the ſeveral Branches of which this Art is compos'd, are daily improving; whilſt new diſcoveries are made in Anatomy, and Chirurgery grows more compleat; whilſt Chymiſtry and Pharmacy furniſh us with new Preparations, and Mechanicks is more ſucceſſfully applied to the animal Structure; it cannot be doubted but ſome uſe may be made of theſe Things to the advantage of Phyſick, and the cure of reputed incurable Diſeaſes. There is no room to queſtion, that many powerful Remedies lye now abſconded, or enveloped in their firſt Principles, if it be conſider'd, that the whole Set we are at this time acquainted with, were once in the ſame ſtate of Darkneſs and Confuſion. Let us but reflect, that Agues were reputed incurable till the Cortex was found, and its Uſes known, as well as the Lues Venerea till Mercury, and the Woods were applied; and conſider by what means not only theſe, but numberleſs other uſeful Medicines were obtain'd; and then there will be very great Encouragement to expect, that if diligent ſearch were made, and the proper Experiments inſtituted, many grand Remedies might be diſcloſed, and ſuch as wou'd be of force ſufficient to cure ſome Diſeaſes which now lye under the unjuſt Sentence of Incurable.

Nor is this the only reaſon we have to hope for ſuch a Redreſs in the Art of Healing, and a conſiderable Reduction of the preſent Incurables: great Aſſiſtance may in this caſe be likewiſe obtain'd from a due management of the Remedies we are already poſſeſs'd of. For there are ſo many Requiſites neceſſary to advance theſe to their higheſt Power, that it may very well be queſtioned, if the utmoſt force they are capable of affording, was ever exerted on the cauſe of any Diſeaſe.

Chymiſtry has improv'd the Efficacy of many Medicaments, and ſhewn them to have ſuch Virtues, as were utterly unknown before that Art became general: And Fire is an Element from which other as great Matters may be juſtly expected. Beſides this, an inverted Order, a well proportion'd Doſe, a proper preparation of the Body and Medicine, a right Choice, [11]a ſelect Combination, with many other Things of the like kind, have an immenſe Power to increaſe the Virtues of Remedies. Here then is an almoſt inexhauſtible fountain of uſeful Varieties put into our Hands, which we can manage as we pleaſe; and if they were properly employ'd, 'tis not to be ſaid what Effects they might produce in obſtinate or reputed incurable Caſes. That this may the better be apprehended, let it be conſider'd by way of Illuſtration, that when the Cortex has prov'd ineffectual for the cure of an Ague, being given before the Body was rightly diſpos'd, it will ſucceed when exhibited after due Preparation; that Opiates mixed with Purgatives will take effect, which adminiſtred ſingle might fail; that Solids will purge when Fluids will not; that lenient Purgatives will open the Body where ſtrong Catharticks wou'd looſe their force; that ſome Medicines ſucceed when given in ſmall quantities, at long Intervals, which adminiſtred otherwiſe would have a contrary effect; and in ſhort, that all poſſible Combinations, Doſes, Preparations, &c. have never yet been try'd, nor perhaps ever can be exhauſted.

From all which it appears, that the cures of ſome reputed incurable Diſeaſes may be juſtly expected, either from a diſcovery of new powerful Remedies, or a more appoſite uſe of the old ones. Our Method therefore ought to have regard to both theſe Deſiderata.

In order to acquire new Remedies, let us ſuppoſe the true and immediate Cauſe of a ſtubborn diſorder to be found, which in all bodily Diſeaſes, is commonly material; our Method of proceeding directs us to obtain this material Cauſe, where-ever it can be come at, and to make the proper Experiments upon that very Matter out of the Body, which being included in it was the Parent of the Diſorder. An Example or two will make all plain. The cretacecus Matter, or chalky Stones, which are often thrown out in a Fit of the Gout, appear to have been the immediate cauſe of that Fit. A proper quantity of theſe therefore being obtain'd, and the Nature of them diſcover'd from the Symptoms of the Diſtemper, &c. we are hence directed to try any Preparation that we know has a power to act upon, and diſſolve Matter of the like kind. But in caſe ſuch a Diſſolvent be unknown to us, then are we to contrive ſome Compoſitions, after the ſame manner as if we were preſcribing [12]to an inveterate caſe of a Patient afflicted with the Diſtemper, and try their Virtues upon theſe Stones, till at length we arrive at a Preparation that proves a real Diſſolvent, at the ſame time that it may be ſafely adminiſtred, ſome convenient way, in ſuch a quantity as to be able to effect the like diſſolution of that cretaceous Matter, whilſt it is circulating in the Fluids of the Body. Such a Compoſition, 'tis reaſonable to expect, wou'd prove a grand Remedy, and perhaps a Specifick, that is, ſuch a Medicine as will effect a Cure without cauſing any ſenſible Evacuation. Underſtand the like Experiments to be made upon the Stones, which are apt to lodge in the Bladder or Kidneys, till a proper Diſſolvent be found, which, if it cannot ſafely effect the deſired diſſolution in the Body, may at leaſt be ſo managed, as to prevent the future Generation of a Stone. Again, ſuppoſing the caſe of an Hydrophobia occaſion'd by the Bite of a mad Dog, where we know the Fluids are contaminated by an actual Poyſon, which being contagious by a Communication of any of thoſe Fluids, a way may very eaſily be contriv'd to obtain a quantity of the infected Saliva, or any other of the animal Juices, in order to make the proper Experiments upon it, till an Antidote for the Venom were by that means diſcover'd. This Antidote might thus be known to be found. Suppoſing two equal Portions of the contaminated Fluid to be procured, and the preſumed Antidote to be mix'd in one of them, let both be communicated by Injection, or otherwiſe to two ſound Dogs; and if that wherein the preſum'd Antidote was contain'd, proves harmleſs, and the other noxious, and the ſame Conſequence attends the ſame Experiment in two or three Repetitions; it would be reaſonably to expect that the Cure of this cruel Diſeaſe was diſcover'd, and the Medicine might therefore be try'd occaſionally upon Hydrophobous Patients, or rather adminiſtred ſoon after the Bite was receiv'd.

How far this Method of proceeding may be put in Practice, I will not preſume to determine; but 'tis very probable that it may be advantageouſly purſu'd at leaſt in all thoſe Diſtempers which yield a groſſer kind of Matter for their Cauſe, or elſe depend upon, a viſible alteration in the Conſiſtence, Texture, &c. of the Fluids. This is certainly a moſt deſirable and rational way of procuring Specificks or grand Remedies, ſince the [13]Lives of Mankind are not hereby in the leaſt endanger'd; and it otherwiſe remains, that we wait for their Diſcovery till mere chance ſhall place them before us, open our Eyes, and force us by repeated Importunities and Sollicitations, at once to acknowledge their Virtues, and our own Indolence. If the whole tribe of reputed incurable Diſeaſes, gave ſuch fair Opportunities as theſe for the diſcovery of their reſpective Specificks (and that moſt of them do not, I would have no one be too poſitive) we might ſoon ſee their number ſhrink, upon allowing a proper Patronage and Encouragement to this kind of Experiments.

