Of INDOLENCE.

IT seems to have been the design of Providence, that all men should labour, every one for himself: that some are rich enough to purchase the labour of o­thers is a mere accident with regard to individuals, in which the care of Providence appears to be no other­wise concerned, than having unequally distributed those powers and abilities by which active and fiery spirits rise uppermost to preserve the harmony of sub­ordination, without which society could never exist. The rich and great have so far forgot this first principle of nature, that they renounce all bodily labour as un­worthy their condition, and thus sacrificing health to indulgence and dignity, they do not enjoy those advan­tages their superior stations and fortunes give them; but in happiness fall often below the labouring hind. I remember to have seen a very ingenious little book upon the origin of evil, in which labor is considered as a great evil. The agreeable author must surely mean when it is excessive, and urged on to the wearing and wasting the body. In general labour is the first princi­ple of good to mankind; I mean the laborious them­selves. Does he mean that it would be better for us all, did the earth spontaneously bring forth her fruits [Page 11] in such abundance that we should no more labor or contend for them than we do for the air, and have no­thing to do but bask in ease, and riot in enjoyment? If so, I can by no means agree with him; for soon, ve­ry soon, in such a state of things, there would not be one healthy man upon the earth, and the whole race must quickly perish. Indeed, I am afraid, notwithstanding all our unreasonable and unphilosophical complainings, the utmost wit of man can not remove the least evil out of nature, without taking with it all the good. But begging pardon for this little digression, and to come back to my own purpose, I think he had been nearer the truth, had he put Indolence in its stead, which is a source of great evil. Nothing undermines the foundation of all our happiness, the health and vi­gor of the body, like it, or lays such a train or diseases to come. But I must endeavour to shew in what man­ner.

It is upon the minutest and almost invisible parts of the body, our best health, strength, and spirits depend: these fine parts, commonly called capillaries, are little pipes or tubes, the extended continuations of the lar­ger blood-vessels, through which the finest parts of the blood must constantly pass, not only to keep these very small channels always free and open, but also that the particle of the blood may in their passage be attenuated, broken, and rubbed into globules perfectly smooth and round, and easily divisible into still less and less, till they escape the sight assisted even by the microscope; which gives ocular demonstration of this most amazing­ly minute circulation. I have observed myself, and a­ny curious patient man may see with a good microscope, in the pellucid membrane of any living animal, this surprizing minuteness. He may select and observe one single vessel, the smallest of those that convey red blood, many of which would not equal the smallest hair in size, through which the blood may be seen passing, not like a fluid, but a number of little red solid balls push­ing [Page 12] one another on till they come to the extremity or ramification of the vessel where it divides into two still less. There the first globule stopping a little, and re­coiling, is push'd on again till it divides into two, and losing its red colour, passes on in the smaller pipes fit­ted only to receive the circulation of serum, lymph, and perhaps still finer fluids; which being thus pre­pared, escape into a minuteness beyond all possible observation. Now the strength of the heart and arte­ries, alone, in a sedentary course of life, is by no me as sufficient to keep up and perpetuate this motion thro' these capillaries, but requires the assistance and joint force of all the muscles of the body to act by intervals, compress the veins, propel and accelerate the circula­tion of the whole mass of blood, in order to force and clear these pipes, and to triturate, cribate, and purify the fluid passing through, forming every particle of it into a perfect globule, which is the form all the atoms of matter must take from much agitation. Without this extraordinary occasional aid, the little vessels would, by their natural elasticity, close up into fibres, or be obstructed by rough angular particles sticking in them, and stopping all passage. Numberless evils of the chronic kind, especially all nervous diseases, owe their origin to this cause alone. Accordingly we see most of those who have liv'd for any time in a state of indolence, grow emaciated and pale by the drying up of these fine vessels; or if they happen to be of a lax habit, having a good appetite, and nothing to vex them, they may be loaded with fat; but they grow pale withal, many of those fine pipes being nevertheless closed up; so that they appear bloated, and their fat unwholesome, having much less blood in their veins than thinner people. Hence we may learn why th [...]se languid pale persons upon the least motion become faint and breathless, the blood hurrying through the larger vessels yet free, and like a croud obstructing its own passage causing a dan­gerous suffocation. Or if they have not been long in [Page 13] this state, nor the capillaries yet quite closed, they glow, especially young women, with a momentary red, the fine vessels being for that time expanded. Thus inac­tiv [...]y first forms obstructions in these exquisitely fine [...], upon which the health and vigor both of body are mind depend entirely, and lays the foundation of many diseases to come; which other concomitant cir­cumstances, such as a violent cold, excess, of any kind, infection from without, or a particular disposi­tion of the body within, make often fatal to many in this habit of life; and which the industrious and ac­tive never feel.

Now I would ask any reasonable person, capable of considering this operation of nature with the least glim­mering of philosophy, or even the attention of com­mon sense, and most assuredly it concerns every man to consider it well, whether he can conceive it possible to substitute any medicine to be swallowed, that shall act upon the blood and vessels, like the joint force of all the muscles of the body, acting and reacting occasionally [...] a regular course of moderate daily labor or exercise. Unless this can be done, I will venture to pronounce that there is no such thing as a lasting cure either for the gout or any other chronic disease. Yes, Sir, says a common practitioner, cordials, volatiles, bracers, strengtheners, will do this, will keep up an increased circulation. Possibly they may for a few hours, by doing mischief for many days: but their action soon subsides, and the stimulus ceases; they must therefore be repeated and repeated for life. Woe be to him that takes them, and to him that leaves them off, unless it be done with great judgment. While they act, they coagulate the juices and corrupt the whole mass of blood; and when omitted, the patient must feel all the languors and horrors of a crapulary fever after re­peated debauch; and must have recourse to them again and again, like a dram-drinker, who cannot bear his existence but in a state of intoxication. No, art can [Page 14] ever come up to nature in this most salutary of all her operations.

But these obstructions from crude particles of the blood, and this inanition of the capillaries, are not all the evils produced by indolence. That sprightly vi­gor and alacrity of health which we feel and enjoy in an active course of life, that zest in appetite, and refresh­ment after eating, which sated luxury seeks in vain from art, is owing wholly to new blood made every day from fresh food prepared and distributed by the joint action of all the parts of the body. No man can have these delightful sensations who lives two days with the [...]me blood, but must be languid and spiritless. To introduce new juices the old must be first thrown off, or there will be no room, there will be too great a plethora or fulness; the first cause of diseases in many cases. In a state of inactivity the old humors pass off so slowly, the insensible perspiration is so inconsiderable, that there is no void to be filled, consequently by de­grees the appetite, which is the last thing that decays, that is, the desire of supply, must daily diminish, and at last be totally lost. Here art can do wonders; it can procure evacuations; we can bleed, purge and vo­mit; but then, to do any good by these, the case must be recent, before the humors are vitiated by too long a stay in the body, which will be the case very soon, for they are all in a perishable state, which makes their daily renewal so essentially necessary to health: but then these artificial evacuations discharge all alike; the new, the middle, and the old juices; that is, the chyle, the blood, the serum, and lymph; and by this indiscrimi­nate action make strange confusion in those that remain: whereas in nature's course there is a constant regular transmutation and succession, from one state to another; that is, from chyle into blood, and blood into serum, and so on, till they are all in their turn, like wave im­pelling wave, having done their office in various shapes, elaborated and ground to such a minute subtlety and [Page 15] fineness, that they pass off in the vapour of insensible perspiration. In a state of indolence they do not pass off either so soon or so regularly as they ought, because there is not motion, nor consequently heat enough to throw off the vapor: they lodge in the body too long, grow putrid, acrimonious, and hurtful many ways, like the matter formed in an ulcer, which while it is yet sweet, there is no balsam the surgeon can apply so healing, but when confined, soon becomes corrosive, and like a caustic eats its way all round in fistulas to find vent. This shews the virulent acrimony of these confined and stagnating humors: hence the breath and perspiration, what there is of it occasionally, of indo­lent people is never sweet; and hence in jails, where these noxious vapors are collected and condensed from crouded wretches languishing in indolence, very ma­lignant and pestilential fevers arise.

