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-The Project Gutenberg eBook, Hypochondriasis, by John Hill

-

-

-This eBook is for the use of anyone anywhere at no cost and with

-almost no restrictions whatsoever.  You may copy it, give it away or

-re-use it under the terms of the Project Gutenberg License included

-with this eBook or online at www.gutenberg.org

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-

-Title: Hypochondriasis

-       A Practical Treatise (1766)

-

-

-Author: John Hill

-

-

-

-Release Date: September 27, 2009  [eBook #30099]

-

-Language: English

-

-Character set encoding: ISO-646-US (US-ASCII)

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-***START OF THE PROJECT GUTENBERG EBOOK HYPOCHONDRIASIS***

-

-

-E-text prepared by Tor Martin Kristiansen, Joseph Cooper, Stephanie Eason,

-and the Project Gutenberg Online Distributed Proofreading Team

-(http://www.pgdp.net)

-

-

-

-The Augustan Reprint Society

-

-JOHN HILL

-

-HYPOCHONDRIASIS

-

-A Practical Treatise.

-

-(1766)

-

-Introduction by

-

-G. S. ROUSSEAU

-

-

-

-

-

-

-

-Publication Number 135

-William Andrews Clark Memorial Library

-University Of California, Los Angeles

-1969

-

-

-

-

-GENERAL EDITORS

-

-  William E. Conway, _William Andrews Clark Memorial Library_

-  George Robert Guffey, _University of California, Los Angeles_

-  Maximillian E. Novak, _University of California, Los Angeles_

-

-

-ASSOCIATE EDITOR

-

-  David S. Rodes, _University of California, Los Angeles_

-

-

-ADVISORY EDITORS

-

-  Richard C. Boys, _University of Michigan_

-  James L. Clifford, _Columbia University_

-  Ralph Cohen, _University of Virginia_

-  Vinton A. Dearing, _University of California, Los Angeles_

-  Arthur Friedman, _University of Chicago_

-  Louis A. Landa, _Princeton University_

-  Earl Miner, _University of California, Los Angeles_

-  Samuel H. Monk, _University of Minnesota_

-  Everett T. Moore, _University of California, Los Angeles_

-  Lawrence Clark Powell, _William Andrews Clark Memorial Library_

-  James Sutherland, _University College, London_

-  H. T. Swedenberg, Jr., _University of California, Los Angeles_

-  Robert Vosper, _William Andrews Clark Memorial Library_

-

-

-CORRESPONDING SECRETARY

-

-  Edna C. Davis, _William Andrews Clark Memorial Library_

-

-

-EDITORIAL ASSISTANT

-

-  Mary Kerbret, _William Andrews Clark Memorial Library_

-

-

-

-

-INTRODUCTION

-

-     "When I first dabbled in this art, the old distemper call'd

-     _Melancholy_ was exchang'd for _Vapours_, and afterwards for the

-     _Hypp_, and at last took up the now current appellation of the

-     _Spleen_, which it still retains, tho' a learned doctor of the

-     west, in a little tract he hath written, divides the _Spleen_ and

-     _Vapours_, not only into the _Hypp_, the _Hyppos_, and the

-     Hyppocons; but subdivides these divisions into the _Markambles_,

-     the _Moonpalls_, the _Strong-Fiacs_, and the _Hockogrokles_."

-

-

-     Nicholas Robinson, _A New System of the Spleen, Vapours, and

-     Hypochondriack Melancholy_ (London, 1729)

-

-

-Treatises on hypochondriasis--the seventeenth-century medical term for a

-wide range of nervous diseases--were old when "Sir" John Hill, the

-eccentric English scientist, physician, apothecary, and hack writer,

-published his _Hypochondriasis_ in 1766.[1] For at least a century and a

-half medical writers as well as lay authors had been writing literature

-of all types (treatises, pamphlets, poems, sermons, epigrams) on this

-most fashionable of English maladies under the variant names of

-"melancholy," "the spleen," "black melancholy," "hysteria," "nervous

-debility," "the hyp." Despite the plethora of _materia scripta_ on the

-subject it makes sense to reprint Hill's _Hypochondriasis_, because it

-is indeed a "practical treatise" and because it offers the modern

-student of neoclassical literature a clear summary of the best thoughts

-that had been put forth on the subject, as well as an explanation of the

-causes, symptoms, and cures of this commonplace malady.

-

-No reader of seventeenth- and eighteenth-century English literature

-needs to be reminded of the interest of writers of the period in the

-condition--"disease" is too confining a term--hypochondriasis.[2] Their

-concern is apparent in both the poetry and prose of two centuries. From

-Robert Burton's Brobdingnagian exposition in _The Anatomy of Melancholy_

-(1621) to Tobias Smollett's depiction of the misanthropic and ailing

-Matthew Bramble in _Humphry Clinker_ (1771), and, of course, well into

-the nineteenth century, afflicted heroes and weeping heroines populate

-the pages of England's literature. There is scarcely a decade in the

-period 1600-1800 that does not contribute to the literature of

-melancholy; so considerable in number are the works that could be placed

-under this heading that it actually makes sense to speak of the

-"literature of melancholy." A kaleidoscopic survey of this literature

-(exclusive of treatises written on the subject) would include mention of

-Milton's "Il Penseroso" and "L'Allegro," the meditative Puritan and

-nervous Anglican thinkers of the Restoration (many of whose narrators,

-such as Richard Baxter, author of the _Reliquiae Baxterianae_,[3] are

-afflicted), Swift's "School of Spleen" in _A Tale of a Tub_, Pope's

-hysterical Belinda in the "Cave of Spleen," the melancholic "I" of

-Samuel Richardson's correspondence, Gray's leucocholy, the

-psychosomatically ailing characters of _The Vicar of Wakefield_ and

-_Tristram Shandy_, Boswell's _Hypochondriack Papers_ (1777-1783)

-contributed to the _London Magazine_, and such "sensible" and

-"sensitive" women as Mrs. Bennett and Miss Bates in the novels of Jane

-Austen. So great in bulk is this literature in the mid eighteenth

-century, that C. A. Moore has written, "statistically, this deserves to

-be called the Age of Melancholy."[4] The vastness of this literature is

-sufficient to justify the reprinting of an unavailable practical

-handbook on the subject by a prolific author all too little known.[5]

-

-The medical background of Hill's pamphlet extends further back than the

-seventeenth century and Burton's _Anatomy_. The ancient Greeks had

-theorized about hypochondria: hypochondriasis signified a disorder

-beneath (hypo) the gristle (chondria) and the disease was discussed

-principally in physiological terms. The belief that hypochondriasis was

-a somatic condition persisted until the second half of the seventeenth

-century at which time an innovation was made by Dr. Thomas Sydenham. In

-addition to showing that hypochondriasis and hysteria (thought previously

-by Sydenham to afflict women only) were the same disease, Sydenham noted

-that the external cause of both was a mental disturbance and not a

-physiological one. He also had a theory that the internal and immediate

-cause was a disorder of the animal spirits arising from a clot and

-resulting in pain, spasms, and bodily disorders. By attributing the

-onset of the malady to mental phenomena and not to obstructions of the

-spleen or viscera, Sydenham was moving towards a psychosomatic theory of

-hypochondriasis, one that was to be debated in the next century in

-England, Holland, and France.[6] Sydenham's influence on the physicians

-of the eighteenth century was profound: Cheyne in England, Boerhaave in

-Holland, La Mettrie in France. Once the theory of the nervous origins of

-hypochondria gained ground--here I merely note coincidence, not historical

-cause and effect--the disease became increasingly fashionable in England,

-particularly among the polite, the aristocratic, and the refined. Students

-of the drama will recall Scrub's denial in _The Beaux' Stratagem_ (1707)

-of the possibility that Archer has the spleen and Mrs. Sullen's

-interjection, "I thought that distemper had been only proper to people of

-quality."