And here I cannot but take notice, how apt we are to plume our ſelves upon living in an Age when experimental Philoſophy flouriſhes. Experiments, its true, are daily made, but I wou'd fain know to what grand Purpoſes they ſerve? Several indeed there are, whoſe deſign is highly Commendable; but are there any now on foot, or that can poſſibly be contriv'd, of greater Moment, than the ſort above mentioned; any more Beneficial to Mankind, or Ornamental to a Nation; any ſo well deſerving the Encouragement of the Wealthy, and the Countenance of the Learned? But inſtead of ſuch uſeful Eſſays as theſe, we generally meet with Attempts ſo mean and low, ſo trivial and contemptible, in compariſon of them, that one wou'd be tempted to think they came from the ignorant Vulgar, and the Herd of Mankind, rather than from the polite and philoſophical Part of the Species. 'Tis a melancholy Reflection, that thoſe Perſons from whoſe open Profeſſion, ſurprizing Diſcoveries might be juſtly expected, ſhould generally amuſe us with the Minutiae of Things, put us off with the Tith of Mint and Cummin, and leave us to ſeek the weightier Matters, the advancement of Phyſic, and the Reduction of Incurables from another Quarter.

But what an Improvement of the Art of Healing may we not expect, what Alleviation of the Miſeries of the Incurable may we not hope for, when a ſpacious Building is now purpoſely crecting for their Reception and Uſe? This ſeems not only a particular Inſtance of compaſſionate Bounty, but a Deſire expreſs'd for the improvement of Phyſic, and the univerſal Benefit of Mankind in an illuſtrious Preſident of a ſolid and diffuſive Good. Phyſicians then, we [14]may reaſonably preſume, will not now be ſo far wanting to themſelves, to their Art, and to human Nature, as to neglect this or the like favourable Opportunities, of raiſing the Reputation of their Profeſſion, by diſcovering the Cures for the unjuſtly ſuppos'd Incurable, and leſſening the Torments of the miſerable Objects, to whom ſuch Goodneſs is ſhewn.

No longer let us, through Eaſe and Indolence, give occaſion to Empiricks to triumph over us, and boaſt themſelves Maſters of Specificks for the Diſeaſes which we inconſiderately pronounce Incurable: No longer let us ſuffer the People to be deluded with the ſpecious Arcana of ignorant Men; Arcana the dear and deſperate purchace of hazardous Experiments, and random trials on the human Kind: No longer let us leave to Chance, and the ſlow workings of Nature, the Diſcovery and Production of thoſe uſeful Remedies which we are furniſh'd with Faculties to ſearch for and obtain. Who does not rather repoſe his Confidence in Reaſon, and the due exerciſe of his own Abilities, than truſt to Accident the management of any Affair? And ſhall we in the Art of Healing alone, put off our inquiries till Chance ſhall deign to preſent us with the means of Recovery, when Health is within our own reach? We ſeem to want no Preparative in this caſe, but a Reſolution to ſtep beyond the ſlow-paced Practice in vogue, and to be guided by our Reaſon in the choice of Experiments. We are every way fitted to go immediately upon ſo uſeful an Undertaking: We have ſeen the Effects of a tolerable number of Trials made upon human Blood, and other animal Fluids; which when improv'd and enlarged, may ſerve to very uſeful Purpoſes: We are furniſh'd with a large ſtock of Data, and know how to increaſe it at Diſcretion: The Cauſes of Diſeaſes are generally known, and Materials for Experiments are every where at hand; ſo that if the Work were heartily ſet about, there is no fear of Succeſs. A Set of Axioms alſo might be laid down to encourage and direct the Undertaking, and ſerve as Rules in the Proſecution of it. Such as the following for Example.

1. Mathematical Certainty ought not to be expected in Phyſic.

2. A Chronic Diſeaſe allows many Opportunities for the Diſcovery and Uſe of Remedies.

[15]

3. The ſucceſs or failure of a ſingle Experiment, is not ſufficient to eſtabliſh or aboliſh the uſe of a Remedy.

4. If any undeſirable Method of Cure ſhall, upon repeated trials, either prove intirely unſucceſsful, or ſuffer more to die than recover, it ought not to be acquieſc'd in, before, at leaſt, other more deſirable and promiſing Methods ſhall have been tried.

5. 'Tis better to try any deſirable and promiſing Method of Cure, than run the hazard of languiſhing out a Life in Pain and Miſery.

6. If any Diſeaſe can be tranſmuted into another, attended with leſs Danger, and leſs Pain, every ſuch Tranſmutation is a Degree of Cure.

7. A Remedy that acts immediately upon the Seat of a Diſeaſe, is more likely to effect a Cure, than one that acts only Conſequentially upon it.

8. No more cauſes of a Diſeaſe need be inquired after, than will fairly and naturally account for its Phaenomena.

9. In every inveterate and dangerous Diſeaſe, the moſt powerful Remedies ought to be immediately applied.

10. No Remedy can rationally be directed before it be known what Life is, together with its Cauſe, State and Effects; and what a Diſeaſe is, together with its Cauſe, State and Effects.

Theſe may ſuffice for a Specimen of what Rules might be given to forward the diſcovery of the Cures of reputed incurable Diſeaſes.

But let this buſineſs proceed as it may, and that the Succeſs will be proportionable to the Application, cannot be denied; we certainly have it already in our Power, by the Uſe of known Remedies to make ſeveral, whether real or reputed Incurables, paſs their Lives with more eaſe and ſatisfaction than they would enjoy without, them: Nay, by well adapted Regimen and Remedies, 'tis poſſible not only to palliate, but to change a ſtubborn Diſtemper, ſo that it may juſtly paſs for a degree of Cure, or really become a partial one. But when a Caſe is peremptorily adjudg'd abſolutely Incurable, the Patient is uſually diſpirited, and with difficulty brought to follow thoſe Rules which wou'd produce this Effect. For which reaſon the Sentence of Incurable, be the Caſe what it will, ſhou'd never be paſs'd with Rigour.