Perpetual blisters have been often thought, and some­times found, to be serviceable in draining off some of these superfluous juices before they are much corrupt­ed, and making, by a faint resemblance of nature's ac­tion, a little more room for new; and it is for this rea­son they do any good at all, by increasing the general circulation, and forcing off a few of those humors that had circulated too long in the body, and were becoming acrid: for the quantity they discharge is so trifling, that there could be no physiology, nor even common sense, in supposing the evacuation to be the benefit pro­cured. By a vomit or purge the discharge is a hund­red fold more, but the good obtained not always so great, because by these the humors are indiscriminate­ly thrown off, and much more of the new than the old. Many have used frequent bleeding to renew their blood, and I have known it answer very well to some, especi­ally old people who had been long accustomed to it, whom it preserved to great age; but then it must be begun in time, before the whole mass of humors be vi­tiated, and continued for life. Is it not strange that [Page 16] men should seek and prefer these violent artificial me­thods to the simple, easy, pleasant and constant action of nature, and chuse rather to take a vomit or a purge than walk, and wear a perpetual blister than make the least use of their limbs?

Thus indolence must inevitably lay the foundation of general disease, and according to the constitution and a few concomitant circumstances will be the kind of the disease: in the very best it may be gout or rheumatism; in weaker habits colic, jaundice, palsy, &c. with all of the hysterical and hypochondriacal class. In vain have ingenious men of reading and study, mental labor and sedentary life, who are more subject to disease in general than the gay and thoughtless, endeavour'd to obviate the evil by abstinence, an excellent means of remedy in many cases, and which few practise but true philosophers, who are not the most likely to want it. But yet even they do not find it answer, and for the reasons which I have just given that we cannot live two days in health and spirits with the same blood; there must be a new daily supply of that ethereal part of our food called up to the brain to support its own, as well as the labor of the whole body. By this I mean the most elaborated refined part of all our juices which constantly repairs and nourishes the smallest vessels and fibres. Whenever this aether fails we must necessarily feel languor and lassitude both of body and mind. With this difference, that in weariness of the limbs from much action the lees and coarser parts are thrown off also, and the first meal and first sleep soon supplies the defect. In mental labor the feculence remains to obstruct all appetite; there is no room, and therefore no call for supply; the whole man suffers and sinks.

Of INTEMPERANCE.

I COME now to speak of Intemperance, for Indo­lence, blunting all our sensations, naturally leads us to Intemperance: we want the whip and spur of luxury to excite our jaded appetites. There is no en­during the perpetual moping languor of indolences: we fly to the stimulating sensualities of the table and the bottle, friend provokes friend to exceed and accu­mulate one evil upon another; a joyous momentary relief is obtained, to be paid for severely soon after: the next morning our horrors increase, and in this course there is no remedy but repetition. Thus who­ever is indolent is intemperate also, and partly from ne­cessity; and the evils necessarily following both these causes often make the rich and great more wretched than the poor, and the ballance of happiness is held more equally between them; for however other things may be distributed, happiness like water always finds its level among men. I wish this observation might cure these of their envy, and teach the others how to enjoy their wealth.

Before I return to my subject, I fear I must make an apology for what I am going to say, and hope no one will be offended when I venture to say that nine in ten of all the chronic diseases in the world, particularly the gout, owe their first rise to intemperance. Many la good man, who piques himself upon being the most so­ber regular creature alive, and never eats but of one or two plain dishes, as he calls them, nor exceeds his pint of wine at any meal; keeps good hours, and never sleeps above eight or nine, may be surprized, if not af­fronted, to have his diseases imputed to intemperance; which he considers as a great crime. And yet he is of­ten ill, sick in his stomach, troubled with indigestion, and crippled by the gout. The case is▪ we judge of [Page 18] temperance and intemperance from our own habits, without any just idea of either. What we are used to do, and see others do, we think right, and never go up to nature for our knowledge. The best way to ex­plain what I mean by intemperance, may be to enquire what is nature's law of temperance, and to deviate from that must be considered as intemperance. And here I must beg leave to observe, that temperance is a thing of which no Englishman has or can have the least idea, if he judges from his own or his neighbors habits. To form som [...] notion of it he must have seen other coun­tries, particularly Spain, Portugal or Italy, and ob­served how men live there. What they call temperance or even tolerable living, with us would be thought downright starving. In this view temperance is local and comparative; but what I mean is natural temper­ance not depending upon place or custom (for I do not mean fasting or abstinence, which can never be saluta­ry but after repletion) and we must not judge of it from countries where a piece of bad bread and an onion with a draught of water is thought a tolerable meal; nor from our own, where beggars live better than the nobles of some countries, and where we riot in the choice of plenty native and exotic every day.

To come then to my idea of it, I think there is an absolute, determined temperance, to be measured by e­very man's natural unprovoked appetite, digestion and consumption, while he continues in a good state of health, and right habit of life. As long as a man eats and drinks no more than his stomach calls for and will bear without the least pain, distention, eructation or uneasiness of any kind; nor than his body consumes and throws off to the last grain; he may be said to live in a very prudent well-regulated state of temperance, that will probably preserve him in health and spirits to great old age.

This is nature's law: and the reverse of it, or in­deed any great deviation from it, must be intemperance. [Page 19] When we eat without appetite, or urge beyond mode­rate satiety, provoked by incentives of any kind: when we drink without thirst for the sake of the liquor; indeed I cannot allow him to be strictly temperate who drinks any wine or strong liquor at all, unless it be me­dicinally, or now and then for the sake of society and good humor, but by no means every day.

Now let us compare this simple idea of temperance with the common course of most men's lives, and ob­serve their progress from health to sickness. For I fear we shall find but very few who have any pretensions to real temperance. In early youth we are insensibly led into intemperance by the indulgence and mistaken fond­ness of parents and friends wishing to make us happy by anticipation. Having thus exhausted the first de­grees of luxury before we come to the dominion of our­selves, we should find no pleasure in our liberty did we not advance in new sensations, nor feel ourselves free but as we abuse it. Thus we go on till some friendly pain or disease bids, or rather forces us to stop. But in youth all the parts of our bodies are strong and flex­ible, and bear the first loads of excess with less hurt, and throw them off soon by their own natural vigor and action, or with very little assistance from artificial eva­cuation. As we grow older, either by nature in due time, or repeated excesses before our time, the body is less able to free itself and wants more aid from art. The man however goes on taking daily more than he wants or can possibly get rid of, he feels himself replete and oppress'd, and his appetite failing his spirits sink for want of fresh supply. He has recourse to dainties, sauces, pickles, provocatives of all sorts. These soon lose their power; and though he washes down each mouthful with a glass of wine, he can relish nothing. What is to be done? Send for a physician. Doctor, I have lost my stomach; pray give me, says he, with great innocence and ignorance, something to give me an appetite; as if want of appetite was a disease to be [Page 20] cured by art. In vain would the physician, moved by particular friendship to the man, or that integrity he owes to all men, give him the best advice in two words, quaere sudando, seek it by labor. He would be thought a man void of all knowledge and skill in his profession, if he did not immediately, or after a few evacuations, prescribe stomachics, bitter spicy infusions in wine or brandy, vitriolic elixirs, bark, steel, &c. By the use of these things the stomach, roused to a little extraordi­nary action, frees itself, by discharging its crude, au­stere, coagulated contents into the bowels, to be thence forwarded into the blood. The man is freed for a time, finds he can eat again, and thinks all well. But this is a short-liv'd delusion. If he is robust, the acrimony floating in the blood will be thrown out, and a fit of gout succeeds; if less so, rheumatism or colic, &c. as I have already said. But let us suppose it to be the gout, which if he bears patiently, and lives moderately, drinking no madeira or brandy to keep it out of his stomach, nature will relieve him in a certain time, and the gouty acrimony concocted and exhausted by the symptomatic fever that always attends, he will recover into health; if assisted by judicious, mild, and soft medicines, his pains might be greatly assuaged and mitigated, and he would recover sooner. But however he recovers, it is but for a short time; for he returns to his former habits, and quickly brings on the same round of complaints again and again, all aggravated by each return, and he less able to bear them; till he becomes a confirm'd invalid and cripple for life, which, with a great deal of useless medication and a few jour­nies to Bath, he drags on, till, in spite of all the doc­tors he has consulted, and the infallible quack medi­cines he has taken, lamenting that none have been lucky enough to hit his case, he sinks below opium and brandy, and dies long before his time. This is the course I have liv'd to see many take, and believe it to be the case of more whom I have never heard of, and [Page 21] which any one may observe in the circle of his acquain­tance: all this chain of evils is brought on and accu­mulated by indolence and intemperance, or mistaken choice of diet. How easily might they have been re­medied, had the real causes been known and attended to in time.