-

-Toward the middle of the eighteenth century, hypochondria was so

-prevalent in people's minds and mouths that it soon assumed the

-abbreviated name "the hyp." Entire poems like William Somervile's _The

-Hyp: a Burlesque Poem in Five Canto's_ (1731) and Tim Scrubb's _A Rod

-for the Hyp-Doctor_ (1731) were devoted to this strain; others, like

-Malcom Flemyng's epic poem, _Neuropathia: sive de morbis hypochondriacis

-et hystericis, libri tres, poema medicum_ (1740), were more technical

-and scientific. Professor Donald Davie has written that he has often

-"heard old fashioned and provincial persons [in England and Scotland]

-even in [my] own lifetime say, 'Oh, you give me the hyp,' where we

-should say 'You give me a pain in the neck'"[7]; and I myself have heard

-the expression, "You give me the pip," where "pip" may be a corruption

-of "hyp." As used in the early eighteenth century, the term "hyp" was

-perhaps not far from what our century has learned to call _Angst_. It

-was also used as a synonym for "lunacy," as the anonymous author of

-_Anti-Siris_ (1744), one of the tracts in the tar-water controversy,

-informs us that "Berkeley tells his Countrymen, they are all mad, or

-_Hypochondriac_, which is but a fashionable name for Madness." Bernard

-Mandeville, the Dutch physician and author of _The Fable of the Bees_,

-seems to have understood perfectly well that hypochondriasis is a

-condition encompassing any number of diseases and not a specific and

-readily definable ailment; a condition, moreover, that hovers

-precariously and bafflingly in limbo between mind and body, and he

-stressed this as the theme of his _Treatise of the Hypochondriack and

-Hysteric Passions, Vulgarly Call'd the Hypo in Men and Vapours in Women_

-(1711). The mental causes are noted as well in an anonymous pamphlet in

-the British Museum, _A Treatise on the Dismal Effects of

-Low-Spiritedness_ (1750) and are echoed in many similar early and

-mid-eighteenth century works. Some medical writers of the age, like

-Nicholas Robinson, had reservations about the external mental bases of

-the hyp and preferred to discuss the condition in terms of internal

-physiological causes:

-

-     ...of that Disorder we call the Vapours, or _Hypochondria_; for

-     they have no material distinctive Characters, but what arise from

-     the same Disease affecting different Sexes, and the Vapours in

-     Women are term'd the _Hypochondria_ in Men, and they proceed from

-     the Contraction of the Vessels being depress'd a little beneath the

-     Balance of Nature, and the Relaxation of the Nerves at the same

-     Time, which creates that Uneasiness and Melancholy that naturally

-     attends Vapours, and which generally is an Intemperature of the

-     whole Body, proceeding from a Depression of the Solids beneath the

-     Balance of Nature; but the Intemperature of the Parts is that

-     Peculiar Disposition whereby they favour any Disease.[8]

-

-

-But the majority of medical thinkers had been persuaded that the

-condition was psychosomatic, and this belief was supported by research

-on nerves by important physicians in the 1740's and 1750's: the Monro

-brothers in London, Robert Whytt in Edinburgh, Albrecht von Haller in

-Leipzig. By mid century the condition known as the hyp was believed to

-be a real, not an imaginary ailment, common, peculiar in its

-manifestations, and indefinable, almost impossible to cure, producing

-very real symptoms of physical illness, and said to originate sometimes

-in depression and idleness. It was summed up by Robert James in his

-_Medicinal Dictionary_ (London, 1743-45):

-

-     If we thoroughly consider its Nature, it will be found to be a

-     spasmodico-flatulent Disorder of the _Primae Viae_, that is, of the

-     Stomach and Intestines, arising from an Inversion or Perversion of

-     their peristaltic Motion, and, by the mutual consent of the Parts,

-     throwing the whole nervous System into irregular Motions, and

-     disturbing the whole Oeconomy of the Functions.... no part or

-     Function of the Body escapes the Influence of this tedious and long

-     protracted Disease, whose Symptoms are so violent and numerous,

-     that it is no easy Task either to enumerate or account for them....

-     No disease is more troublesome, either to the Patient or Physician,

-     than hypochondriac Disorders; and it often happens, that, thro' the

-     Fault of both, the Cure is either unnecessarily protracted, or

-     totally frustrated; for the Patients are so delighted, not only

-     with a Variety of Medicines, but also of Physicians.... On the

-     contrary, few physicians are sufficiently acquainted with the true

-     Genius and Nature of this perplexing Disorder; for which Reason

-     they boldly prescribe almost everything contained in the Shops, not

-     without an irreparable Injury to the Patient (article on

-     "Hypochondriacus Morbis").

-

-This is a more technical description than Hill gives anywhere in his

-handbook, but it serves well to summarize the background of the condition

-about which Sir John wrote.

-

-Hill's _Hypochondriasis_ adds little that is new to the theory of the

-disease. It incorporates much of the thinking set forth by the writings

-mentioned above, particularly those of George Cheyne, whose medical

-works _The English Malady_ (1733) and _The Natural Method of Cureing the

-Diseases of the Body, and the Disorders of the Mind Depending on the

-Body_ (1742) Hill knew. He is also conversant with some Continental

-writers on the subject, two of whom--Isaac Biberg, author of The

-_Oeconomy of Nature_ (1751), and Rene Reaumur who had written a history

-of insects (1722)[9]--he mentions explicitly, and with William

-Stukeley's _Of the Spleen_ (1723). Internal evidence indicates that Hill

-had read or was familiar with the ideas propounded in Richard

-Blackmore's _Treatise of the Spleen and Vapours_ (1725) and Nicholas

-Robinson's _A New System of the Spleen, Vapours, and Hypochondriack

-Melancholy_ (1729).

-

-Hill's arrangement of sections is logical: he first defines the

-condition (I), then proceeds to discuss persons most susceptible to it

-(II), its major symptoms (III), consequences (IV), causes (V), and cures

-(VI-VIII). In the first four sections almost every statement is

-commonplace and requires no commentary (for example, Hill's opening

-remark: "To call the Hypochondriasis a fanciful malady, is ignorant and

-cruel. It is a real, and a sad disease: an obstruction of the spleen by

-thickened and distempered blood; extending itself often to the liver,

-and other parts; and unhappily is in England very frequent: physick

-scarce knows one more fertile in ill; or more difficult of cure.") His

-belief that the condition afflicts sedentary persons, particularly

-students, philosophers, theologians, and that it is not restricted to

-women alone--as some contemporary thinkers still maintained--is also

-impossible to trace to a single source, as is his description (p. 12) of

-the most prevalent physiological _symptoms_ ("lowness of spirits, and

-inaptitude to motion; a disrelish of amusements, a love of solitude....

-Wild thoughts; a sense of fullness") and _causes_ (the poor and damp

-English climate and the resultant clotting of blood in the spleen) of

-the illness.

-

-Sections V-VIII, dealing with causes and cures, are less commonplace and

-display some of Hill's eccentricities as a writer and thinker. He uses

-the section entitled "Cures" as a means to peddle his newly discovered

-cure-all, water dock,[10] which Smollett satirized through the mouth of

-Tabitha Bramble in _Humphry Clinker_ (1771). Hill also rebelled against

-contemporary apothecaries and physicians who prescribed popular

-medicines--such as Berkeley's tar-water, Dover's mercury powders, and

-James's fever-powders--as universal panaceas for the cure of the hyp.

-"No acrid medicine must be directed, for that may act too hastily,

-dissolve the impacted matter at once, and let it loose, to the

-destruction of the sufferer; no antimonial, no mercurial, no martial

-preparation must be taken; in short, no chymistry: nature is the shop

-that heaven has set before us, and we must seek our medicine there"

-(p. 24). However scientifically correct Hill may have been in minimizing

-the efficacy of current pills and potions advertised as remedies for the

-hyp, he was unusual for his time in objecting so strongly to them. Less

-eccentric was his allegiance to the "Ancients" rather than to the

-"Moderns" so far as chemical treatment (i.e., restoration of the humours

-by chemical rearrangement) of hypochondriasis is concerned.[11] "The

-venerable ancients," Hill writes, "who knew not this new art, will lead

-us in the search; and (faithful relators as they are of truth) will tell

-us whence we may deduce our hope; and what we are to fear" (p. 24).