[16]

There is another thing ſtill behind, and I am glad to find it inſiſted upon by, no leſs a Perſon than that Ornament to our Nation, the great Lord Bacon, whom I have already had occaſion to mention; not only becauſe I know it is neceſſary for the Author of any Doctrine which carries the Air of Novelty, to produce his Voucher; but becauſe the Thing it ſelf ſeems ſomewhat contrary to the general Practice of Phyſicians, and the Senſe of ſome People. 'Tis concerning the proper Means to render Death eaſy, or leſs irkſom, when its approach can no longer be put off or delay'd by the Uſe of Remedies: Concerning which, our great Author expreſſes himſelf in this manner. a ‘"Etiam plane cenſeo ad officum Medici pertinere, non tantum ut ſanitatem reſtituat, verum etiam ut dolores & cruciatus Morborum mitiget: Neque id ipſum ſolummodo, cum illa mitigatio Doloris, veluti Symptomatis periculoſi, ad convaleſcentiam faciat & conducat, imo vero cum abjectâ prorſus omni ſanitatis ſpe, Exceſſum tantum praebeat è vita magis lenem & placidum. Siquidem non parva eſt felicitatis pars, (quam ſibi tantopere precari ſolebat Auguſtus Caeſar) illa Euthanaſia. — At noſtris temporibus Medicis quaſi Religio eſt, aegrotis poſtquam deplorati ſint aſſidere, ubi ſi officio ſuo, atque adeo humanitati ipſi de [...]ſſe nolint, & artem ediſcere, & diligentiam praeſtare deberent, quâ animam agentes, facilius & mitius è vita demigrent. Hanc autem partem, inquiſitionem de Euthanaſia exteriori —inter Deſiderata reponimus."’ de Aug. Scient. L. IV. C. 2. p. 311. And accordingly his Lordſhip ſets down as a Deſideratum, A Method to cauſe a Compoſure in dying, and does not appear to diſapprove even of that courſe which Epicurus took to obtain this end, which was by intoxicating himſelf.

—Hinc Stygias ebrius hauſit Aquas.
[17]

But tho' the Phyſicians of our Time are acquainted with better ways than this, to cauſe ſuch a Compoſure, yet I don't know how it happens that few are careful to put them in Practice; unleſs it be for fear of bringing Death the ſooner upon the Patient, inſtead of rendring the paſſage out of Life more eaſy. For I believe there are not many who apprehend ſuch a Procedure to be unnatural, and who would chuſe to feel that Pain and Torture which ſome weak Minds may fancy Nature intended they ſhou'd; and ſo be willing to dye by the regular workings of Providence, rather than be thrown out of the ordinary way by human Art. 'Tis therefore methinks a proper enquiry, by what means this compoſure in Death may be obtain'd, and whether it cou'd not be effected by a Remedy which ſhould rather promote than prevent a Recovery. And ſince there may be frequent occaſions for ſuch an Aſſiſtant; ſince it would be inhuman to deny it, when requeſted; and ſince the Art in it ſelf is doubtleſs very deſirable, and highly beneficial, 'tis pity that any opportunity of improving it ſhould be neglected.

An Attempt to ſettle a juſt Notion of Incurable in Phyſic.

[18]

NO proper meaning being generally convey'd by the word Incurable, 'tis neceſſary to appropriate one to ſo important a Term.

That the bad tendency of a Diſtemper, from its firſt Exiſtence to its lateſt continuance in the Body, cannot in the leaſt be prevented; or that, after a ſtated Period, the cure of a caſe can by human Means, be advanced no farther, is what this Term in propriety of Speech ſhou'd conſtantly ſignify.

But, a looſe and abuſive Senſe of the Word has ſo univerſally obtain'd, and is ſo apt on ſeveral occaſions to be run into, that 'twill be difficult to make it always carry this more reſtrain'd and correct Signification. Nor is it an eaſy matter in ſome Caſes, to obtain ſuch a diſtinct and poſitive Idea as ought to be rais'd by this Sound, when we talk of Diſeaſes in a Philoſophical manner; which perhaps is one reaſon why ſo many Diſtempers commonly paſs under this Denomination; and that when a certain form of Remedies has for a determin'd ſpace of Time, been uſed without the deſired Effect, the caſe is merely upon this account pronounc'd Incurable. But 'tis apparent that there may happen a wide difference between a real and ſuch a reputed incurable Diſtemper; ſince to conſtitute the former, tis neceſſary that it will utterly elude the force of what the moſt perfect Phyſicians can rationally preſcribe for its Cure; when to make the latter, 'tis enough that it has eluded the Preſcriptions of one or two Practitioners. To confirm a Diſeaſe really Incurable, the utmoſt powers of Remedies muſt prove [19]ineffectual: To cauſe it to paſs for Incurable, that it has baffled the faſhionable Practice will ſuffice. Some Reaſon drawn from the Nature of the Thing, is requiſite to ſhew a Caſe to be abſolutely Incurable; to denominate a Patient ſo, a groundleſs Conjecture will ſerve.

'Tis likewiſe evident, that reputed Incurable may chance, at the ſame time, to prove real incurable Diſeaſes; ſo that to introduce a more accurate Diſtinction, and to ſhew the true difference betwixt them, is of great Importance.

'Tis not neceſſary however, in an Eſſay which rather propoſes what ought to be done, before we make ſo free with a Term, upon whoſe uſe the Lives and Health of Mankind depend, than undertakes to do it; 'tis not neceſſary, I ſay, in ſuch an Eſſay as this, to deſcend ſo far as to inquire what Life and Health are, what their Cauſes and Effects, wherein they conſiſt, by what various Means, and how far they may be impair'd or diminiſh'd before Death neceſſarily enſues; all which it wou'd be abſolutely requiſite to know in the reſpective Diſtempers, if we were willing to ſee whether any, and which of the Catalogue of Diſeaſes are in their own Nature abſolutely, and in every Stage properly Incurable; or if we would fix the Point in other Caſes, to which when Diſeaſes arrive, they will never admit of farther Alleviation. Theſe Things are here ſuppos'd to be in great meaſure known already, altho' they highly deſerve the moſt exact and careful Inquiry.

But not to let this weighty Matter paſs intirely unregarded, it ſhou'd be obſerved, that if a Diſtemper be abſolutely Incurable, the reaſon why it is ſo, muſt ariſe either from the Nature of the Diſorder, or the natural Imperfection of Medicine; and conſequently where the Properties and immediate Cauſe of a Diſeaſe are well known, and yet from them no Reaſon can be deduced to manifeſt the caſe Incurable; that it paſſes for ſuch, ought to be attributed to the natural Imperfection of the Art of Healing. But the Art of Healing cannot be ſaid to be naturally Imperfect, till its utmoſt extent be known, that is, till the animal Oeconomy, and the immediate Cauſes of its Diſorders are throughly underſtood, and the utmoſt Powers of the known Remedies have been fully obtain'd; if not alſo, till all the diſcoverable [20]ones have after the beſt Manner been experienc'd. Now if all theſe Advantages have not been acquir'd in our Days, as no conſiderate Perſon will ſay they have, it follows, that no Diſtemper can properly by us be called Incurable, but where ſome evident Cauſe of its being ſo, appears from the Nature of the Thing it ſelf. For unleſs this Cauſe be manifeſt, to pretend a Diſeaſe is not to be alleviated in any of its Stages, or that a Cure can be carry'd no farther, when we don't know why, is a bold Gueſs; and to pronounce the Caſe Incurable, even after we have done our utmoſt, will mean no more than that the Remedies hitherto uſed in it, have fail'd of the defir'd Effect. But wou'd not ſuch a Cenſure be equally Ridiculous, as to ſay, ten or an hundred unſucceſsful Experiments have been made to tranſmute Metals, and therefore their Tranſmutation is undiſcoverable? Here then is a Foundation for a juſt Diſtinction between real and reputed incurable Diſeaſes.