I believe I must here explain a little more fully what I mean by provoking the appetite; which I take to be the general mode of intemperance among men, for custom has made all kinds of incentives to excess so common, that those of daily use, far from being consi­dered in the class of intemperance, are by most people thought to be not only salutary but necessary; and they never suspect the least evil from the common de­coraments of the table, salt, pepper, mustard, vinegar; and yet, however extraordinary it may seem, I will venture to pronounce that excess in any of these must be doubly prejudicial to health; hurtful in themselves by their acrimony, they provoke the appetite beyond natural satiety to receive an oppressive load, which the stomach itself would soon feel, were it not artificially stimulat [...]d to discharge it into the blood by wine and strong liquors immediately after. Thus one error brings on another, and when men have eaten too much, they drink too much also by a kind of necessity. He will certainly be a healthier man who is very moderate in the use of these things, than he who exceeds: they may be sometimes useful as medicines, but can never add to the wholesomeness of our daily food. To give some weight to what I say, there are whole nations in the world that have never known any of them, and are healthy, strong and vigorous.

If this be true of the common provocatives at every poor man's board, who is there that exceeds not na­ture's law? who is truly temperate? What shall we say of that studied, labored, refined extravagance at the ta­bles of the rich, where the culinary arts are push'd to that excess, that luxury is become false to itself, and [Page 22] things are valued not as they are good and agreeable to the natural and undebauch'd appetite, but high, inflam­matory, rare, out of season, and costly; where, though variety is aimed at, every thing has the same taste, and nothing its own. I am sorry and ashamed that men professing luxury should understand it so little as to think it lies in the dish or the sauce or multitude of ei­ther; or that urging beyond natural satiety can afford any real enjoyment But this they do by all the re­searches of culinary and medical art, introducing all the foreign aids to luxury, every stimulative provoca­tive that can be found in acids, salts, fiery spices, and essences of all kinds, to rouse their nerves to a little feeling; not knowing the more they are chafed and ir­ritated the more callous they still grow; and the same things must now be more frequently repeated, increas­ed in quantity, and exalted in quality, till they know not where to stop, and every meal they make serves only to overload and oppress the stomach, to foul and inflame the blood, obstruct and choak all the capillary channels, bring on a hectic fever of irritation, that though it raise the spirits for the evening, leaves behind it all the horrid sensations of inanition and cra­pula the next morning; and but that nature is so kind as to stop them in their career with a painful fit of gout or some other illness, in which she gets a little respite, they would soon be at the end of their course.

Men bring all these evils upon themselves, either not knowing or not attending to two things; the one, that pleasure is a coy coquet, and to be enjoy'd must not always be pursued; we must sometimes sit still, that she may come and court us in her turn; the other, that pleasure and happiness are as distinct things as riot and enjoyment: besides, pleasure is not infinite, and our sensations are limited: we can bear but a certain mea­sure, anst all urging beyond it, infallibly brings pain in it's stead. Let the men of high experience bear me [Page 23] testimony that this is true of all the luxuries of the ta­ble, wine, music, women, and every sensuality.

These men may tell me, perhaps, that I have made a mighty fine declamation against luxury and intempe­rance; but what is this to the purpose? they desire not to be told of their faults, nor to hear disagreeable truths which they know already. Have I no art or skill to reconcile health and luxury, no remedy, no rare secret to repair and restore sensation and vigor worn to rags? no Medea's kettle to boil anew? If not, do not describe to us a life of moderation, tempe­rance and exercise: it is not worth having upon these terms. I am aware of the unreasonable expectations of many, that their demands would rise high, some of them to the impossible. At present I am only setting forth the causes; when I come to talk of remedy I will en­deavour to convince them that the artificial helps they expect are not in nature, but that there are in nature ways and means by which many gouty, broken consti­tutions, that have been despaired of, might be repaired and restored to a very desirable degree of health and enjoyment. But I must first say a word or two to the intemperate or mistaken in the middle class of life.

In England all degrees of men are furnish'd with the means of intemperance, and therefore it is no wonder that most men are intemperate. If they are less so in other countries, it is not that they have more virtue, but they want the means: their oppressive govern­ments, the precarious state of property, and their su­perstitious religion, keep them so poor that luxury is not in their power. They have however this advan­tage from it, that they are much less afflicted with chronic diseases than we are. I verily believe there are more gouts in England, than in all the rest of Europe: a proof that good living is more universal. But not to the advocates for this good living do I wish to address myself; I fear they will be as incorrigible as their supe­riors in higher and more refined luxury. But there are [Page 24] some not intemperate from choice, but example, habit, custom, mistake, not knowing their daily diet to be unwholesome and productive of their diseases. To these it may be of some use to have the unwholesome pointed out, and their choice directed to better things. Men of laborious occupations, who work in the open air, can and do bear great excesses and much unwholesome diet, without much hurt: I never knew a sick or gouty gardener that was not a remarkable sot. But men of sedentary trades and business, shopkeepers of all kinds, feel much sooner and more heavily the ill effects of in­temperance or mistaken choice in their meat and drink. Their first care therefore ought to be not to add the diseases [...]f intemperance to those of inactivity, but pro­portion [...]hat they take as well in quantity as in quality to their [...]onsumption. But let us see how well they do this. They all say they live upon plain things, and never indulge in made dishes; but they will eat hearti­ly of a goose or duck, with a large quantity of sage, o­nion, pepper and salt, a pig with similar preparation, and a hare with higher and more compounded seasoning. Do they ever eat veal without stuffing, or even a leg of mutton without caper-sauce? If ever they eat a steak or a chop, if it is sometimes without pepper, I believe it is never without pickles, the worst of all poi­sons. They are surprized that such meals should rise on their stomachs with flatulence, sour and bitter hic­cups and eructations, which if they did not keep them down with a sufficient quantity of wine or sometimes a dram, they would be troubled with all the time of di­gestion. If this method succeeds so far as to quiet their stomachs for the present, they go on with it, regardless or ignorant of future and distant consequences. Thus are these sharp, harsh, hot and inflammatory things forced out of the stomach into the blood, before it has had time to dilute and subdue, or reject them, and the superfluous load they bring along with them. And thus is laid the foundation of every disease, that appears [Page 25] when these acrid and fiery particles are accumulated in the blood to a certain degree.

There are others whose pretensions to plain diet may seem better founded, but who nevertheless eat and are very fond of things unwholsome, and very unfit for men of sedentary lives, such as salted and smoked flesh and fish of all kinds, hams, tongues, heavy flour pud­dings, toasted cheese, &c. all which are of such hard and indissoluble texture, that they never dissolve well in the stomach of a plowman: the same salt, seasoning, and smoke, which harden and preserve them from pu­trefaction before they are eaten, keep them from disso­lution afterwards, so that they never are digested at all; nor is it possible any good nourishment should ever come from them: the salts they contain are indeed melted in the intestinal juices, and get into the blood, producing, in the best constitutions, those tettery, itchy, or scaly eruptions, commonly but very erroneously called the scurvy, which is quite another kind of disease. To this kind of food is owing the bad health of country people, and their children's rickety heads and limbs, and big and hard bellies.

