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 Prac⯑tice, 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 per⯑haps 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 Cir⯑cle, 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, inve⯑niunt 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 Medico⯑rum 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 Curati⯑onibus Morborum, qui habentur pro Inſanabilibus; ut evocentur & exciten⯑tur Medici aliique egregii & magnanimi; qui huic operi, quantum largitur Natura rerum, incumbant; quando hoc ipſum, iſtos Morbos pronunci⯑are Inſanabiles, neglectum & incuriam veluti lege ſanciat, & ignoran⯑tiam 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 Diſ⯑eaſes were an hundred Years agoe, unwarrantably call'd Incurable; and al⯑lowing 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 Cen⯑ſures 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, Chy⯑rurgery, Chymiſtry, Pharmacy, and Botany, a noble Addition to the Ma⯑teria 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 com⯑mon 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 de⯑clared 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 Qua⯑lity in Philoſophy, a Term which manag'd with Addreſs, amus'd the Mul⯑titude, 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 uſe⯑ful 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 in⯑fant Knowledge of Diſeaſes and Remedies. 'Tis leſs to be wonder'd at there⯑fore 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 deſ⯑perate 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 ap⯑plied [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 incu⯑rable, 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 Poſte⯑rity 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 proper⯑ly 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 ulti⯑mate 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 Con⯑ſequence [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 free⯑dom 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 Diſ⯑eaſe, 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 Re⯑medies are wanting to remove them; and then by the proper Experiments ob⯑tain 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 encoura⯑ging and purſuing this noble Method in Phyſic, we ſeem almoſt entirely to [7]diſcountenance and contemn it; inſtead of endeavouring by this means to cul⯑tivate 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 al⯑ways 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 ma⯑ny 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 em⯑ploy'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 Drud⯑gery 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 cultivati⯑on 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 E⯑clipſe, or other Reſults of numerous Obſervations, and laborious Calcula⯑tions? 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 Man⯑kind are immediately concern'd in it, I am at a loſs to know. But to re⯑turn.

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 pro⯑ceed 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 de⯑ſirable and promiſing Method of Cure for an inveterate Caſe, when the current Practice has proved unſucceſsful; that is, ſuch a Method as ſhall, be⯑fore 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 Pati⯑ent; 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 ratio⯑nal 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 prefera⯑ble 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 diſ⯑covery of a deſirable and promiſing Method of Cure, he cannot do bet⯑ter, in the way of his Profeſſion, than to recommend it.

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 Phyſici⯑ans 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 Reme⯑dies; and therefore rarely ventured to truſt ſo dangerous a Thing as Rea⯑ſon 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 ex⯑toll'd, and Reaſon, fallacious Reaſon was decry'd and contemn'd, as ha⯑ving 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 Re⯑medy, 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 re⯑ſtrain'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 o⯑ther Pretence, why this beſt of Faculties ſhould be thrown aſide as uſe⯑leſs, 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 ap⯑plied to diſcover the cures of, at leaſt, the reputed incurable Diſeaſes a⯑mong us. For in theſe Caſes, our preſent ſtock of Experience is confeſ⯑ſedly 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 argu⯑ing 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 im⯑proveable, 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 A⯑natomy, and Chirurgery grows more compleat; whilſt Chymiſtry and Phar⯑macy furniſh us with new Preparations, and Mechanicks is more ſucceſſ⯑fully 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 Prin⯑ciples, if it be conſider'd, that the whole Set we are at this time ac⯑quainted 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 be⯑came general: And Fire is an Element from which other as great Matters may be juſtly expected. Beſides this, an inverted Order, a well propor⯑tion'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 al⯑moſt 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 Diſ⯑eaſes may be juſtly expected, either from a diſcovery of new powerful Reme⯑dies, 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 com⯑monly 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 up⯑on 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, ap⯑pear 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 Prepa⯑ration 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 pre⯑ſcribing [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 Prepa⯑ration 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 ef⯑fect 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 Me⯑dicine as will effect a Cure without cauſing any ſenſible Evacuation. Un⯑derſtand 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 con⯑taminated 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 at⯑tends the ſame Experiment in two or three Repetitions; it would be rea⯑ſonably 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 Mat⯑ter for their Cauſe, or elſe depend upon, a viſible alteration in the Con⯑ſiſtence, 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 Solli⯑citations, 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. Experi⯑ments, 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 Com⯑mendable; but are there any now on foot, or that can poſſibly be con⯑triv'd, of greater Moment, than the ſort above mentioned; any more Bene⯑ficial 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 At⯑tempts ſo mean and low, ſo trivial and contemptible, in compariſon of them, that one wou'd be tempted to think they came from the igno⯑rant 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 weigh⯑tier 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 ſpa⯑cious Building is now purpoſely crecting for their Reception and Uſe? This ſeems not only a particular Inſtance of compaſſionate Bounty, but a Deſire ex⯑preſs'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 Speci⯑ficks 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 Ex⯑periments, 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 manage⯑ment 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 Re⯑covery, when Health is within our own reach? We ſeem to want no Pre⯑parative 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 enlar⯑ged, 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 Di⯑ſeaſes 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 di⯑rect 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.