Thus we ſee in Chirurgery, thoſe Wounds are properly adjudg'd Mortal or Incurable, which happen in ſuch Parts of the Body whoſe Union was of abſolute neceſſity to the continuance of Life; as for Example, a tranſverſe Section of the Larynx, which intirely ſtops Reſpiration; a diſunion of the Cerebellum, which prevents the Influx of the Fluid there ſecreted into the Heart; &c. Theſe and the like Caſes are juſtly deem'd Incurable, from the very Inſtant when the Wounds were firſt inflicted; becauſe here the vital Functions are evidently deſtroyed, without any opportunity being allow'd for the Uſe of Remedies. This is the moſt determin'd and genuine Senſe of the Word, and therefore the Uſe of it in other Caſes ought to be judg'd of, by its Approach to, or Receſs from this original Meaning. And accordingly where the Fatality of Wounds is leſs ſudden, and leſs certain, as in Obſtructions of the animal Faculties, ſuppoſe by a tranſverſe Section of the Oesophagus, the Term Incurable cannot with equal Certainty be apply'd at the Inſtant the Wound was receiv'd, becauſe there may be other Ways contriv'd of conveying Nutriment to the Body, beſides by the Mouth; and in the mean Time, Opportunities may be afforded, of applying the proper Remedies. But if the Body could be ſupply'd with Nutriment only by the Mouth, and [21]there were no Opportunities allow'd for the Uſe of Means for Recovery, then ſuch a Caſe might, with equal Certainty, be pronounc'd Incurable, or mortal, as one of the former Kind; though the Prediction would not be ſo ſoon fulfilled. In all ſuch Caſes as theſe, 'tis evident when and why the Term incurable is applicable, which is always governed by the Nature of the Thing, and the Opportunities there are for the Uſe of Remedies, or elſe by the natural Imperfection of the Art of Chirurgery: Whereas on the contrary, in ſeveral Diſeaſes, both Acute and Chronic, this Term is apply'd, where no ſuch Reaſons appear. Thus when certain equivocal Symptoms come on in acute Diſtempers, without having any Regard to the immediate or material Cauſe of the Diſorders of the animal Oeconomy; they conſiſt in without ſo much as any poſitive Idea in our Minds, obtain'd from reflecting on the Nature of the Diſtemper; and without conſidering the State of the Art of Healing, we at preſent make no Scruple to adjudge them mortal, or Incurable, though neither the vital, natural, or animal Faculties are wanting. Thus for Inſtance, we proceed in the Plague, malignant Fever, Goal-Diſtemper, and the confluent Species of the Small-Pox, &c. when perhaps if the Matter were carefully examin'd into, ſuch Diſeaſes ought never to be call'd Incurable, till they arrive at the very Point of Death. But if there be any Reaſon to ſuſpend this final Judgment in acute Caſes, is there not vaſtly more to be cautious, how we paſs ſuch a Cenſure in chronic Diſeaſes, where no Opportunities are wanting to make the neceſſary Inquiries to find out the Cauſe, and to apply the proper Remedies? And what reaſon can poſſibly be aſſigned, that the reſpective Specificks for the Gout and Stone, ſhall never be diſcover'd; or that no means can be contriv'd to alleviate the Pain of thoſe Diſeaſes, farther than is effected by the preſent Practice? Who can pretend, that an Antidote for the Bite of a mad Dog is undiſcoverable, when he conſiders we are Maſters of the Specifick for that of the Viper? But to call theſe, and ſeveral other Diſeaſes Incurable, is the Way to make them ſo, as being apt to put a Stop to farther Inquiries into the Nature of them, and retard the Diſcovery of any Thing that [22]has a Relation to their Cure. At leaſt then, let no one pretend to call any Caſe Incurable, till he is well acquainted with the Subject of Diſeaſes; till he knows their true and immediate Cauſe, and the utmoſt Virtues of the ſeveral Remedies we are at preſent poſſeſs'd of.

An animated human Body, we are certain, is a pure mechanical Structure, wholly compos'd of Solids and Fluids; and conſequently the immediate Cauſe of every bodily Diſeaſe, can be only Matter and Motion.

The utmoſt Virtues of Remedies cannot be known, till the Remedies have been moſt artificially prepar'd and combin'd, moſt ſeaſonably and properly apply'd, exhibited in the moſt juſt Quantity, at the moſt proper Intervals, and laſtly, continu'd in exact Proportion to the Demand of the Diſtemper. All which Requiſites, there is little Reaſon to believe, have been hitherto ſtrictly obſerv'd in their Exhibition. And beſides the Improvement which may be made in the preſent Set of Remedies, 'tis not to be doubted, as was before obſerv'd, that many others, of equal Virtue, may be diſcover'd by proper Application; upon all which Accounts, it were greatly to be wiſh'd, that Phyſicians would never apply the Term Incurable to any Caſes, but ſuch alone where that Matter and Motion are wanting, which Life, even in its loweſt and weakeſt State requires, or when all means, by which they uſed to be ſupply'd, are intirely cut off. For if a Diſtemper be curable only in Part, 'tis improperly call'd incurable, till that partial Cure, can by human Means, be carry'd no farther.

We daily obſerve ſo many unexpected and ſurprizing Turns in the Diſorders of a human Body; Nature here acts by ſo many ſecret Springs, and makes ſo many unforeſeen Sallies and Excurſions, as if ſhe took Delight to mock our Toil, baffle our beſt concerted Meaſures, and reverſe our beſt form'd Judgments, that it is preſumptuous, where the Caſe is not manifeſt, to pretend to fix and determine the Point ſhe ſhall juſt come up to, and not exceed; to ſay, hitherto ſhalt thou come, and no farther; here the Diſeaſe is Incurable, and here the Art of Healing fails. No one leſs than an abſolute Maſter of this Art, [23]will ſurely ever go ſo far. If indeed we could always obtain from an exact obſervation of the Properties of Diſeaſes, their true and immediate Cauſes, and had a previous Knowledge of the utmoſt Effects, the beſt adapted Regimen and Remedies would have upon them, then we might preſume to determine what Caſes either were, or were not incurable, by the preſent known Remedies; and no one, without this Qualification, can paſs a valid Judgment. Let us then endeavour to increaſe our Knowledge of Diſtempers and Remedies, by all poſſible Means, and not venture to pronounce the Sentence of incurable upon Diſeaſes, at leaſt till we have acquir'd ſuch a Definition of them, as will bring us acquainted with their real Cauſes; and till we are Maſters of the beſt Way of managing and improving the Remedies we enjoy.