Another capital mistake many people fall into, who in other respects are very moderate in their diet, is, that the flesh-meat they eat is always over-done; if boiled too much, the juices are lost; if over-roasted, fried, or broiled, the action of the fire, continued too long, changes the mild animal flesh into something of another quality; the fat is made bitter and rancid, which fire will always do by the sweetest oil; and the scorched outside of the lean dry and acrimonious; the less there­fore all flesh meat undergoes the power of fire, the milder and wholsomer it is. I do not mean by this to recommend the customs of Cannioals or beasts of prey, that devour animals alive: but it may be observed, that the first are free from our diseases, and the other a­mazingly strong and vigorous. We may learn this from them at least, that our meat cannot be the wholsomer [Page 26] for being, as some call it, thoroughly done; and that we should learn to like it with some of its red juices un­spoiled by the fire. Upon this principle the English cookery is to be preferred to the French, who stew and roast to rags; and of English cookery broiling must be the best.

This leads me to another observation, which perhaps none but physicians, or those who have studied well the nature of man and his aliments, are able to make. It is this: that man being born to devour most of the fruits and animals of the earth and water, there ought to be a certain proportion of animal and vegetable sub­stances in his food; the animal tending spontaneously to putrefaction, [...]he vegetable correcting that tendency from going too far: thus from the due mixture of both qualities results that neutral property, equally distant from acid as alcali, that is essentially necessary to pro­duce good blood. This is so manifest, that whoever will observe attentively may see, whenever either of these prevails in the body, there is so strong a desire and longing for things of the other sort, as well as plea­sing sensation in the palate and stomach when they are taken, as plainly indicates the natural want. Let a man have lived long upon flesh-meat wholly, he will have a more eager appetite for fruit and vegetables; and if kept too long without them, as is the case with those who have lived some time at sea, will grow sick of the real scurvy; but if before they are too far gone they reach the land, they will eat the first common grass they can come at with more avidity than a horse or ox, and be perfectly cured by it. In like manner they who have lived long upon vegetables (which regimen is of­ten prescribed to invalids, especially in the gout) will have great craving for flesh meat. We ought to learn from all this to attend diligently to the calls of nature, and ballance the mixture with due proportion, not only that our vitals may have the less labor in preparing and making our juices fit for nourishment, but to prevent [Page 27] the diseases that are peculiar to the predominancy of ei­ther. And here I may observe, that the error of most men's diet in every class of life is, that the acid, crude and austere almost always abound; not that they do not eat flesh meat enough, but they spoil it in the preparation and cookery, changing its animal nature into some­thing worse than vegetable, taking off entirely all its tendency to dissolution and putrefaction by salting, smoking, pickling, potting, and preserving things that in their own simple nature would soon corrupt and dis­solve; but by these preparations are hardened and em­balmed to keep for years like mummies. The same may be said of every kind of made dishes; the salts, spices, hot herbs, and acids with which they are sea­soned and compounded, preserve and harden them to keep for ever: the sauces and gravies they swim in have the same effect as so much pickle. The things we feed upon ought all to be in a perishable state, or they will never furnish the materials of good blood; and whatever is hardened or seasoned so as to keep long be­fore it be eaten, ought not to be eaten at all, for it will never dissolve in the stomach.

The nature of most chronic diseases, and their first symptom heartburn, as it is commonly called, plainly shew the original cause to be acid crudity prevailing in the juices; producing coagulations, concretions and obstructions of various kinds; all which are very mani­fest in the gout, rheumatism, stone, and most nervous cases: the remedies also that sometimes relieve and pal­liate, confirm this; such as the volatile al [...]alies, harts­horn, salt ammoniac, testaceous powder [...], sope, &c. Many may be surprized at this, and say it cannot be; for, though they have these diseases, they take little or no acids: but there are many things they take that are acescent, that is, liable to become a [...]id, especially by the heat of the stomach. This they are not aware of; but they are in their nature much more prejudicial than things already sour; for, besides that people take [Page 28] not these in any quantity, the acescent never become four but by the act of fermentation, which, being raised in the stomach where it ought never to happen, pro­duces strange tumults, wind, vapor, gas, that is that fume arising from fermenting liquors of any kind, which has been known sometimes to kill at a stroke. It may here be necessary to enumerate some of those things called acescent. These are sweets of every kind, puddings, cakes, pastry, creams, confections, &c. and every thing made of flour, especially fermented; bread in particular, so far from being the wholsome thing ma­ny imagine, is not only unwholsome by its acescency, but, by the strong ferment it contains, it forces into fermentation every thing capable of it, that it meets with in the stomach ^*: the bread of London I fear is particularly so; partly by being robbed of its bran, which in some degree would soften and correct it, but chiefly by having in it, besides its usual ferment, a great quantity of sour alum, most absurdly added to make it unnaturally white. ^¶. In this light we must al­so consider most sorts of seasonings, stuffings, force­meats, and compounded sauces. But the greatest ac­cescent, or rather bane of all, high and low, rich or o­therwise, whoever they are that take it constantly, is wine: wine alone produces more diseases than all the other causes put together. All men allow that wine taken to excess is hurtful: they see the immediate e­vils that follow; but distant effects, that require more attentive and deducive observation, very few see or be­lieve; and, judging from present and agreeable feel­ings, they say that a little wine is wholesome, and good [Page 29] for every one, and accordingly take it every day, give it their children, and teach them to like it by debauch­ing their natural taste in the earliest infancy: thus they come to relish it by habit, and to be uneasy without it like snuff takers without their tobacco: the want is e­qually habitual and unnatural in both cases; for the stomach wants wine no more than the nose does snuff: the immediate sensation of both, after a little use, is plea­sant; but the remote effect of the wine taken constant­ly infinitely more pernicious than of the snuff. This hurts the nose only; the other accumulating a little in­digestion every day, corrupts all the juices of the body most essentially. And though it be often taken with a view to promote digestion and assist the operations of the stomach, it manifestly does harm to both. Instead of digesting and dissolving, it hardens, and prevents dis­solution, and curdles and corrupts the milky chyle and first juices produced from our food. It warms indeed and stimulates the stomach to greater exertion than is natural or necessary, and thereby enables it to discharge its contents the sooner; whence that agreeable feel of warmth and comfort from its immediate action. But by his extraordinary action it forces our food out of the stomach too soon, before it is softened, dissolved, and properly prepared, and sends it into the bowels crude, hard, and austere, in that case to be carried into the blood, there to produce every kind of disease. What­ever therefore the advocates for a little wine every day may think, or argue in favour of it, they are most un­doubtedly in a very great error, and it were certainly much better and safer to drink a bottle and get a little merry once a week, drinking water only or small beer at all other times: in which interval nature might to­tally subdue it and recover intirely. Water is the only liquor nature knows of or has provided for all animals; and whatever nature gives us, we may depend upon it, is best and safest for us. Accordingly we see that when we have committed any excesses or mistakes of [Page 30] any kind, and suffer from them, it is water that re­lives. Hence the chief good of Bath, Spa, and many other medicinal waters, especially to hard drinkers. It is the element that dilutes and carries off crudities and in­digestions, &c. the mineral virtues they contain may make them tolerable to the stomach in their passage, but do, as I believe, little more in the body: it is the wa­ter that cures. Wine, i [...] [...]t be not one of our own inven­tions, was given us as a cordial in sickness, weariness, sorrow, and old age, and a most salutary charm it would be for most of these evils, did we not exhaust its power by daily use, and instead of taking it as such, drink it up as common draught in youth and health to make us mad. I know this is a very tender topic to touch up­on, and too favourite a pleasure to argue against with any reasonable hope of convincing; most men having so indulged themselves in this bewitching habit, that they think they cannot live without a little wine every day, and their very existence depends upon it; their stomachs require it, nature calls for it, St. Paul ad­vises it, it must be good. Thus men catch at every shadow of an argument that favours their inclinations. St. Paul advises it as a medicine sometimes, but cer­tainly not every day. There is no medicine I know of, that, taken every day, will not either cease to act en­tirely, or by acting too much do harm. It will be said, that many drink wine every day without gout, stone, or any disease at all in consequence of it. I believe not many, or I should know some of them. If any are so strong as to bear it to old age unhurt, they must be ve­ry active as well as strong to subdue it. But I have nothing to say to these; my business is with invalids who complain, and certainly ought not to measure con­stitutions with those above their match. The same ar­guments will hold equally in favour of every other bad habit. Your nose will want its snuff, your palate its spices; and when the fashion was for women to be small [Page 31] wasted, their galled sides grown callous by the long im­pression of the stays wanted their support. Nature, like a true female, cries out at the first violence, but sub­mits in time, is reconciled, and grows fond of the ravish­er. But it is the business of philosophers to distinguish carefully between the real wants of nature and the ar­tificial calls of habit; and when we find these begin to hurt us, we ought to make the utmost persevering ef­forts to break the enchantment of bad customs; and though it cost us some uneasy sensations at first, we must bear them patiently; they will not kill; and a very little time will reconcile us to better modes of life.