-

-Still more idiosyncratic, perhaps, is Hill's contention (p. 25) that the

-air of dry, high grounds worsens the condition of the patient. Virtually

-every writer I have read on the subject believed that onset of the hyp

-was caused by one of the six non-naturals--air, diet, lack of sufficient

-sleep, too little or too much exercise, defective evacuation, the

-passions of the mind; and although some medical writers emphasized the

-last of these,[12] few would have concurred with Hill that the fetid air

-of London was less harmful than the clearer air at Highgate. All readers

-of the novel of the period will recall the hypochondriacal Matt

-Bramble's tirade against the stench of London air. Beliefs of the

-variety here mentioned cause me to question Hill's importance in the

-history of medicine; there can be no question about his contributions to

-the advancement of the science of botany through popularization of

-Linnaeus' system of bisexual classification, but Hill's medical

-importance is summarized best as that of a compiler. His recommendation

-of the study of botany as a cure for melancholics is sensible but verges

-on becoming "a digression in praise of the author," a poetic _apologia

-pro vita sua_ in Augustan fashion:

-

-     For me, I should advise above all other things the study of nature.

-     Let him begin with plants: he will here find a continual pleasure,

-     and continual change; fertile of a thousand useful things; even of

-     the utility we are seeking here. This will induce him to walk; and

-     every hedge and hillock, every foot-path side, and thicket, will

-     afford him some new object. He will be tempted to be continually in

-     the air; and continually to change the nature and quality of the

-     air, by visiting in succession the high lands and the low, the

-     lawn, the heath, the forest. He will never want inducement to be

-     abroad; and the unceasing variety of the subjects of his

-     observation, will prevent his walking hastily: he will pursue his

-     studies in the air; and that contemplative turn of mind, which in

-     his closet threatened his destruction, will thus become the great

-     means of his recovery (pp. 26-27).

-

-Hill was forever extolling the claims of a life devoted to the study of

-nature, as we see in a late work, _The Virtues of British Herbs_ (1770).

-Judicious as is the logic of this recommendation, one cannot help but

-feel that the emphasis here is less on diversion as a cure and more on

-the botanic attractions of "every hedge and hillock, every foot-path

-side, and thicket."

-

-While Hill's rules and regulations regarding proper diet (Section VII)

-are standard, several taken almost _verbatim et literatim_ from Cheyne's

-list in _The English Malady_ (1733), his recommendation (Section VIII)

-of "Spleen-Wort" as the best medicine for the hypochondriac patient is

-not. Since Hill devotes so much space to the virtues of this herb and

-concludes his work extolling this plant, a word should be said about it.

-Throughout his life he was an active botanist. Apothecary, physician,

-and writer though he was, it was ultimately botany that was his ruling

-passion, as is made abundantly clear in his correspondence.[13] Wherever

-he lived--whether in the small house in St. James's Street or in the

-larger one on the Bayswater Road--he cultivated an herb garden that

-flattered his knowledge and ability. Connoisseurs raved about its

-species and considered it one of the showpieces of London. His arrogant

-personality alone prevented him from becoming the first Keeper of the

-Apothecary's Garden in Chelsea, although he was for a time

-superintendent to the Dowager Princess of Wales's gardens at Kensington

-Palace and at Kew. His interest in cultivation of herbs nevertheless

-continued; over the years Hill produced more than thirty botanical

-works, many of them devoted to the medical virtues of rare herbs such as

-"Spleen-Wort." Among these are _The British Herbal_ (1756), _On the

-Virtues of Sage in Lengthening Human Life_ (1763), _Centaury, the Great

-Stomachic_ (1765), _Polypody_ (1768), _A Method of Curing Jaundice_

-(1768), _Instances of the Virtue of Petasite Root_ (1771), and _Twenty

-Five New Plants_ (1773).[14] It is therefore not surprising that he

-should believe a specific herb to be the best remedy for a complicated

-medical condition. Nor is his reference to the Ancients as authority for

-the herbal pacification of an inflamed spleen surprising in the light of

-his researches: he was convinced that every illness could be cured by

-taking an appropriate herb or combination of herbs. Whereas a few

-nonmedical writers--such as John Wesley in _Primitive Physick_

-(1747)--had advocated the taking of one or two herbs in moderate dosage

-as anti-hysterics (the eighteenth-century term for all cures of the

-hyp), no medical writer of the century ever promoted the use of herbs to

-the extent that Hill did. In fairness to him, it is important to note

-that his herbal remedies were harmless and that many found their way

-into the official _London Pharmacopeia_. "The virtues of this smooth

-Spleen-wort," he insists, "have stood the test of ages; and the plant

-every where retained its name and credit: and one of our good

-herbarists, who had seen a wonderful case of a swoln spleen, so big, and

-hard as to be felt with terror, brought back to a state of nature by it"

-(p. 37).[15] The greatest portion of Hill's concluding section combines

-advertisement for the powder medicine he was himself manufacturing at a

-handsome profit together with a protest against competing apothecaries:

-"An intelligent person was directed to go to the medicinal herb shops in

-the several markets, and buy some of this Spleen-wort; the name was

-written, and shewn to every one; every shop received his money, and

-almost every one sold a different plant, under the name of this: but

-what is very striking, not one of them the right" (p. 42).

-

-Treatises on hypochondriasis did not cease to be printed after Hill's in

-1766, but continued to issue from the presses into the nineteenth

-century. A good example of this is the tome by John Reid, physician to

-the Finsbury Dispensary in London, _Essays on Insanity, Hypochondriasis

-and Other Nervous Affections_ (1816), which summarizes theories of the

-malady.[16] A bibliographical study of such works would probably reveal

-a larger number of titles in the nineteenth century than in the previous

-one, but by this time the nature and definition of hypochondria had

-changed significantly.

-

-If John Hill's volume is not an important contribution in the history of

-medicine, it is a lucid and brief exposition of many of the best ideas

-that had been thought and written on the hyp, with the exception of his

-uninhibited prescribing of herbal medicines as cure-alls. An

-understanding of this disease is essential for readers of neoclassical

-English literature, especially when we reflect upon the fact that some

-of the best literature of the period was composed by writers whom it

-afflicted. It is perhaps not without significance that the greatest poet

-of the Augustan age, Alexander Pope, thought it necessary as he lay on

-his deathbed in May 1744 to exclaim with his last breath, "I never was

-hippish in my whole life."[17]

-

-  University of California,

-  Los Angeles

-

-

-

-

-NOTES TO THE INTRODUCTION

-

-

-[1] The text here reproduced is that of the copy in the Library of the

-Royal Society of Medicine, London. Title pages of different copies of

-the first edition of 1766 vary. For example, the title page of the copy

-in the British Museum reads, _Hypochondriasis; a Practical Treatise On

-the Nature and Cure of that Disorder, Commonly called the Hyp and the

-Hypo_. The copy in the Royal Society of Medicine contains, among other

-additions, the words "by Sir John Hill" in pencil, and "8vo Lond.

-1766," written in ink and probably a later addition.

-

-[2] Melancholy, hypochondriasis, and the spleen were considered in the

-seventeenth and eighteenth centuries to be one complex condition, a

-malady rather than a malaise, which is but a symptom. Distinctions among

-these, of interest primarily to medical historians, cannot be treated

-here. As good a definition as any is found in Dr. Johnson's _Dictionary_

-(1755): "Hypochondriacal.... 1. Melancholy; disordered in the

-imagination.... 2. Producing melancholy...." The literature of

-melancholy has been surveyed in part by C. A. Moore, "The English

-Malady," _Backgrounds of English Literature 1700-1760_ (Minneapolis,

-1953), pp. 179-235. In medical parlance, "hypochondria" means the soft

-parts of the body below the costal cartilages, and the singular form of

-the word, "hypochondrium," means the viscera situated in the

-hypochondria, i.e., the liver, gall bladder, and spleen.