To diſcover whether a reputed incurable be alſo a real incurable Diſtemper, I apprehend the beſt Courſe to be taken, is firſt to ſet down the ſeveral Properties of every Caſe diſtinctly; next, to draw as many Conſequences from theſe Properties, as may give Light into the Nature of the Caſe, and aſſiſt in diſcovering its immediate Cauſe: And when this is obtain'd, we are naturally directed to ſearch for the Remedy; ſo that at length, by this Method of Proceeding, we ſhall ſee how far our preſent Stock of Remedies will reach, after they have been duly improv'd; and what we are farther directed to ſeek for, to advance the Art of Healing to a greater Perfection. To uſher in this Method, I will here ſet down a few ſhort Examples, by way of Specimen, of what may be expected from it, upon a proper application. The Caſes I ſhall chuſe to inſtance in, are reputed Incurable, either from their firſt appearance, to their ultimate Stage, or after a ſet Time; the Sequel will ſhew whether they really deſerve the Appellation of incurable, or ought to be reſcu'd, and ſet free from the tyrannical Impoſition of a miſemploy'd Term.

A Specimen of a rational Method, to diſcover the Cures of reputed Incurable Diſeaſes.

[24]

Of MADNESS.

1. THERE are two Species of this Diſtemper, viz. Melancholia and Mania.

2. The Properties of the Melancholia are; to proceed from ſome Diſorder in the Mind.

3. To be preceded by Anxiety, Want of Sleep, intenſe Thought, frequent Anger, or any violent Paſſion; profuſe Venery, Pain in the Head, Suppreſſion of the natural Evacuations, burning and laſting Fevers, violent Exerciſe long continu'd, hot and dry Weather.

4. To manifeſt it ſelf by Fear and Sadneſs, and the Colour of the Skin, which grows pale, yellow, brown, livid; by Spots of the ſame Colour, a ſlow Pulſe, hard Reſpiration, Secretion and Excretion leſſen'd, Loſs of Appetite, Loſs of Fleſh, Love of Solitude, laſting Paſſions, Fixedneſs on ſome Thought, a Preſſure, Coarctation or Repletion about the Viſcera or Hypochondria.

5. When 'tis of long continuance, it cauſes the Apoplexy, Epilepſy, Mania, Convulſions, &c.

[25]

6. 'Tis ſometimes naturally cured by a cuticular Eruption, large Vatices, great Swelling and conſequent Flux of the Haemorrhoids, and an Excretion black Bile by the Mouth or Anus.

7. The Properties of the Mania are generally the ſame, but differ in a few Particulars; for Inſtance,

8. Boldneſs and Anger here attend inſtead of Fear and Sadneſs in the former.

9. Immenſe muſcular Strength.

10. Very great Watchfulneſs.

11. A ſurprizing Endurance of Cold and Hunger.

12. Moſt dreadful and outragious Ideas.

13. All Secretions in a manner ſtopt.

14. Anatomy ſhews in both Species, that the Brain and its Meninges are dry, hard and criſp; its Cortex yellow, and that its Veſſels abound in Varices, and are diſtended with a black viſcid Gore.

15. The Mania, after an obſtinate reſiſtance of the common Practice, has been cured by ſpontaneous Varices or Haemorrhoids, by a Dropſy, Dyſentery, a tertian or quartan Ague, and large Haemorrhages.

16. Does it not follow, that the immediate Cauſe of both Species is an Evaporation of the more ſubtile Parts of the Fluids? 1. 2. 3. 7. 10. 13. 14.

17. That the Mania differs from the Hypochondria only in degree, 4. 5. 6. 14. 15. Since they both have the ſame Cauſes, and exhibit the ſame Appearance upon Diſſection?

18. That this Diſeaſe unjuſtly paſſes for incurable 6. 15. even altho' a Year or two may have been unſucceſsfully ſpent in attempting its Cure?

19. And laſtly, that the Specific wanting in both Species, is ſuch a Remedy, as will prevent this Evaporation 16. which remains to be diſcover'd by proper Experiments.

20. In the mean time, perhaps no known Remedy will more forcibly contract the Pores, and prevent this Evaporation, than the Cold Bath, when uſed ſo as to exert its proper force.

[26]

21. Now the Cold Bath can only act upon the Body by its Gravity or Preſſure, the Inſinuation of the Parts whereof it is compos'd, and its Coldneſs; but its Gravity or Preſſure will be proportionably increaſed by a deeper Immerſion, and this will conſequently render the Inſinuation of the Water proportionably greater. Its Coldneſs alſo may be immenſely increas'd by the addition of Sal Armoniac, &c. Here therefore is a Remedy of an unlimited Force, which ſeems to be exceedingly well adapted to the Cure of this Diſeaſe: And accordingly, 'tis found in Fact to anſwer, the beſt of any known Remedy in this Diſtemper, tho' made uſe of under very great Diſadvantages.

Of the Rabies Canina, or Hydrophobia, conſequent upon the Bite of a mad-Dog.

[27]

THE Properties of this Diſeaſe are as follow.

1. 'Tis ſpontaneous in many Animals, eſpecially in Dogs, Foxes, and Wolves, which communicate it not only to one another, but to Men, by Contagion.

2. The ſlighteſt Bite of an Animal thus infected is often fatal, as it is alſo to touch their Saliva with the Tongue, or to handle ſuch Inſtruments much, as have been uſed about them.

3. The Contagion in a human Body, manifeſts itſelf at various Intervals in various Subjects; in ſome it will lurk for ſeveral Years.

4. The Place where the Bite happen'd firſt becomes painful, the Pain ſpreads to the adjacent Parts, a Wearineſs and Heavineſs is felt in the Fleſh, the Sleep is broken, diſcompos'd, frightful, and attended with Convulſions. The Patient is uneaſy when awake, he ſighs, is ſad, and ſeeks Solitude. Theſe Symptoms gradually increaſe, and a Difficulty of Reſpiration comes on, which is now frequently interrupted with Sighs; an unuſual Dread and Terror upon beholding any Liquid, loſs of Appetite; to taſte any Liquor cauſes very great Anxiety, Tremors and Convulſions; vomiting of a viſcid bilious or green Matter, Heat, Fever, Watching, Priapiſmus, ſtrange diſorderly Ideas. The Tongue is dry, and extended out of the Mouth, there is a Hoarſeneſs and very great Drought; the Patient at length now becomes outragious upon attempting [28]to drink; he endeavours to bite whoever he meets with; he foams at the Mouth, and gnaſhes with his Teeth; a cold Sweat comes on; he grows moſt outragiouſly mad, and, with the utmoſt Difficulty of Reſpiration, dies convulſive.

5. From Diſſection it appears, That the Organs of Deglutition are inflam'd, that a viſcid bilious matter is lodg'd in the Stomach, that the Gall-Bladeer is full of black Bile, that the Pericardium is dry, that the Lungs are greatly overcharg'd with Blood, that the Arteries are full of a very liquid Blood, but the Veins empty. Tis remarkable, that this Blood will ſcarce coagulate, when extravaſated and expoſed to the Air. All the Muſcles, Viſcera, Brain, and Spinal Marrow appear too dry.