There is another capital mistake many labor under in the choice of their wine, peferring the strong, hot and coarse sorts, Madeira, Port, Mountain, &c. to the milder, more elegant, and certainly less unwhol­some French and Italian wines, occounting them bet­ter for the stomach, and good against wind, &c. My observation has been, that they who use these strong stomach wines to cure wind are never free from it, and all the gouty disorders of indigestion. Indeed, it cannot well be otherwise; for there is nothing so repugnant to natural digestion as the use of these strong liquors, which instead of dissolving harden every thing; and thus for ever, when the first warmth is gone off, leave a crapulary, crude, sour load of yesterday to ferment, fret, and irritate the stomach and bowels every day.

Thus have I endeavoured to point out two of the true, primary, capital causes of the gout, and most other chronic diseases; and most sincerely wish that what I have said may engage those whom it mostly con­cerns, the gouty, the infirm and valetudinary of every class, to observe, reflect and think for themselves up­on the hints I have thrown out; in which light what I have said, must be considered, rather than as logical or demonstrative proof. I know the reasoning and argu­ments may be much improved and carried farther, and if I had more leisure I might have attempted it: but I [Page 32] am well aware of the unsurmountable difficulty of con­vincing men against their will by any arguments at all. I chuse therefore at present to invite them to self-con­viction from their own observations and experience. I flatter myself they will find it well worth their pains, to reason a little more than they do with and for them­selves; and it will be a great point gained for them, if it turns their misled opinions from all that imaginary power of restoring health in any of that multitude of ri­diculous and most truly contemptible medicines, that are daily obtruded upon the public, with endless lies to recommend them, by a set of the poorest, most ig­norant and paultry rogues in the nation; and engage their attention to their true remedy, a right institution of life. In judging of which, if they find themselves unequal to the task, they may be assisted by men of skill, abilities and honesty.

Of VEXATION.

I COME now to the last general cause of chronic diseases, Vexation. A very fruitful parent of ma­ny bodily evils, producing generally diseases of inani­tion, much more difficult, not only to be cured, but relieved, than those we suffer either from indolence or intemperance. But as it is not so common a cause of the gout as the other two, it may not be necessary to consider it very minutely at present. I shall not there­fore enter deeply into the regions of metaphysical con­jecture, nor run wild after my own conceits, or theirs who have gone astray before me in guessing at the in­comprehensible union of soul and body, and their mu­tual powers of acting upon each other. I shall content myself with observing only, what may be of some use, that every great degree of vexation, whether in the shape of anger, envy, resentment, discontent or sor­row, [Page 33] has most destructive and deleterious effects upon the vitals of the body, whether sudden and violent, or slow and lasting long.

The first immediate effect of violent grief or vexati­on is to take off the action of the stomach intirely. Let us suppose a man, in the best health, the highest good humor and spirits, as well as good stomach, sitting down to dinner with his friends, receives suddenly some very afflicting news. Instantly his appetite is gone, and he can neither eat nor swallow a morsel. Let the same thing happen after he has made a hearty chearful meal, as suddenly the action of his stomach, the whole power of digestion is cut off totally, as if it were become pa­ralytic; and what he has eaten lies a most oppressive load. Perhaps as the excess of weakness is often con­vulsion, it may be rejected with a violent vomit, or do greater mischief. For which reason such strokes of distress are less hurtful received upon an empty than a full stomach. But why is this? what connexion is there between a piece of bad news and a man's stomach full or empty? whatever the cause be, the effect is certain and invariably. It is because the animal spi­rits, or the action of the nerves, whatever be the secret cause of their power, is called off to supply and support the tumultuous agitation of the brain, and the sto­mach, with all its appendages and their secretions, is left powerless and paralytic, and must therefore either act convulsively or not at all?

Besides this pernicious effect of perverting the na­tural action of the stomach and intestines, the whole circulation of the blood is disturbed. The contraction and dilatation of the heart, that is, the alternate action by which it opens to receive the blood from the veins, and closes again to force it out through the arteries; which operation ought to be as true and certain as the vibrations of a pendulum, are broken and uneven: the heart flutters, palpitates; now is overloaded with blood and in danger of suffocation, now receive none at all: [Page 34] consequently all the secretions must be as irregular, some of the glands receiving too abundant a supply that either hurries through, or oppresses and overpowers them, others none at all. Hence that hasty [...] of pale limpid urine in amazing quantities, [...] sudden bursts of unmeaning tears: sometimes [...] dryness and choaking thirst, sometimes the overflowing of the mouth with water instead of saliva, and many other nervous and hysterical affections, fits, syncope, epilepsy, &c. all which indicate the greatest tumults and per­turbations in the inmost recesses of the nervous and vital frame. Many kinds of diseases have sprung from this fountain, of such unaccountably horrid and terrify­ing appearances, that formerly they could no otherwise account for them but by the malefice of sorcery, and the immediate possession of devils.

In flower, more silent, but longer continued grief, the effects are similar, but not so violent. Many little strokes repeated will do the same thing in time that a great blow does at once. The function of the stomach will be more gently disturbed and perverted, its juices vitiated, and all its contents will for ever turn sour, bitter or rancid; so that no mild milky chyle, or whole­some material of nourishment, can ever come into the blood. The patient must languish with cachectic inanition, universal bad habit of body, or pine and waste with atrophy, the want of nourishing supply; whence arise complications of various diseases succeed­ing each other always from bad to worse: and unless he can subdue his anxiety, and restore peace of mind, he must in time sink under it, and die, as it is said, of a broken heart.

Whoever vexes long, must certainly want nourish­ment; for, besides the disturbed state of the stomach, it's broken appetite and bad digestion, from whence what supply there is must come not only ill-prepared, but vitiated into the blood; there can be no sleep in this state of mind: the perturbed spirit cannot rest; and [Page 35] it is in sleep that all nourishment is performed, and the finer parts of the body, chafed and worn with the fa­tigue of the day, are repaired and restored to their natural vigor. While we are awake this cannot so well be done; because the incessant action of the body or mind, being always partial and irregular, prevents that equal distribution of the blood to all parts alike, from which each fibre and filament receives that share or portion that suits it best. In sleep, when it is quiet and natural, all the muscles of the body, that is, all its active powers that are subject to our will, are lulled to rest, composed and relaxed into a genial temporary kind of palsy, that leaves not the least obstruction or hindrance of the passage of the blood to every atom. Accordingly the pulse is always slower and more equal, the respiration deeper and more regular, and the same degree of vital warmth diffused alike through every part; so that the extremeties are equally warm with the heart.