-

-[3] See Samuel Clifford's _The Signs and Causes of Melancholy, with

-directions suited to the case of those who are afflicted with it.

-Collected out of the works of Mr. Richard Baxter_ (London, 1716) in the

-British Museum.

-

-[4] _Backgrounds of English Literature_, p. 179.

-

-[5] See my forthcoming biography, _The Literary Quack: A Life of 'Sir'

-John Hill of London_, and John Kennedy's _Some Remarks on the Life and

-Writings of Dr. J---- H----, Inspector General of Great Britain_

-(London, 1752).

-

-[6] For some of this background see L. J. Rather, _Mind and Body in

-Eighteenth Century Medicine: A Study Based on Jerome Gaub's De Regimine

-Mentis_ (London, 1965), pp. 135-90 _passim_.

-

-[7] _Science and Literature 1700-1740_ (London, 1964), pp. 50-51.

-

-[8] _A New Theory of Physick_ (London, 1725), p. 56.

-

-[9] Biberg was a Swedish naturalist and had studied botany under

-Linnaeus in Uppsala; Reaumur, a French botanist, had contributed papers

-to the _Philosophical Transactions_ of the Royal Society in London.

-

-[10] _The Power of Water-Dock against the Scurvy whether in the Plain

-Root or Essence...._ (London, 1765), had been published six months

-earlier than _Hypochondriasis_ and had earned Hill a handsome profit.

-

-[11] I have treated aspects of this subject in my article, "Matt Bramble

-and The Sulphur Controversy in the XVIIIth Century: Medical Background

-of _Humphry Clinker_," _JHI_, XXVIII (1967), 577-90.

-

-[12] See, for example, Jeremiah Waineright, _A Mechanical Account of the

-Non-Naturals_ (1707); John Arbuthnot, _An Essay Concerning the Effects

-of Air on Human Bodies_ (1733); Frank Nichols, _De Anima Medica_ (1750).

-

-[13] Hill's correspondence is not published but shall be printed as an

-appendix to my forthcoming biography.

-

-[14] I have discussed some of these works in connection with the medical

-background of John Wesley's _Primitive Physick_ (1747). See G. S.

-Rousseau, _Harvard Library Bulletin_, XVI (1968), 242-56.

-

-[15] It is difficult to know with certainty when Hill first became

-interested in the herb. He mentions it in passing in _The British

-Herbal_ (1756), I, 526 and may have sold it as early as 1742 when he

-opened an apothecary shop.

-

-[16] Reid's dissertation at Edinburgh, entitled _De Insania_ (1798),

-contains materials on the relationship of the imagination to all forms

-of mental disturbance. Secondary literature on hypochondria is

-plentiful. Works include: R. H. Gillespie, _Hypochondria_ (London,

-1928), William K. Richmond, _The English Disease_ (London, 1958),

-Charles Chenevix Trench, _The Royal Malady_ (New York, 1964), and Ilza

-Vieth, _Hysteria: The History of a Disease_ (Chicago, 1965), and "On

-Hysterical and Hypochondriacal Afflictions," _Bulletin of the History of

-Medicine_, XXX (1956), 233-40.

-

-[17] Joseph Spence, _Observations, Anecdotes, and Characters of Books

-and Men_, ed. James M. Osborn (Oxford, 1966), I, 264.

-

-I am indebted to A. D. Morris, M.D., F.R.S.M., for help of various sorts

-in writing this introduction.

-

-

-

-

-BIBLIOGRAPHICAL NOTE

-

-The text of this facsimile of _Hypochondriasis_ is reproduced from a

-copy in the Library of the Royal Society of Medicine, London.

-

-

-

-

-     HYPOCHONDRIASIS.

-

-            A

-

-  PRACTICAL TREATISE, &c.

-

-

-

-HYPOCHONDRIASIS.

-

-

-SECT. I.

-

-The NATURE of the DISORDER.

-

-

-To call the Hypochondriasis a fanciful malady, is ignorant and cruel. It

-is a real, and a sad disease: an obstruction of the spleen by thickened

-and distempered blood; extending itself often to the liver, and other

-parts; and unhappily is in England very frequent: physick scarce knows

-one more fertile in ill; or more difficult of cure.

-

-The blood is a mixture of many fluids, which, in a state of health, are

-so combined, that the whole passes freely through its appointed vessels;

-but if by the loss of the thinner parts, the rest becomes too gross to

-be thus carried through, it will stop where the circulation has least

-power; and having thus stopped it will accumulate; heaping by degrees

-obstruction on obstruction.

-

-Health and chearfulness, and the quiet exercise of mind, depend upon a

-perfect circulation: is it a wonder then, when this becomes impeded the

-body looses of its health, and the temper of its sprightliness? to be

-otherwise would be the miracle; and he inhumanly insults the afflicted,

-who calls all this a voluntary frowardness. Its slightest state brings

-with it sickness, anguish and oppression; and innumerable ills follow

-its advancing steps, unless prevented by timely care; till life itself

-grows burthensome.

-

-The disease was common in antient Greece; and her physicians understood

-it, better than those perhaps of later times, in any other country; who

-though happy in many advantages these fathers of the science could not

-have, yet want the great assistance of frequent watching it in all its

-stages.

-

-Those venerable writers have delivered its nature, and its cure: in the

-first every thing now shews they were right; and what they have said as

-to the latter will be found equally true and certain. This, so far as

-present experience has confirmed it, and no farther, will be here laid

-before the afflicted in a few plain words.

-

-

-

-

-SECT. II.

-

-Persons Subject to it.

-

-

-Fatigue of mind, and great exertion of its powers often give birth to

-this disease; and always tend to encrease it. The finer spirits are

-wasted by the labour of the brain: the Philosopher rises from his study

-more exhausted than the Peasant leaves his drudgery; without the benefit

-that he has from exercise. Greatness of mind, and steady virtue;

-determined resolution, and manly firmness, when put in action, and

-intent upon their object, all also lead to it: perhaps whatever tends to

-the ennobling of the soul has equal share in bringing on this weakness

-of the body.

-

-From this we may learn easily who are the men most subject to it; the

-grave and studious, those of a sedate temper and enlarged understanding,

-the learned and wise, the virtuous and the valiant: those whom it were

-the interest of the world to wish were free from this and every other

-illness; and who perhaps, except for this alloy, would have too large a

-portion of human happiness.

-

-Though these are most, it is not these alone, who are subject to it.

-There are countries where it is endemial, and in other places some have

-the seeds of it in their constitution; and in some it takes rise from

-accidents. In these last it is the easiest of cure; and in the first

-most difficult.

-

-Beside the Greeks already named, the Jews of old time were heavily

-afflicted with this disease; and in their descendants to this day it is

-often constitutional: the Spaniards have it almost to a man; and so have

-the American Indians. Perhaps the character of these several nations may

-be connected with it. The steady honour, and firm valour of the

-Spaniard, very like that of the ancient Doric nation, who followed the

-flute not the trumpet to the field; and met the enemy, not with shouts

-and fury, but with a determined virtue: it is the temper of the

-Hypochondriac to be slow, but unmoveably resolved: the Jew has shewn

-this mistakenly, but almost miraculously; and the poor Indian, untaught

-as he is, faces all peril with composure, and sings his death-song with

-an unalter'd countenance.

-

-Among particular persons the most inquiring and contemplative are those

-who suffer oftenest by this disease; and of all degrees of men I think

-the clergy. I do not mean the hunting, shooting, drinking clergy, who

-bear the tables of the great; but the retir'd and conscientious; such as

-attend in midnight silence to their duty; and seek in their own cool

-breasts, or wheresoever else they may be found, new admonitions for an

-age plunged in new vices. To this disease we owe the irreparable loss of

-Dr. YOUNG; and the present danger of many other the best and most

-improved amongst us. May what is here to be proposed assist in their

-preservation!

-

-The Geometrician or the learned Philosopher of whatever denomination,

-whose course of study fixes his eye for ever on one object, his mind

-intensely and continually employed upon one thought, should be warned

-also that he is in danger; or if he find himself already afflicted, he

-should be told that the same course of life, which brought it on, will,

-without due care, encrease it to the most dreaded violence.