6. Is not therefore the immediate Cauſe of this Diſeaſe a ſubtile Poiſon in the Fluids, whoſe Specific Antidote is unknown to us?

7. And till this Antidote can be found, is it not clear, that all manner of Evacuations, eſpecially Phlebotomy or rather Arteriotomy, are to be uſed in every Stage of the Diſeaſe; and all other Meaſures to be purſu'd, which tend to introduce new Fluids, in the Room of the contaminated Set; or at leaſt to diſcharge ſo much of the Virus, as to leſſen its pernicious Conſequences?

8. The Effects of this Virus in the Body, being ſo very dreadful and fatal, may juſtify the Uſe even of ſevere and hazardous Means to prevent 'em, ſo that at leaſt Phlebotomy ad Animi Deliquium uſ (que) may be occaſionally repeated; not only upon that Account, but alſo by reaſon of the very great Inflammation that attends it. And becauſe Fear is known to have been ſerviceable in this Caſe; may it not be very proper to contrive ſome extraordinary Ways to raiſe this Paſſion to a very great Degree, if not before Immerſion in the cold Bath, at leaſt by means thereof, being us'd in almoſt its utmoſt force?

Of the Palſy.

[29]

1. THERE are three Species of this Diſeaſe. 1. Where Motion alone is wanting. 2. Where Senſation alone is wanting. 3. Where both Motion and Senſation are wanting.

2. 'Tis often preceded by the Apoplexy, Epilepſy, or Convulſions, a Retention of the natural Evacuations, a Tranſlation of the Matter of an acute or chronic Diſeaſe; Wounds, Contuſions, Luxations, Compreſſions, Eroſions, &c. intenſe Cold or Heat, too free an Uſe of hot Water, Exhalations of poiſonous Minerals admitted into the Body.

3. The paralytic Parts grow cold, ſoft, flaccid and waſte gradually.

4. 'Tis often critically cur'd, or by the Force of Nature, either by a ſpontaneous and laſting Diarrhaea, a Fever, an inſenſible Diſſipation of the morbific Cauſe, or laſtly, by a convulſive Motion of the Part.

5. From hence it follows, that the immediate Cauſe of the Palſy is a Want of the Influx of the Blood, or nervous Fluid, or both, into the Part, 1, 2, 3.

6. That the Parts loſe their natural Elaſticity. 2, 3.

7. That when both the nervous and arterial Fluid is wanting to the Part, and the Canals are depriv'd of their natural Elaſticity, the Caſe is moſt inveterate.

8. That its Cauſe may be either external or internal. 2.

9. That the Want of the nervous and arterial Fluid, is either owing to a Fault in their reſpective Canals, or to the Fluids themſelves. 2.

[30]

10. That it may be cured either by a Specific or an Evacuant, 4. and conſequently is not juſtly reputed incurable.

11. That the Cure depends upon removing the Obſtruction to the Influx of the Fluids, and deriving them in their natural State, into their reſpective Canals.

12. That the Cure muſt be adapted to the Cauſe.

13. Suppoſing then, both Canals and Fluids to be affected; the Canals to have become cold and flaccid, and the Fluids groſs and tenacious; 'tis plain, that a powerful Diſſolvent, which at the ſame time that it liquifies and purifies the Blood, promotes a free Circulation in the diſorder'd Parts, and reſtores the Elaſticity to the Canals, will prove a Specific in this Caſe: And why the Cortex Peruvianus, when rais'd to its utmoſt or proportionable Power, may not prove this Specific, perhaps nothing but the proper Experiments will ſhew.

14. The very great Effects of a due Uſe of the Cortex, not only in intermitting Fevers, but in many other Diſorders, both of the Solids and Fluids, are too well known to ſtand in need of a particular Enumeration; and this Medicament is now ſo univerſally allow'd to be ſafe as well as efficacious, when properly apply'd, that I know of no Objection that can lie againſt the Uſe of it in the Palſy. Thoſe who think it not of Force ſufficient in ſuch an obſtinate Diſtemper as this, when, after ſome Months have to no Purpoſe been ſpent upon it, 'tis reputed Incurable, will pleaſe to conſider its ſurprizing Effects on the Solids and Fluids in a rebellious Quartan Ague, in what very large Doſes 'tis capable of being exhibited, and how much a prudent Mixture of Sal Abſinth: &c. will add to its Virtue; eſpecially if ſo grand a Remedy as the cold Bath, when duly improv'd, may be call'd in to its Aſſiſtance, as in the Diſtemper we are ſpeaking of, it frequently may.

Of the Lues Venerea.

[31]

1. WHEN this Diſeaſe is hereditary, or become univerſal, it appears under various Forms, but may be diſtinguiſh'd by theſe Properties.

It generally begins with an Itching, Heat, and Inflammation in ſome Part of the Body. Whitiſh Puſtules appear, which drying, ſcale off, and leave a Cavity; or elſe break, grow deep, afford a yellow Mucus, or corroſive Sanies, and form Ulcers incurable by common Medicines. Theſe afterwards increaſe in Number both externally and internally. The inguinal Glands ſwell, collect Matter, break of themſelves, and diſcharge. Shankers, Verrucae, Porri, Mariſcae, Condylomata, Caruncles, Strangury, Eroſion of the Urethra, and Parts adjacent. Stiffneſs in the Joints, and Pain of the Limbs. Eroſion of the Cartilages. The Bones grow carious, and riſe in ſtubborn Apoſtems, corrupting the adjacent Parts. The Viſcera mortify, and the Fleſh corrupts.

2. This Diſtemper is found to be communicated by Lactation, Sweat, Saliva, and Exhalation.

3. From hence, it's Cauſe is a corroſive Taint admitted into the Body, which gradually aſſimilates the Fluids to it ſelf, corrupts the Solids, and becomes contagious by a Communication of the Fluids.

4. The Specific wanting here is therefore ſuch an one as will deſtroy the force of this Corroſive, or put a ſtop to the Contagion in the animal Fluids; which there is an opportunity of diſcovering by the proper Experiments.

[32]

5. In the mean time, if we expect this ſpecific Virtue from any known Medicament, 'tis neceſſary it ſhou'd be uſed as a Specific, that is, by ſuffering it to be detain'd in the Body as long as poſſible, to let it have it's utmoſt Effects upon the Solids and Fluids: And who can ſay that Mercury, thus properly manag'd, will not have ſuch a ſpecific Virtue?

This is a matter of no ſmall moment, and certainly deſerves to be well examin'd; for if this reaſoning will hold good, it follows, that much Pain and Fatigue, very great Danger and Loathſomneſs, the neceſſary attendants of a Salivation, are often undergone to no purpoſe, or elſe to a bad one; whilſt ſuch a hazardous Method frequently failing to Cure the Diſeaſe, occaſions it afterwards to paſs for Incurable. In which Caſe, this ſpecific Uſe of Mercury, may bid very fair for a Cure.