Vexation operating in this manner upon the organs of digestion and concoction, and disturbing and ob­structing the natural progress of nutrition, must often produce diseases similar to those of long-continued in­temperance; it's first effect being indigestion with all it's symptoms, wind, eructation, heart-burn, hiccup, &c. It is no wonder therefore it should sometimes bring on a fit of gout, which, as I have said, is mani­festly a disease of crudity and indigestion; and often the gout in the stomach and bowels. Indeed most cold crude colics are of this kind. Schirrous concretions will also be formed in the spleen, liver, glands of the mesentery, and throughout the whole system of the belly Many of these indurated tumors will appear outwardly, so as to be felt by the hand; these in time will degenerate into cancers and cancerous ulcerations, and many fatal evils, not the least of which, in my opinion, is, that the patient will suffer a long time be­fore he dies.

[Page 36] All the passions when they are inordinate may have injurious effects upon the vital frame: excessive joy has sometimes given a fatal blow, and sudden bursts of laughter done great mischiefs, especially to delicate of weakly people, who have often been thrown into spasms, cramps, convulsions, hysteric fits and haemorrhages by them. But as I think the word Vexation comprehends the chief of those passions that hurt us most, and mean not to make a metaphysical enquiry about them, it is needless to be particular upon each. It may suffice to have shewn the immediate and remote influence of vex­ation upon the human body.

Whatever men may think of their diseases, their stra [...] symptoms and appearances, and their unac­countable causes, these are the three original great sources of most of the chronic diseases of mankind; which I have endeavoured to set forth and explain in so familiar a manner, that I hope I have been perfectly intelligible to every one who will venture to think and judge for himself. To such rational people only I ad­dress myself; and to enable them to do this the better, I have furnished these hints and observations, which may be extended, improved and applied to particular cases. I want not, nor wish to obtrude my ideas upon any man, however warranted I may think myself from the observation and experience of my whole life: my principal aim has been only to make men stop a little in their career, and consider with themselves whether it may not be possible for them to be mistaken, even in that course of diet and those habits of life which they never suspected. If they are ill, and for any time, there must be a more substantial cause for it, than they are in general willing to allow. It is not always catch­ing cold, for we do not catch cold so often as we think we do; and when a healthy robust person takes cold, which can happen but rarely, if this be the whole of the disease, it cannot last long. But the truth is, when the crudity, superfluity and acrimony of an indolent, in­temperate [Page 37] temperate life have accumulated to such a degree as to make us sick, then we say we have taken cold, or com­plain of a bad constitution, when we have spoiled per­haps a very good one; or with Sydenham, that the epidemic constitution of the air has infected us, or that this or that triffle has disagreed. I am fully and firmly persuaded, that whoever will reflect with some degree of intelligence and sanity, be just to himself, and can­did with his physician, will in general be able to trace his complaints and diseases up to one or other of these three causes. And whoever does this, must infallibly see how vain and idle all his hopes and expectations of lasting remedy and established health must be from any kind of quack medicines, or indeed the common and too general practice of physic, when the whole is rested upon something given to swallow; how inadequate the means are to the end proposed and hoped for; how ill vomiting and purging can supply the place of temper­ance; bleeding, blistering and all artificial evacuation, of activity; cordials and opium, of peace of mind. Is not this to fill the body with harsh and unwholesome juices, and then tear it to pieces to get them out again? To make artificial holes and sores in the skin to renew the blood and discharge superfluities, instead of employ­ing muscular motion to rub off and grind down all the acrimony of angular aculeated particles, and make them smooth and round, and easily divisible; and to employ intoxication and stupefaction to take off the sense of pain, and leave the cause where it was, or fix it faster? Can any reasonable person hope for health or long life by any of these unnatural methods, when these only are employed? Let him look round among his neighbours and acquaintance; and tell me whether, not only all the gouty, but rheumatic, colicky, jaundiced, paralytic, dropsical people he has ever seen, are not either always so, or by fits so; and whether those returning paroxysms or fits of these disorders do not always grow worse and worse, in spite of all their medication and quackery, [Page 38] till a complication or apoplexy comes on, that at last, though long before their time, puts an end to their miserable lives. These evils are considered as the in­heritance of human nature, unavoidable and incurable, and submitted to in absolute despair; though there has not one rational attempt, that I know of, ever yet been made to remedy them in earnest. All the methods hi­therto employed have only been to relieve, and those often so perniciously, that the future health has been sacrificed to obtain present relief or ease. This must for ever be the case when in chronic cases it is obtained by art, and nature has no share; or where the physician does all, and the patient nothing for himself.

Of the Cure of the Gout and all other Chronic Diseases, and the Repair of a broken Constitution.

HAVING set forth the real causes of the gout, and all it's congenial diseases, I come now to the most essential part, to administer all possible comfort to those whom great pain and long suffering may have made attentive and docile, and willing to take health upon the terms it is possible to have it. To the young and voluptuous, who are yet in their career, and de­clare for a short life and a merry one, I have nothing to say but this, that a short life is very seldom a merry one; on the contrary, is generally made up of a few years of riotous pleasure without happiness, to be severely paid for by as many more of pain, sickness, regret and despair.

Having shewn that the gout is not hereditary, not inherent in our constitutions, but produced by the daily accumulations of indigested, unsubdued acrimony and superfluity, which, when they abound to a certain [Page 39] degree, must end either in a fit of the gout, or some other disease, according to the constitution, as long as any vigor is left in the body; for nature will for ever free or endeavor to free itself, and purge the blood of its impurities by gout, by fever, by pain of one kind or other, that takes off the appetite, and for a time gives respite, and prevents the pouring in of more and more enemies to disturb it's operation, and make it in­effectual. Thus young people, after a fit of gout is happily and well gone off, are as free from it, as if they had never had it; and if they would take warning and be careful not to breed it again, most certainly would for ever remain free. How absurd therefore, how ridiculously ignorant must be every attempt to cure the gout in futuro by medicine, before it be yet formed, before it has any existence! Can such a medi­cine give supernatural strength, and enable an old man living in indolence to digest and consume, or discharge the superfluities of his daily intemperance? that is, to give him more vigorous powers than nature gave him at one-and-twenty, or when the gout came first upon him. The Duke of Portland's powder promised to do something like this, and most certainly kept off the gout for two or three years. But what was it? and what did it really do? It was a strong spicy bitter taken in substance, in a large quantity, for a long time; it's effect was to keep up a constant fever as long as it was taken; this kept the gouty matter always afloat, and prevented it's fixing any where. But there was no liv­ing long with a constant fever; accordingly many of those who took it died very soon. I myself observed between fifty and sixty of it's advocates, some my pa­tients, some my acquaintance or neighbours, who were apparently cured by it; but in less than six years time, omnes and internecionem caesi, they all died to a man.

Many similar attempts have been made with other medicines to cure not only the gout, but most other chronic diseases, and with the same fatal effects. An­timony [Page 40] and Mercury elaborated into poisons by che­mistry have been administered, particularly the solu­tion of sublimate has torn many a stomach to rags, so that it could never bear common food afterwards. The deadly night-shade, and hemlock, and many such dreadful poisons, have been given as alteratives to re­store health. The intention here seems to be, kill or cure, to raise a violent agitation or fever in the body, in hopes it may prove strong enough to throw off the disease and medicine together. The effect has ever been, notwithstanding a little apparent and deceitful relief may have been perceived from the first efforts, that it has sunk under both loads, and, exhausted by repeated straining, much sooner than by the disease alone.

Can any one in his senses suppose that diseases a man has been his whole life contracting, and to which he is adding every day by perseverance in unwholsome diet, and bad habits, are to be thus removed by a coup de main ou de baguette? or that they will not return, be they cured or conjured away ever so often, whilst he continues the same mode of life that brought them on at first?