-

-The middle period of life is that in which there is the greatest danger

-of an attack from this disease; and the latter end of autumn, when the

-summer heats have a little time been over, is the season when in our

-climate its first assaults are most to be expected. The same time of the

-year always increases the disorder in those who have been before

-afflicted with it; and it is a truth must be confessed, that from its

-first attack the patient grows continually, though slowly, worse; unless

-a careful regimen prevent it.

-

-The constitutions most liable to this obstruction are the lean, and dark

-complexioned; the grave and sedentary. Let such watch the first

-symptoms; and obviate, (as they may with ease) that which it will be

-much more difficult to remove.

-

-It is happy a disease, wherein the patient must do a great deal for

-himself, falls, for the most part, upon those who have the powers of

-reason strongest. Let them only be aware of this, that the distemper

-naturally disposes them to inactivity; and reason will have no use

-unless accompanied with resolution to enforce it.

-

-Though the physician can do something toward the cure, much more depends

-upon the patient; and here his constancy of mind will be employed most

-happily. No one is better qualified to judge on a fair hearing what

-course is the most fit; and having made that choice, he must with

-patience wait its good effects. Diseases that come on slowly must have

-time for curing; an attention to the first appearances of the disorder

-will be always happiest; because when least established it is easiest

-overthrown: but when that happy period has been neglected, he must wait

-the effects of such a course as will dilute and melt the obstructing

-matter gradually; for till that be done it is not only vain, but

-sometimes dangerous, to attempt its expulsion from the body.

-

-The blood easily separates itself into the grosser and the thinner

-parts: we see this in bleeding; and from the toughness of the red cake

-may guess how very difficult it will be to dissolve a substance of like

-firmness in the vessels of the body. That it can thus become thickened

-within the body, a Pleurisy shews us too evidently: in that case it is

-brought on suddenly, and with inflammation; in this other, slowly and

-without; and here, even before it forms the obstruction, can bring on

-many mischiefs. Various causes can produce the same effect, but that in

-all cases operates most durably, which operates most slowly. The watery

-part of the blood is its mild part; in the remaining gross matter of it,

-are acrid salts and burning oils, and these, when destitute of that

-happy dilution nature gives them in a healthy body, are capable of doing

-great mischief to the tender vessels in which they are kept stagnant.

-

-

-

-

-SECT. III.

-

-The SYMPTOMS of the DISORDER.

-

-

-The first and lightest of the signs that shew this illness are a lowness

-of spirits, and inaptitude to motion; a disrelish of amusements, a love

-of solitude and a habit of thinking, even on trifling subjects, with too

-much steadiness. A very little help may combat these: but if that

-indolence which is indeed a part of the disorder, will neglect them;

-worse must be expected soon to follow.

-

-Wild thoughts; a sense of fullness, weight, and oppression in the body,

-a want of appetite, or, what is worse, an appetite without digestion;

-for these are the conditions of different states of the disease, a

-fullness and a difficulty of breathing after meals, a straitness of the

-breast, pains and flatulencies in the bowels, and an unaptness to

-discharge their contents.

-

-The pulse becomes low, weak, and unequal; and there are frequent

-palpitations of the heart, a little dark-coloured urine is voided at

-some times; and a flood of colourless and insipid at others; relieving

-for a moment, but increasing the distemper: there is in some cases also

-a continual teazing cough, with a choaking stoppage in the throat at

-times; then heartburn, sickness, hardness of the belly, and a costive

-habit, or a tormenting and vain irritation.

-

-The lips turn pale, the eyes loose their brightness and by degrees the

-white grows as it were greenish, the gums want their due firmness, with

-their proper colour; and an unpleasing foulness grows upon the teeth:

-the inside of the mouth is pale and furred, and the throat dry and

-husky: the colour of the skin is pale (though there are periods when the

-face is florid) and as the obstruction gathers ground, and more affects

-the liver, the whole body becomes yellow, tawny, greenish, and at length

-of that deep and dusky hue, to which men of swift imagination have given

-the name of blackness.

-

-These symptoms do not all appear in any one period of the disease, or in

-one case, but at one time or other all of them, as well as those which

-follow: the flesh becomes cold to the touch, though the patient does not

-himself perceive it; the limbs grow numbed and torpid, the breathing

-dull and slow, and the voice hollow; and usually the appetite in this

-period declines, and comes almost to nothing: night sweats come on,

-black swellings appear on the veins, the flesh wastes and the breast

-becomes flat and hollow: the mouth is full of a thin spittle, the head

-is dizzy and confus'd, and sometimes there is an unconquerable numbness

-in the organs of speech.

-

-I have known the temporary silence that follows upon this last symptom

-become a jest to the common herd; and the unhappy patient, instead of

-compassion and assistance, receive the reproof of sullenness, from those

-who should have known and acted better.

-

-About twenty years ago I met on a visit at Catthorpe in Leicestershire a

-young gentleman of distinguished learning and abilities, who at certain

-times was speechless. The vulgar thought it a pretence: and a jocose

-lady, where he was at tea with company, putting him as she said to a

-trial, poured out a dish very strong and without sugar. He drank it and

-returned the cup with a bow of great reserve, and his eye bent on the

-ground: she then filled the cup with sugar, and pouring weak tea on it,

-sent it him: he drank that too, looked at her steadily, and blushed for

-her. The lady declared the man was dumb; the rest thought him perverse,

-and obstinate; but a constant and steady perseverance in an easy method

-cured him.

-

-All these are miseries which the disease, while it retains its natural

-form, can bring upon the patient; and thus he will in time be worn out,

-and led miserably, though slowly, to the grave. Let him not indulge his

-inactivity so far as to give way to this, because it is represented as

-far off; the disease may suddenly and frightfully change its nature; and

-swifter evils follow.

-

-

-

-

-SECT. IV.

-

-The DANGER.

-

-

-We have done with the obstruction considered in itself; but this, though

-often unsurmountable by art, at least by the methods now in use, will be

-sometimes broken through at once by nature, or by accidents; and bring

-on fatal evils. These are strictly different diseases, and are no

-otherway concerned here, than as the consequences of that of which we

-are treating.

-

-The thick and glutinous blood which has so long stagnated in the spleen,

-will have in that time altered its nature, and acquired a very great

-degree of acrimony: while it lies dormant, this does no more mischiefs,

-than those named already; but when violent exercise, a fit of outrageous

-anger, or any thing else that suddenly shocks and disturbs the frame,

-puts it in motion, it melts at once into a kind of liquid putrefaction.

-Being now thin, it mixes itself readily with the blood again, and brings

-on putrid fevers; destroys the substance of the spleen itself, or being

-thrown upon some other of the viscera, corrodes them, and leads on this

-way a swift and miserable death. If it fall upon the liver, its tender

-pulpy substance is soon destroyed, jaundices beyond the help of art

-first follow, then dropsies and all their train of misery; if on lungs,

-consumptions; if on the brain, convulsions, epilepsy, palsy, apoplexy;

-if on the surface, leprosy.

-

-The intention of cure is to melt this coagulation softly, not to break

-it violently; and then to give it a very gentle passage through the

-bowels. There is no safe way for it to take but that; and even that when

-urged too far may bring on fatal dysenteries.

-

-Let none wonder at the sudden devastation which sometimes arises from

-this long stagnant matter, when liquified too hastily: how long, how

-many years the impacted matter will continue quiet in a schirrous tumour

-of the breast; but being once put in motion, whether from accident, or

-in the course of nature, what can describe; or what can stop its

-havock!

-

-Instances of the other are too frequent. A nobleman the other day died

-paralytick: dissection shewed a spleen consumed by an abscess, formed

-from the dissolved matter of such an obstruction: and 'tis scarce longer

-since, a learned gentleman, who had been several years lost to his

-friends, by the extreams of a Hypochondriacal disorder, seem'd gradually

-without assistance to recover: but the lungs suffered while the spleen

-was freed; and he died very soon of what is called a galloping

-consumption.