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, ei⯑ther 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 pro⯑miſing 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 Reme⯑dies 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 for⯑ward the diſcovery of the Cures of reputed incurable Diſeaſes.

But let this buſineſs proceed as it may, and that the Succeſs will be pro⯑portionable to the Application, cannot be denied; we certainly have it already in our Power, by the Uſe of known Remedies to make ſe⯑veral, 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 per⯑emptorily 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.

There is another thing ſtill behind, and I am glad to find it inſiſted up⯑on 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 car⯑ries 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 convale⯑ſcentiam faciat & conducat, imo vero cum abjectâ prorſus omni ſanita⯑tis ſpe, Exceſſum tantum praebeat è vita magis lenem & placidum. Si⯑quidem non parva eſt felicitatis pars, (quam ſibi tantopere precari ſole⯑bat 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, & diligen⯑tiam praeſtare deberent, quâ animam agentes, facilius & mitius è vita de⯑migrent. 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 intoxi⯑cating himſelf.

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 Pro⯑cedure 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 en⯑quiry, 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 pre⯑vent 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.

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 la⯑teſt 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 ſig⯑nify.

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 Phi⯑loſophical 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 con⯑firm 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 faſhion⯑able Practice will ſuffice. Some Reaſon drawn from the Nature of the Thing, is requiſite to ſhew a Caſe to be abſolutely Incurable; to denomi⯑nate 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 Im⯑portance.

'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 whe⯑ther 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 In⯑quiry.

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 Im⯑perfection of Medicine; and conſequently where the Properties and imme⯑diate 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 diſ⯑coverable [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, ap⯑pears from the Nature of the Thing it ſelf. For unleſs this Cauſe be ma⯑nifeſt, 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 un⯑diſcoverable? 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 tranſ⯑verſe 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 be⯑ing 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 ſud⯑den, and leſs certain, as in Obſtructions of the animal Faculties, ſup⯑poſe by a tranſverſe Section of the Oesophagus, the Term Incurable can⯑not with equal Certainty be apply'd at the Inſtant the Wound was re⯑ceiv'd, becauſe there may be other Ways contriv'd of conveying Nu⯑triment to the Body, beſides by the Mouth; and in the mean Time, Op⯑portunities 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 Reco⯑very, then ſuch a Caſe might, with equal Certainty, be pronounc'd In⯑curable, 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 go⯑verned 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 Diſtem⯑pers, 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 Fe⯑ver, 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 Judg⯑ment 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 aſ⯑ſigned, that the reſpective Specificks for the Gout and Stone, ſhall ne⯑ver 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 In⯑curable, 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 ut⯑moſt 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 Mo⯑tion.

The utmoſt Virtues of Remedies cannot be known, till the Reme⯑dies 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 De⯑mand 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 o⯑thers, 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 on⯑ly 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 Mea⯑ſures, 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 imme⯑diate 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 in⯑curable, 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 Ma⯑ſters 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 Na⯑ture of the Caſe, and aſſiſt in diſcovering its immediate Cauſe: And when this is obtain'd, we are naturally directed to ſearch for the Re⯑medy; 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 Spe⯑cimen, 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 Im⯑poſition of a miſemploy'd Term.

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