What then is to be done? how and in what manner are chronic diseases and cachexies to be cured, and health restored and established? I have already shewn that the causes of these evils are Indolence, Intemper­ance, and Vexation; and if there be any truth or weight in what I have said, the remedies are obvious. Activity, Temperance and Peace of Mind. It will be said, the remedies are obvious, but impracticable. Would you bid the feeble cripple, who cannot stand, take up his bed and walk? the man who has lost all appetite, abstain? and the sleepless wretch rack'd with pain enjoy peace of mind? No certainly; I am not so absurd. These must be assisted by medicine; and if they have not exhausted all its power already, a little respite, a favourable interval may be obtained, that with [Page 41] with other artificial aids co-operating, may be greatly improved to their advantage, and if rightly employed they may get on from strength to strength, till they recover into perfect health. But it is not my design at present to expatiate upon that particular kind of medi­cal relief which every chronic case may require; it would lead me into too wide a field, and too far from my present purpose, which is to shew that the gout, in most of its stages and degrees, may be cured, a pre­sent paroxysm or fit relieved, its return for ever safely prevented, and the patient established in perfect health.

Let us suppose the case of a man from forty to fifty years of age, who has had at least twenty fits of gout; by which most of his joints have been so clogg'd and obstructed, as to make walking or any kind of motion very uneasy to him: let him have had it sometimes in his stomach, a little in his head, and often all over him, so as to make him universally sick and low-spirit­ed, especially before a regular fit has come to relieve him. This I apprehend to be as bad a case as we need propose, and that it will not be expected that every old cripple whose joints are burnt to chalk, and his bones grown together and united by anchilosis, who must be carried from his bed to his table and back again, should be proposed as an object of medication and cure: and yet even he might perhaps receive some relief and pal­liation in pain, if he has any great degree of it, which is not very common in this case. Let us therefore suppose the first example.

If the point be to assuage the violent raging of a pre­sent paroxysm; this may be safely done by giving some soft and slowly-operating laxative, neither hot nor cold, but warm, either in small doses repeated so as move the patient once or twice in twenty-four hours, or by a larger dose oftener in less time, according to the strength and exigency. This may be followed by a few lenient absorbent correctors of acrimony or even [Page 42] gentle anodynes: proper catalapsms may also be safely applied to the raging part, which often assuage pain surprizingly; with as much mild and spontaneously-dissolving nourishment as may keep the spirits from sinking too low: but I would wish them to sink a little, and exhort the patient to bear that lowness with pa­tience and resignation, till nature, assisted by soft and succulent food, can have time to relieve him. This easy method of treating a fit of the gout would answer in any age; and if the patient was young and vigor­ous, and the pain violent, there could be no danger in taking away a little blood. Thus in two or three days time I have often seen a severe fit mitigated and made tolerable; and this is a better way of treating it with regard to future consequences, than bearing it with pa­tience and suffering it to take its course: for the sooner the joints are relieved from distension and pain, the less danger there is of their being calcined and utterly de­stroyed. But instead of this, the general practice is quite the reverse. Oh! keep up your spirits, they cry; keep it out of your stomach at all events; where, whenever it rages in distant part, it is not at all in­clined to come. As you cannot eat, you must drink the more freely. So they take cordials, strong wines, and rich spoon-meats. By urging in this manner, a great fever is raised, the pain enraged and prolonged; and a fit, that would have ended spontaneously in less than a week, protracted to a month or six weeks and when it goes off at last, leaves such obstruction and weakness in the parts, as cripple the man ever after. All this I hope will be fairly and candidly understood; for there are doubtless a great variety of gouty cases, but no case that will not admit of medical assistance ju­diciously administered.

But the most capital point of all, and what is most­ly desired by all, is to prevent its return, or changing into any other disease, and to establish health. Most men would be very well pleased and happy could this [Page 43] be done by any medical trick or nostrum, with full li­berty of living as they list, and indulging every appe­tite and passion without controul. Some poor silly creatures, ignorant of all philosophy and the nature of causes and effects, have been led into experiments of this kind by a few artful rogues, very much to the prejudice of their future health, and danger of their lives also; expecting from medicine what it never did or can perform alone, the cure of chronic diseases.

I think it needless here to take any pains to shew the inefficacy of all the common modes of practice, vomit­ing, purging, bleeding, blistering, issues &c. They have been found ineffectual not only in the gout, but all other chronic cases. All sensible practitioners must know their effects to be but temporary, and that they are meant and used only as means of present relief. Let us see therefore by what practicable plan or regimen the person here described, when a fit of the gout is happily ended, may for ever prevent it's return, and so confirm his general health that it shall not again be overset by every slight cold or triffling accident.

I have already shewn that a certain degree of activity or bodily motion is necessary at intervals every day, to raise the circulation to that pitch, that will keep the fine vessels open and the old blood pure, and also make new from the fresh juices. If the patient cannot be brought to this, he has no chance of recovering to per­fect health. If therefore he can neither walk nor ride at all, he must by degrees be brought to do both by the assistance of others, which may be given him in the fol­lowing manner: Let a handy active servant or two be employed to rub him all over as he lies in bed with flannels, or flannel gloves, fumigated with gums and spices, which will contribute greatly to brace and strengthen his nerves and fibres, and move his blood without any fatigue to himself ^*This may take up from [Page 44] five to ten minutes at first, but must be repeated five of six times a day, supposing him totally unable to help himself. But if he can walk a hundred yards only, it will forward him greatly to walk those hundred yards every two hours, and if he can bear a carriage, let him go out in it every day, till he begins to be tired. The first day or two all this may disturb and fatigue him a little; but if he has patience to persevere to the fourth, I dare promise him some amendment and increase of strength; which he must employ, as young merchants do a little money, to get more. Thus he must go on rubbing, walking, and riding a little more and more every day, stopping always upon the first sensation of weariness to rest a little, till he be able to walk two or three miles at a stretch, or ride ten without any weari­ness at all. This is recommended with an intention to dislodge and throw off all remains of crude gouty con­cretions that may have obstructed his joints, on lain concealed in any of the lacunae or recesses of his body; to free the circulation in minimis and all it's secretions, Perspirations, and discharges whatever: and though this intention can never be but very defectively answered by medicines, it may certainly by assisted and greatly pro­moted by a few well-chosen mild antimonial, absorbent or saponaceous deobstruents and sweetners, that, like Putting shot or gravel into a bottle, with a good deal of agitation will greatly help to make it clean, but without agitation will do nothing ^*.

[Page 45] While we are thus endeavouring to resolve all old obstructions, to open the fine vessels, and strain and purify the blood, and by degrees to enable the man to use a certain degree of exercise or labor every day; great care must be taken in the choice of his diet, that no new acrimony be added to the old, to thwart and frustrate this salutary operation. His food must be soft, mild, and spontaneously digesting, and in mode ate quantity, so as to give the least possible labor to the stomach and bowels; that it may neither turn sour, nor bitter, nor rancid, nor any way degenerate from those qualities necessary to make good blood. Such things are, at first, new-laid eggs boiled so as not to harden the white creamy part of them, tripe, calves feet, chicken, partridge, rabbits, most sorts of white mild fish, such as whiting, skate, cod, turbot, &c. and all sorts of shell fish, particularly oysters raw. Very soon he will be strong enough to eat beef, veal, mutton, lamb, pork, venison, &c. but these must all be kept till they are tender, and eaten with their own gravies without any compounded sauces or pickles whatever: instead of which, boiled or stewed vegetables, and sal­lads of lettuce and endive, may be used: and the luxury that is not unwholsome may be allowed, light puddings, custards, creams, blanc manager, &c. and ripe fruits of all kinds and seasons. But because ^* wine undoubtedly produces nine in ten of all the gouts in the world, wine must be avoided, or taken very spar­ingly, [Page 46] and but seldom. How is this to be done? Can a man used to it every day, who thinks he cannot live without it, and that his existence depends upon it, leave it off safely? If he thinks he must die of the ex­periment, doing it all at once, he may do it by degrees, and drink but half the quantity of yesterday till he has brought it to nothing. But the danger of attempting it in this manner is, that it will never be done; and, like a procrastinating sinner, he will forever put off his penitential resolution till to-morrow. If he did it all at once, I would be hanged if he died of the attempt; he would be uneasy for three or four days, that's all. He may change his liquor, and drink a little good porter, and by degrees come to small beer, the wholsomest and best of all liquors except good soft water. But I do not mean that this rigorous abstinence from wine is to last for life, but only during the conflict with the di­sease. As soon as he has recovered health and strength to use exercise enough to subdue it, he may safely in­dulge once a week, or perhaps twice, with a pint of wine for the sake of good humour and good company, if they cannot be enjoyed without it; for I would not be such a churl as to forbid, or even damp, one of the greatest joys of human life.