-

-When the obstruction is great and of long continuance, if it be thus

-hastily moved, the consequence is, equally, a sudden and a miserable

-death, whether, like the matter of a cancer, it remains in its place; or

-like that of a bad small pox, be thrown upon some other vital part.

-

-Let not the patient be too much alarmed; this is laid down to caution,

-not to terrify him: it is fit he should know his danger, and attend to

-it; for the prevention is easy; and the cure, even of the most advanced

-stages, when undertaken by gentle means, is not at all impracticable: to

-assist the physician, let him look into himself, and recollect the

-source of his complaint. This he may judge of from the following

-notices.

-

-

-

-

-SECT. V.

-

-The Causes of the HYPOCHONDRIASIS.

-

-

-The obstruction which forms this disease, may take its origin from

-different accidents: a fever ill cured has often caused it; or the

-piles, which had been used to discharge largely, ceasing; a marshy soil,

-poisoned with stagnant water, has given it to some persons; and altho'

-indolence and inactivity are oftenest at the root, yet it has arisen

-from too great exercise.

-

-Real grief has often brought it on; and even love, for sometimes that is

-real. Study and fixed attention of the mind have been accused before;

-and add to these the stooping posture of the body, which most men use,

-though none should use it, in writing and in reading. This has

-contributed too much to it; but of all other things night studies are

-the most destructive. The steady stillness, and dusky habit of all

-nature in those hours, enforce, encourage, and support that settled

-gloom, which rises from fixt thought; and sinks the body to the grave;

-even while it carries up the mind to heaven. He who would have his lamp

-

-        _At midnight hour

-  Be seen in some high lonely tower,_[18]

-

-will waste the flame of this unheeded life: and while he labours to

-unsphere the spirit of Plato[18] will let loose his own.

-

-

-

-

-SECT. VI.

-

-The Cure of the HYPOCHONDRIASIS.

-

-

-Let him who would escape the mischiefs of an obstructed spleen, avoid

-the things here named: and let him who suffers from the malady,

-endeavour to remember to which of them it has been owing; for half the

-hope depends upon that knowledge.

-

-Nature has sometimes made a cure herself, and we should watch her ways;

-for art never is so right as when it imitates her: sometimes the

-patient's own resolution has set him free. This is always in his power,

-and at all times will do wonders.

-

-The bleeding of the piles, from nature's single efforts, has at once

-cured a miserable man; where their cessation was the cause of the

-disorder. A leprosy has appeared upon the skin, and all the symptoms of

-the former sickness vanished. This among the Jews happened often: both

-diseases we know were common among them: and I have here seen something

-very like it: Water-Dock has thrown out scorbutic eruptions, and all the

-former symptoms of an Hypochondriacal disorder have disappeared:

-returning indeed when these were unadvisedly struck in; but keeping off

-entirely when they were better treated. A natural purging unsuppressed

-has sometimes done the same good office: but this is hazardous.

-

-It is easy to be directed from such instances; only let us take the

-whole along with us. Bleeding would have answered nature's purpose, if

-she could not have opened of herself the haemorrhoidal vessels; but he

-who should give medicines for that purpose, might destroy his patient by

-too great disturbance. If a natural looseness may perform the cure, so

-may an artificial; when the original source of the disorder points that

-way. But these are helps that take place only in particular cases.

-

-The general and universal method of cure must be by some mild and gently

-resolving medicine, under the influence of which the obstructing matter

-may be voided that, or some other way with safety. The best season to

-undertake this is the autumn, but even here there must be caution.

-

-In the first place, no strong evacuating remedy must be given; for that,

-by carrying off the thinner parts of the juices, will tend to thicken

-the remainder; and certainly encrease the distemper. No acrid medicine

-must be directed, for that may act too hastily, dissolve the impacted

-matter at once, and let it loose, to the destruction of the sufferer; no

-antimonial, no mercurial, no martial preparation must be taken; in

-short, no chymistry: nature is the shop that heaven has set before us,

-and we must seek our medicine there. The venerable ancients, who knew

-not this new art, will lead us in the search; and (faithful relators as

-they are of truth) will tell us whence we may deduce our hope; and what

-we are to fear.

-

-But prior to the course of any medicine, and as an essential to any good

-hope from it, the patient must prescribe himself a proper course of

-life, and a well chosen diet: let us assist him in his choice; and speak

-of this first, as it comes first in order.

-

-

-

-

-SECT. VI.

-

-Rules of Life for Hypochondriac Persons.

-

-

-Air and exercise, as they are the best preservers of health, and

-greatest assistants in the cure of all long continued diseases, will

-have their full effect in this; but there requires some caution in the

-choice, and management of them. It is common to think the air of high

-grounds best; but experience near home shews otherwise: the

-Hypochondriac patient is always worse at Highgate even than in London.

-

-The air he breathes should be temperate; not exposed to the utmost

-violences of heat and cold, and the swift changes from one to the

-other; which are most felt on those high grounds. The side of a hill is

-the best place for him: and though wet grounds are hurtful; yet let

-there be the shade of trees, to tempt him often to a walk; and soften by

-their exhalation the over dryness of the air.

-

-The exercise he takes should be frequent; but not violent. Motion

-preserves the firmness of the parts, and elasticity of the vessels; it

-prevents that aggregation of thick humours which he is most to fear. A

-sedentary life always produces weakness, and that mischief always

-follows: weak eyes are gummy, weak lungs are clogged with phlegm, and

-weak bowels waste themselves in vapid diarrhoeas.

-

-Let him invite himself abroad, and let his friends invite him by every

-innocent inducement. For me, I should advise above all other things the

-study of nature. Let him begin with plants: he will here find a

-continual pleasure, and continual change; fertile of a thousand useful

-things; even of the utility we are seeking here. This will induce him to

-walk; and every hedge and hillock, every foot-path side, and thicket,

-will afford him some new object. He will be tempted to be continually

-in the air, and continually to change the nature and quality of the air,

-by visiting in succession the high lands and the low, the lawn, the

-heath, the forest. He will never want inducement to be abroad; and the

-unceasing variety of the subjects of his observation, will prevent his

-walking hastily: he will pursue his studies in the air; and that

-contemplative turn of mind, which in his closet threatened his

-destruction, will thus become the great means of his recovery.

-

-If the mind tire upon this, from the repeated use, another of nature's

-kingdoms opens itself at once upon him; the plant he is weary of

-observing, feeds some insect he may examine; nor is there a stone that

-lies before his foot, but may afford instruction and amusement.

-

-Even what the vulgar call the most abject things will shew a wonderful

-utility; and lead the mind, in pious contemplation higher than the

-stars. The poorest moss that is trampled under foot, has its important

-uses: is it at the bottom of a wood we find it? why there it shelters

-the fallen seeds; hides them from birds, and covers them from frost;

-and thus becomes the foster father of another forest! creeps it along

-the surface of a rock? even there its good is infinite! its small roots

-run into the stone, and the rains make their way after them; the moss

-having lived its time dies; it rots and with the mouldered fragments of

-the stone forms earth; wherein, after a few successions, useful plants

-may grow, and feed more useful cattle![19]

-

-Is there a weed more humble in its aspect, more trampled on, or more

-despised than knot grass! no art can get the better of its growth, no

-labour can destroy it; 'twere pity if they could, for the thing lives

-where nothing would of use to us; and its large and most wonderfully

-abundant seeds, feed in hard winters, half the birds of Heaven.

-

-What the weak moss performs upon the rock the loathed toadstool brings

-about in timber: is an oak dead where man's eye will not find it? this

-fungus roots itself upon the bark, and rots the wood beneath it; hither

-the beetle creeps for shelter, and for sustenance; him the woodpecker

-follows as his prey; and while he tears the tree in search of him, he

-scatters it about the ground; which it manures.

-

-Nor is it the beetle alone that thus insinuates itself into the

-substance of the vegetable tribe: the tender aphide[20], whom a touch

-destroys, burrows between the two skins of a leaf, for shelter from his

-winged enemies; tracing, with more than Dedalaean art, his various

-meanders; and veining the green surface with these white lines more

-beautifully than the best Aegyptian marble.