There is but one Objection, that I know of, can be made againſt this way of turning Mercury into a Specific, for the Cure of the Lues Venerea, viz. That the Venereal Taint or Virus, being plentifully evacuated by Salivation, as appears from the quantity and ſtench of the Saliva, a contrary way of proceeding will have a contrary Effect, and conſequently detain and lock up the Virus in the Body.

That ſome Portion of the Venereal Taint is evacuated with the Saliva in a Salivation, cannot be deny'd, any more than that ſome is likewiſe evacuated with the Urine, and other Excretions, ſince in both Caſes the Virus will evidently manifeſt it ſelf by propagating the Contagion. 2. But that it is more plentifully evacuated by the Salivary Glands in the former Caſe, than it wou'd be by the Renal in the latter, were proper Diureticks exhibited, may be juſtly queſtion'd, if the ſtench of the Saliva be no proof of it. But 'tis well known that the Saliva evacuated in the Salivation of a Perſon who is entirely free from any Venereal Taint, is equally fetid with that of a Venereal Patient.

Again, ſucceſſive Salivations have been oftentimes regularly rais'd, and prudently carried on, ſo as to cauſe a very plentiful Excretion of fetid Saliva; but notwithſtanding this, the Lues has been left uncured: from whence it ſhou'd appear that the Cure does not depend upon an evacuation [33]of ferid Saliva. Nor will this perhaps admit of a doubt, if it be remember'd that many, on the contrary, have been cured of the Lues, by Mercury, who cou'd never be brought to Salivate at all; and that others, whom upon account of ſome Diſeaſe of the Breaſt, or the like, it has not been thought prudent to venture under ſo dangerous a Flux by the Mouth, have happily recover'd by this ſpecific Uſe of the ſame.

And agreeable to this Doctrine is that Practice of the beſt Phyſicians, who even after the moſt profuſe Flux by the Mouth, either exhibit proper Doſes of Mercury, during the ſpace of ſeveral weeks after the Salivation is drop'd, without any Deſign to bring it on again; or elſe put the Patient into a Courſe of ſpecific Diet-Drink; as well knowing that unleſs ſomewhat of this kind be done, the Patient is not ſecure, but runs the hazard of a relapſe.

'Tis evident that Mercury exhibited ſo as to Purge or Salivate, cannot exert its full Force upon the Body; becauſe by thoſe very Excretions it is ſoon thrown out, as appears, in that it may be reviv'd from the Excrements and reinſtated in Poſſeſſion of its former Properties: If therefore we wou'd obtain the utmoſt Effects of this grand Medicament, ought it not by a prudent management to be detain'd, in a large quantity, as long as poſſible in the Body? This Method alone, methinks, can determine whether Mercury will prove a true Specific for the Lues Venerea.

Moreover, ſuch an Uſe of Mercury is not only directed by the nature of the Diſeaſe, but by the ſimilar Effects of other Remedies. The Lues Venerea is a very ſtubborn and obſtinate Diſtemper, and where it once ſeiſes, is with great difficulty removed; it ſeems ſtrongly to adhere to the body, or rather it entangles it ſelf ſo as to become one with it, as appears particularly by its laſting Effects after a partial Cure; (for Mercury as 'tis generally exhibited, only palliates, but ſeldom eradicates this Diſeaſe, as is well known to the more curious obſervers:) ought not then the Remedy alſo to be entangled and united with the Body, in order to exert its full Force, and be upon equal Terms with its Adverſary? Thus we ſee every Day when the [34]Cortex, exhibited in an Intermittent, is evacuated by Stool, 'tis of no Effect towards curing the Diſeaſe, tho' adminiſtred in a very large Quantity; but ſtop this Evacuation, let the Medicine remain in the Body, circulate with the Fluids, and exert it's full Force, it becomes a very different and vaſtly more powerful Remedy than before, and juſtly deſerves to be call'd a Specific.

Of the Gout.

[35]

1. THE chief Properties of the Gout are, to return generally in the Spring and Autumn. 2. Seldom to affect any but Men of a groſs and corpulent Habit. 3. To ſucceed high Living, hard Study, violent Exerciſe, the free Uſe of Acids, and taking Cold on the Feet.

2. A Fit is uſually preceeded by Crudity, or rawneſs felt in the Stomach, heavineſs, Coſtiveneſs, a ſtoppage of Sweat in the Feet, and by Varices.

3. When regular, it ſeizes the internal Parts of the Foot, its Perioſteum, Nerves, Membranes, Ligaments, and Tendons about the Joynts: And when irregular, that is, when it moves about or diſperſes it ſelf, it always falls on the like membranous and nervous Parts.

4. A Fit comes on with a tenſive, burning, gnawing Pain, which increaſes gradually to it's height, then decreaſes, as the Part grows moiſt, red, and tumid.

5. The Pain goes off in a Diaphoreſis, leaving an Itching behind it.

6. It ſcales the Part, or burſting the Veſſels, throws off a ſolid cretaceous Matter.

7. 'Tis more violent, as the Swelling is leſs, and vice verſâ.

8. The more ſevere the Fit, the greater the Interval of its return, and vice verſâ.

9. Does it not follow that the immediate Cauſe of the Gout, both in its knotty and ſmooth Species, is a cretaceous Matter lodg'd in ſome nervous and membranous Part? For a Fit never ceaſes 'till this Matter is thrown off in the former Species, and to ſuppoſe a like Expulſion in the latter, tho' made in a leſs ſenſible manner, fairly and naturally accounts for the other [36]Phaenomena, which are the ſame in both. It ſhould follow therefore, that theſe two Caſes differ only as the Cauſe happens to be more or leſs perſpirable, 3.4.5.6.

10. Does not the Cauſe of this Diſeaſe lurk in the Body in the Abſence of a Fit? 1.7.8. If the Gout be ever properly hereditary, this is ſtill more evident.

11. It appears that this Cauſe is depoſited upon various Parts by the Fluids; 2. For the Solids never exchange Places; and conſequently the Fluids alone, in the Abſence of a Fit, are the Seat or Vehicle of this Cauſe.

12. This Cauſe upon many Occaſions 1. is apt to ſtagnate, or be depoſited in the ſmalleſt Canals, and ſuch as are moſt remote from the Brain and Heart, where the Circulation is languid, and the Parts are naturally preſſed, contracted and leſs yielding, 3.

13. This Matter is corroſive 4.6.

14. As the Veſſels are more ſtiff and rigid, 12. and the Matter more corroſive and tenacious, 11.13. the Diſeaſe will be more ſevere.

15. Both the Solids and Fluids being concerned in the Fit, the Cure ought at that Time to regard them both: But in the Abſence of a Fit, the Cure need only regard the Alteration of the Fluids 11.

16. The Cure then in the Abſence of a Fit, is to be effected, either by a proper Diſſolvent of a cretaceous Matter in the Fluids, or by proper Evacuation.