-

-'Twere endless to proceed; nor is it needful: one object will not fail

-to lead on to another, and every where the goodness of his God will

-shine before him even in what are thought the vilest things; his

-greatness in the lead of them.

-

-Let him pursue these thoughts, and seek abroad the objects and the

-instigations to them: but let him in these and all other excursions

-avoid equally the dews of early morning, and of evening.

-

-The more than usual exercise of this prescription will dispose him to

-more than customary sleep, let him indulge it freely; so far from

-hurting, it will help his cure.

-

-Let him avoid all excesses: drink need scarce be named, for we are

-writing to men of better and of nobler minds, than can be tempted to

-that humiliating vice. Those who in this disorder have too great an

-appetite, must not indulge it; much eaten was never well digested: but

-of all excesses the most fatal in this case is that of venery. It is the

-excess we speak of.

-

-

-

-

-SECT. VII.

-

-The proper DIET.

-

-

-In the first place acids must be avoided carefully; and all things that

-are in a state of fermentation, for they will breed acidity. Provisions

-hardened by salting never should be tasted; much less those cured by

-smoaking, and by salting. Bacon is indigestible in an Hypochondriac

-stomach; and hams, impregnated as is now the custom, with acid fumes

-from the wood fires over which they are hung, have that additional

-mischief.

-

-Milk ought to be a great article in the diet: and even in this there

-should be choice. The milk of grass-fed cows has its true quality: no

-other. There are a multitude of ways in which this may be made a part

-both of our foods and drinks, and they should all be used.

-

-The great and general caution is that the diet be at all times of a kind

-loosening and gently stimulating; light but not acrid. Veal, lamb,

-fowls, lobsters, crabs, craw-fish, fresh water fish and mutton broth,

-with plenty of boiled vegetables, are always right; and give enough

-variety.

-

-Raw vegetables are all bad: sour wines, old cheese, and bottled beer are

-things never to be once tasted. Indeed much wine is wrong, be it of what

-kind soever. It is the first of cordials; and as such I would have it

-taken in this disease when it is wanted: plainly as a medicine, rather

-than a part of diet. Malt liquor carefully chosen is certainly the best

-drink. This must be neither new, nor tending to sourness; perfectly

-clear, and of a moderate strength: it is the native liquor of our

-country, and the most healthful.

-

-Too much tea weakens; and even sugar is in this disorder hurtful: but

-honey may supply its place in most things; and this is not only harmless

-but medicinal; a very powerful dissolvent of impacted humours, and a

-great deobstruent.

-

-What wine is drank should be of some of the sweet kinds. Old Hock has

-been found on enquiry to yield more than ten times the acid of the sweet

-wines; and in red Port, at least in what we are content to call so,

-there is an astringent quality, that is most mischievous in these cases:

-it is said there is often alum in it: how pregnant with mischief that

-must be to persons whose bowels require to be kept open, is most

-evident. Summer fruits perfectly ripe are not only harmless but

-medicinal; but if eaten unripe they will be very prejudicial. A light

-supper, which will leave an appetite for a milk breakfast, is always

-right; this will not let the stomach be ravenous for dinner, as it is

-apt to be in those who make that their only meal.

-

-One caution more must be given, and it may seem a strange one: it is

-that the patient attend regularly to his hours of eating. We have to do

-with men for the most part whose soul is the great object of their

-regard; but let them not forget they have a body.

-

-The late Dr. STUKELY has told me, that one day by appointment visiting

-Sir ISAAC NEWTON, the servant told him, he was in his study. No one was

-permitted to disturb him there; but as it was near dinner time, the

-visitor sat down to wait for him. After a time dinner was brought in; a

-boil'd chicken under a cover. An hour pass'd, and Sir ISAAC did not

-appear. The doctor eat the fowl, and covering up the empty dish, bad

-them dress their master another. Before that was ready, the great man

-came down; he apologiz'd for his delay, and added, "give me but leave to

-take my short dinner, and I shall be at your service; I am fatigued and

-faint." Saying this, he lifted up the cover; and without any emotion,

-turned about to STUKELY with a smile; "See says he, what we studious

-people are, I forgot I had din'd."

-

-

-

-

-SECT. VIII.

-

-The MEDICINE.

-

-

-'Tis the ill fate of this disease, more than of all others to be

-misunderstood at first, and thence neglected; till the physician shakes

-his head at a few first questions. None steals so fatally upon the

-sufferer: its advances are by very slow degrees; but every day it grows

-more difficult of cure.

-

-That this obstruction in the spleen is the true malady, the cases

-related by the antients, present observation, and the unerring

-testimonies of dissections leave no room to doubt. Being understood, the

-path is open where to seek a remedy: and our best guides in this, as in

-the former instance, will be those venerable Greeks; who saw a thousand

-of these cases, where we see one; and with less than half our theory,

-cured twice as many patients.

-

-One established doctrine holds place in all these writers; that whatever

-by a hasty fermentation dissolves the impacted matter of the

-obstruction, and sends it in that state into the blood, does incredible

-mischief: but that whatever medicine softens it by slow degrees, and, as

-it melts, delivers it to the bowels without disturbance; will cure with

-equal certainty and safety.

-

-For this good purpose, they knew and tried a multitude of herbs; but in

-the end they fixed on one: and on their repeated trials of this, they

-banished all the rest. This stood alone for the cure of the disease; and

-from its virtue received the name of SPLEEN-WORT[21]. O wise and happy

-Greeks! authors of knowledge and perpetuators of it! With them the very

-name they gave a plant declared its virtues: with us, a writer calls a

-plant from some friend; that the good gardener who receives the honour,

-may call another by his name who gave it. We now add the term _smooth_

-to this herb, to distinguish it from another, called by the same general

-term, though not much resembling it.

-

-The virtues of this smooth Spleen-wort have flood the test of ages; and

-the plant every where retained its name and credit: and one of our good

-herbalists, who had seen a wonderful case of a swoln spleen, so big, and

-hard as to be felt with terror, brought back to a state of nature by it;

-and all the miserable symptoms vanish; thought Spleen-wort not enough

-expressive of its excellence; but stamp'd on it the name of MILT-WASTE.

-

-In the Greek Islands now, the use of it is known to every one; and even

-the lazy monks who take it, are no longer splenetic. In the west of

-England, the rocks are stripped of it with diligence; and every old woman

-tells you how charming that leaf is for bookish men: in Russia they use

-a plant of this kind in their malt liquor: it came into fashion there

-for the cure of this disease; which from its constant use is scarce

-known any longer; and they suppose 'tis added to their liquor for a

-flavour.

-

-The ancients held it in a kind of veneration; and used what has been

-called a superstition in the gathering it. It was to be taken up with a

-sharp knife, without violence, and laid upon the clean linen: no time

-but the still darkness of the night was proper, and even the moon was

-not to shine upon it[22]. I know they have been ridiculed for this; for

-nothing is so vain as learned ignorance: but let me be permitted once to

-vindicate them.

-

-The plant has leaves that can close in their sides; and their under part

-is covered thick with a yellow powder, consisting of the seeds, and seed

-vessels: in these they knew the virtue most resided: this was the golden

-dust[23] they held so valuable; and this they knew they could not be too

-cautious to preserve. They were not ignorant of the sleep of plants; a

-matter lately spoken of by some, as if a new discovery; and being

-sensible that light, a dry air, an expanded leaf, and a tempestuous

-season, were the means of losing this fine dust; and knowing also that

-darkness alone brought on that closing of the leaf which thence has

-been called sleep; and which helped to defend and to secure it, they

-therefore took such time, and used such means as could best preserve the

-plant entire; and even save what might be scattered from it.--And now

-where is their superstition?

-

-From this plant thus collected they prepared a medicine, which in a

-course of forty days scarce ever failed to make a perfect cure.

-

-We have the plant wild with us; and till the fashion of rough chemical

-preparations took off our attention from these gentler remedies, it was

-in frequent use and great repute. I trust it will be so again: and many

-thank me for restoring it to notice.

-

-Spleen-wort gives out its virtues freely in a tincture; and a small dose

-of this, mixing readily with the blood and juices, gradually dissolves

-the obstruction; and by a little at a time delivers its contents to be

-thrown off without pain, from the bowels. Let this be done while the

-viscera are yet sound and the cure is perfect. More than the forty days

-of the Greek method is scarce ever required; much oftener two thirds of

-that time suffice; and every day, from the first dose of it, the patient

-feels the happy change that is growing in his constitution. His food no

-more turns putrid on his stomach, but yields its healthful nourishment.

-The swelling after meals therefore vanishes; and with that goes the

-lowness, and anxiety, the difficult breath, and the distracting cholick:

-he can bear the approach of rainy weather without pain; he finds himself

-more apt for motion, and ready to take that exercise which is to be

-assistant in his cure; life seems no longer burthensome. His bowels get

-into the natural condition of health, and perform their office once at

-least a day; better if a little more: the dull and dead colour of his

-skin goes off, his lips grow red again, and every sign of health

-returns.

-

-Let him who takes the medicine, say whether any thing here be

-exaggerated. Let him, if he pleases to give himself the trouble, talk

-over with me, or write to me, this gradual decrease of his complaints,

-as he proceeds in his cure. My uncertain state of health does not

-permit me to practise physic in the usual way, but I am very desirous to

-do what good I can, and shall never refuse my advice, such as it may be,

-to any person rich or poor, in whatever manner he may apply for it. I

-shall refer him to no apothecary, whose bills require he should be

-drenched with potions; but tell him, in this as in all other cases,

-where to find some simple herb; which he may if he please prepare

-himself; or if he had rather spare that trouble, may have it so prepared

-from me.

-

-With regard to Spleen-wort, no method of using it is more effectual than

-simply taking it in powder; the only advantage of a tincture, is that a

-proper dose may be given, and yet the stomach not be loaded with so

-large a quantity: it is an easier and pleasanter method, and nothing

-more.

-

-If any person choose to take it in the other way, I should still wish

-him once at least to apply to me; that he may be assured what he is

-about to take is the right plant. Abuses in medicines are at this time

-very great, and in no instance worse than what relates to herbs. The

-best of our physicians have complained upon this head with warmth, but

-without redress: they know the virtues and the value of many of our

-native plants, but dread to prescribe them; lest some wrong thing should

-be administered in their place; perhaps inefficacious, perhaps

-mischievous, nay it may be fatal. The few simple things I direct are

-always before me; and it will at all times be a pleasure to me, in this

-and any other instance, to see whether what any person is about to take

-be right. I have great obligations to the public, and this is the best

-return that I know how to make.

-

-To see the need of such a caution, hear a transaction but of yesterday!

-An intelligent person was directed to go to the medicinal herb shops in

-the several markets, and buy some of this Spleen-wort; the name was

-written, and shewn to every one; every shop received his money, and

-almost every one sold a different plant, under the name of this: but

-what is very striking, not one of them the right. Such is the chance of

-health in those hands through which the best means of it usually pass;

-even in the most regular course of application.

-

-I would not be understood to limit the little services I may this way be

-able to render the afflicted, to this single instance; much less to

-propose to myself any advantages from it. Whoever pleases will be

-welcome to me, upon any such occasion; and whatever be the herb on which

-he places a dependance, he shall be shewn it growing. I once recommended

-a garden to be established for this use, at the public expence: one

-great person has put it in my power to answer all its purposes.

-

-

-                        F  I  N  I  S.

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-WILLIAM ANDREWS CLARK MEMORIAL LIBRARY

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-1948-1949

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-16. Henry Nevil Payne, _The Fatal Jealousie_ (1673).

-

-18. Anonymous, "Of Genius," in _The Occasional Paper_, Vol. III, No. 10

-(1719), and Aaron Hill, Preface to _The Creation_ (1720).

-

-

-1949-1950

-

-19. Susanna Centlivre, _The Busie Body_ (1709).

-

-20. Lewis Theobald, _Preface to the Works of Shakespeare_ (1734).

-

-22. Samuel Johnson, _The Vanity of Human Wishes_ (1749), and two

-_Rambler_ papers (1750).

-

-23. John Dryden, _His Majesties Declaration Defended_ (1681).

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-1951-1952

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-31. Thomas Gray, _An Elegy Wrote in a Country Churchyard_ (1751), and

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-1952-1953

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-41. Bernard Mandeville, _A Letter to Dion_ (1732).

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-1963-1964

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-104. Thomas D'Urfey, _Wonders in the Sun; or, The Kingdom of the Birds_

-(1706).

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-1964-1965

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-110. John Tutchin, _Selected Poems_ (1685-1700).

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-111. Anonymous, _Political Justice_ (1736).

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-112. Robert Dodsley, _An Essay on Fable_ (1764).

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-113. T. R., _An Essay Concerning Critical and Curious Learning_ (1698).

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-114. _Two Poems Against Pope_: Leonard Welsted, _One Epistle to Mr. A.

-Pope_ (1730), and Anonymous, _The Blatant Beast_ (1742).

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-1965-1966

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-115. Daniel Defoe and others, _Accounts of the Apparition of Mrs. Veal_.

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-(1717).

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-120. Bernard Mandeville, _Aesop Dress'd or a Collection of Fables_

-(1704).

-

-

-1966-1967

-

-123. Edmond Malone, _Cursory Observations on the Poems Attributed to Mr.

-Thomas Rowley_ (1782).

-

-124. Anonymous, _The Female Wits_ (1704).

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-125. Anonymous, _The Scribleriad_ (1742). Lord Hervey, _The Difference

-Between Verbal and Practical Virtue_ (1742).

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-126. _Le Lutrin: an Heroick Poem, Written Originally in French by

-Monsieur Boileau: Made English by N. O._ (1682).

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-1967-1968

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-127-

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-128. Charles Macklin, _A Will and No Will, or a Bone for the Lawyers_

-(1746). _The New Play Criticiz'd, or The Plague of Envy_ (1747).

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-129. Lawrence Echard, Prefaces to _Terence's Comedies_ (1694) and

-_Plautus's Comedies_ (1694).

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-130. Henry More, _Democritus Platonissans_ (1646).

-

-131. John Evelyn, _The History of Sabatai Sevi, The Suppos'd Messiah of

-the Jews_ (1669).

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-132. Walter Harte, _An Essay on Satire, Particularly on the Dunciad_

-(1730).

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-Publications of the first fifteen years of the Society (numbers 1-90)

-are available in paperbound units of six issues at $16.00 per unit, from

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-Publications of the first fifteen years of the Society (numbers 1-90)

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-REGULAR PUBLICATIONS FOR 1968-1969

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-133. John Courtenay, _A Poetical Review of the Literary and Moral

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-134. John Downes, _Roscius Anglicanus_ (1708). Introduction by John

-Loftis.

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-135. Sir John Hill, _Hypochondriasis, a Practical Treatise on the Nature

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-by G. S. Rousseau.

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-Lectures on Elocution and the English Language_ (1759). Introduction by

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-137. Arthur Murphy, _The Englishman From Paris_ (1756). Introduction by

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-SPECIAL PUBLICATION FOR 1968-1969

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-Already published in this series are:

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-an Introduction by Earl Miner.

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-2. John Gay, _Fables_ (1727, 1738), with an Introduction by Vinton A.

-Dearing.

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-3. Elkanah Settle, _The Empress of Morocco_ (1673) with five plates;

-_Notes and Observations on the Empress of Morocco_ (1674) by John

-Dryden, John Crowne and Thomas Shadwell; _Notes and Observations on the

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-Footnotes:

-

-[18] Milton's Penseroso.

-

-[19] Biberg.

-

-[20] Reaumur.

-

-[21] asplenon

-

-[22] Silente Luna.

-

-[23] Pulvis Aureus.

-

-

-

-

-      *      *      *      *      *

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-Transcriber's Notes:

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-  Long "s" has been modernized.

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