17. Till the Specific can be found for this Caſe, perhaps Evacuations might be contriv'd, to carry off the Semina of the Diſeaſe, during that large Interval (1.) which is uſually interpos'd between two Fits; and by that Means a new Set of Fluids be procur'd, and a proper Regimen and Remedies uſed to prevent the future Generation of this Cauſe. For if the Cauſe of the Diſeaſe, in the Abſence of the Fit, exits in the Fluids, 11. and be equally diſperſed in them, as there appears Reaſon, from the ſuppos'd preſent State of Health, to believe; 'tis certain, that an Evacuation of Blood, at a large Orifice, would leſſen the Quantity of [37]this Cauſe in the Body: and could not Phlebotomy be ſo manag'd, as to detract as much of it as would otherwiſe be thrown out by the enſuing Fit; and if ſo, would not this prevent a Fit as effectually as the having undergone one? In the abſence of the Fit, the Body is ſound, and the Effects of moderate Phlebotomy on a ſound Body, we know are to leſſen the Quantity of the Blood, and rarify the remaining Part; to take off from the Reſiſtance of the Fluids, allow a more free Contraction of the Canals, and a Recovery of their Elaſticity; to diſſolve Coagulations, to open Obſtructions, and promote a free Circulation; and laſtly, to forward both Secretions and Excretions, and to allow of a Renovation of the Fluids or Maſs of Blood. Now there are none of theſe Effects, taken ſeparately or conjointly, but ſeem of themſelves to have a direct Tendency to forward the Cure, provided the firſt Digeſtion can be well ſecur'd, and Crudities in the others prevented; which greatly depending upon a prudent Choice of the Subject, and a proper Management during the Uſe of the Remedy, no greater Objections will perhaps lie againſt this Method, where a Perſon is willing to purſue it, than are to be produc'd againſt other approv'd and eſtabliſh'd Forms of Procedure in other Diſeaſes.

Phlebotomy, after the manner propos'd, has never that I know of, been try'd by Way of Prevention or Cure of the Gout, though in the Rheumatiſm, an acknowledg'd ſimilar Caſe, it frequently has with very good Succeſs; and is one of the beſt known Methods of Cure, for that Diſtemper. And the ſame Operation, when perform'd in the common Manner, or uſed as an Aſſiſtant in the Cure of the Gout, has ſometimes been found of Service. But as this Caſe has ſeldom been preſcrib'd to by Phyſicians of Judgment, it being always look'd upon as Incurable, or ſuch a Diſeaſe as was render'd worſe by the Uſe of Phyſic, it has fallen almoſt entirely to the Management of Empiricks, from whoſe Practice I will not, in a Caſe of ſo great Nicety, venture to draw a Concluſion.

As theſe few Examples are propos'd by Way of Specimen, it muſt be obſerv'd, that it did not ſuit with the Nature of the Deſign, to enumerate [38]all the Properties and Phonomena of every Diſeaſe, under its reſpective Title, tho' there may perhaps be commonly enow from whence to deduce their immediate Cauſe, and a ſuitable Method of Cure. Nor are all the poſſible Advantages taken of what Properties are ſet down, upon account of the deſign'd Brevity of this Diſcourſe. It ought not therefore to be attributed to neglect, that under Madneſs, no Notice was taken, of what Service a prudent Exhibition of the Cortex, Sal, Abſinth. &c. might be, during the Uſe of the particular Remedy, there recommended; nor any Mention made of the proper Ways of endeavouring to reduce the Mind to its natural State: Nor again how advantagious, deep Inciſions, frequent Scarifications, ſtrong Attractives, actual Cauteries, powerful Digeſtives, ſharp Corroſives, proper Lotions, &c. in the Bite of a mad-Dog: How uſeful ſtrong ſtimulating Remedies in the Palſy; or what better Methods than the common, there are of treating the inveterate or confirm'd Lues Venerea: Nor laſtly, of what Service a Courſe of Relaxatives, Perſpiratives, Sudorificks, Corroboratives, Stomachicks, or a Salivation in the Gout; or the moſt proper Method of treating that Diſeaſe during the Fit, though the Properties mention'd will lead to it.

Much leſs could it be expected, that the Diet, Regimen, and Medicines requiſite, or uſeful in each Proceſs, ſhould be there inſiſted on, which would be to have ſwell'd a Volume upon each Diſtemper.

Thus then have I done what I at firſt props'd; which was only to offer at ſome probable Means to improve the Phyſical Practice with Regard to inveterate Caſes, or ſuch as are undeſervedly ſtil'd Incurable; in hopes, at the ſame Time, to wipe off ſome Part of that Reproach, which has fallen on the Art of Healing, through a Remiſſneſs to cultivate ſo neceſſary and beneficial a Part of it. I am ſenſible how little I have contributed to ſo great a Work, yet if this imperfect Sketch may happen to give Occaſion to a due Proſecution of the Deſign, I ſhall not repent that I ventured to communicate ſo ſlender a Performance to the Public.

FINIS.
Notes
a
When they enquire into Diſeaſes, find ſo many which they aſſert to be Incurable, either from their firſt Appearance, or after they have continu'd ſome Time, that the Proſcriptions of L. Scylla, and the Triumv [...]rate were [...]ing in Compariſon of the Proſcriptions of Phyſicians, by which, with the moſt unjuſt Sentence imaginable, they deliver Men over to Death many of whom, notwithſtanding, eſcape with leſs Diffic [...]y than a [...]d thoſe formerly under the Roman Proſeriptions. A Treatiſe therefore is wanting upon the Cures of repared incurable Diſeaſes, to the [...]nd that both Phyſicians and others of Eminence and Reſolution may be encouraged and excited to purſue this Matter as far as the Nature of it will permit; ſince to denounce Diſ [...]es Incurable is to eſtabliſh Neg [...]gence and Careleſneſs, as it were by a Law, at the ſame time that it [...]eens Ignorance from Rep [...]oach.
a
‘"I am clearly of Opinion. That 'tis the Duty of a Phyſician to mitigate the Pain and Torture of a Diſeaſe, as wel as to reſtore Heath, and this not only when ſuch a Mitigation tends to a Recovery, as it is the removal of a dangerous Symptom, but alſo when there being no farther Hopes of a Recovery, it can only ſerve to make the Paſſage out of Life more calm and eaſy. For that Complacency in Death, which Auguſtus. ſo much deſired. [...]s no ſmall Happineſs.—But 'tis a point of Conſcience with the Phyſicians or our Days, to ſit by the Sick after they have given them over; when in my Opinion, if they wou'd do an Office of Humanity in their own Profeſſion, they ought to be gaining Skill in their Art, whilſt they endeavoured to make the dying Perſon depart with more Eaſe and Tranquillity".’
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Citation Suggestion for this Object
TextGrid Repository (2020). TEI. 5617 A treatise of incurable diseases containing I An essay on the proper means to reduce the number of incurables II An attempt to settle a just notion of incurable in physick III A specimen of a ra. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-585A-D