If any man should say it is better to have a little gout than take all these pains, and submit to this dis­cipline; this is not the alternative: perhaps it may be more eligible to live at large, and have but a little gout now and then, that goes off well, and leaves no trace behind; but this is very seldom the case. The mis­fortune is, that a little gout most commonly comes again and again more severely, till it becomes a great gout, till it cripples the man, and shortens his life at least twenty years, embittering all the latter part of it. If any one thinks this description of it, which is the real state of the case nine times in ten, preferable to that gradual exertion of his own powers and strictness of regimen, or rather attention to himself with very [Page 47] moderate abstinence or self-denial for a year or two, as here recommended; I have no reply to make him, but must give him up to his own choice.

The severity of these efforts and this abstemious care need be continued no longer than the disease or the ef­fects of it remain. When by perseverance in the prac­tice of them, together with the medical aids here re­commended, the patient shall have recovered his strength and locomotive powers, he may preserve and perpetuate them, and his title to longevity, upon the following plan.

He must never lose sight of the three great princi­ples of health and long life, Activity, Temperance, and Peace of Mind. With these ever in view, he may eat and drink of every thing the earth produces, but his diet must be plain, simple, solid and tender, or in proportion to his consumption; he must eat but of one thing or two at most at a meal, and this will soon bring him to be satisfied with about half his usual quantity: for all men eat about twice as much as they ought to do, provoked by variety: he must drink but little of any liquor, and never till he has done eating: the drier every man's diet is, the better. No wine oftener than once or twice a week at most; and this must be con­sidered as a luxurious indulgence. If he be sometimes led unawares into a debauch, it must be expiated by abstinence and double exercise the next day, and he may take a little of my magnesia and rhubarb as a good antidote: or if he cannot sleep with his unusual load, he may drink water, and with his finger in his throat throw it up. I have known some old soldiers by this trick alone, never taking their dose to bed with them, live to kill their acquaintance two or three times over. One moderate meal a day is abundantly sufficient; therefore it is better to omit supper, because dinner is not so easily avoided. Instead of supper, any good ripe fruit of the season would be very salutary, preventing costiveness, and keeping the bowels free and open, [Page 48] and cooling, correcting, and carrying off the heats and crudities of his indigestion.

His activity need be no more than to persevere in the habit of rubbing all over night and morning for eight or ten minutes, and walking three or four miles every day, or riding ten, or using any bodily labor or exercise equivalent to it. In bad weather I can see no great evil in throwing a cloak round his shoulders and walking even in the rain; the only difficulty is to sum­mon resolution enough to venture out; and a little use would take off all danger of catching cold, by hardening and securing him against the possibility of it upon that and all other occasions. If he dares not risque this, some succedaneum must be used within doors; more especially when bad weather continues any time. I recommend it to all men to wash their feet every day, the gouty in particular, and not lie a bed above seven hours in summer, and eight in winter.

Whoever thinks there cannot be luxury enough in this course of life, I am persuaded will not find more in any other: for good health, with all its natural appe­tites and sensations in perfect order, is the only true foundation of luxury. And whoever cultivates it upon the false principles of culinary or medical art, urging to excess by stimulating provocatives of any kind, in­stead of pleasure and enjoyment will meet with pain and disgust.

Some perhaps may be reasonable enough to observe and say, This plan of yours is very simple; there is no­thing marvellous in it; no wonderful discovery of any of the latent powers of medicine: but will a regimen so easy to be complied with as this, cure the gout, stone, dropsy, &c? Will it repair broken constitutions and restore old invalids to health? My answer is, that if I may trust the experience of my whole life, and above all the experience I have had in my own person, having not only got rid of the gout, of which I have had four severe fits in my younger days, but also emerged from [Page 49] the lowest ebb of life, that a man could possibly be re­duced to by cholic, jaundice, and a complication of complaints, and recovered to perfect health; which I have now uninterruptedly enjoyed above ten years: I say, if I may rely upon all this, I may with great safety pronounce and promise that the plan here recommend­ed, assisted at first with all the collateral aids of medicine peculiar to each case, correcting many an untoward concomitant symptom, pursued with resolution and pa­tience, will certainly procure to others the same benefits I received from it, and cure every curable disease. If this be thought too much to promise, I beg it may be considered, that a life of bad habits produces all these diseases: nothing therefore so likely as good ones long con [...]ined to restore or preserve health.

What can the best physician do more than discover and point out to his patients the real causes of their diseases? You will say, he must find a remedy: this he will do for you also as long as he can. But I will tell you a [...]ret: his remedies are chiefly evacuations; and as long as your body can bear scouring and cleansing ^* he will do you some temporary, apparent service: but when it begins to wear out, his remedies will last no longer; you must try better methods; you must not repeat the cause so often; for he cannot for ever build up as fast as you can pull down. In short, you must reform your life, and change all your bad habits for good ones; and if you have patience to wait the slow operations of nature properly assisted, you will have no reason to regret your former luxuries.

We are all so much the creatures of habit, which forms and fashions us to good or ill almost as much as nature itself, that we ought to be very attentive and [Page 50] careful that our daily habits may ever tend to the con­firmation not the destruction of health. It is not what we do now and then that can injure us greatly, but what we do every day must either do us great good or harm; either establishing our health, or fixing our dis­eases, for life.

If, after all, any man should say, these restraints, this care in chusing what is wholsome, this constant watch­ing over all we do, would make life so grievous, that health were not worth having upon these terms; I wish him to stop a little, and consider them well before he rejects them intirely; and whether there be any better for him. It can do him no great harm to try a month or two; if he does, I flatter myself he will find that custom will take off the greatest part of the grievance, and perseverance make them not only tolerable but pleasant. If he thinks health may be enjoyed upon easier terms, I fear he will be miserably deceived; for health, like beauty, may be won by our own attention, efforts and assiduities, but cannot be had by purchase. Whoever thinks to buy either, will have the misfortune to find it not long his own, though he has paid for it.

But there may be others whom long suffering has made more patient and reasonable; these may be glad to hear that a little health is to be had on any terms; and it may be very comfortable to them to know that there is scarcely any state of weakness so low, supposing the vitals not mortally hurt, from which they may not recover into very desirable health and strength, and by these means, exerted with persevering patience. I say this to invalids in general: for thus may be cured not only the gout, but very bad rheumatisms, ischiaticas, rickets, stone, jaundice, dropsy, asthma, cachexies, and complications of many kinds. Whatever chronic diseases will not give way to this system of medication, will be found, I greatly fear, too hard for any other. And should there be a particular case, in which some fortunate violence or chance may have apparently suc­ceeded [Page 51] for a time, the return of the evil, or change to something worse, can no way be so well guarded against and prevented, as by some such rational and natural institution of life.

Thus have I endeavoured to set forth the real causes of chronic diseases in general, and the true principles of convalescence, health and longevity. If I have ha­zarded any thing new or contrary to received opinions, it has been from a thorough conviction of it's truth, however dangerous to fame and fortune; both which I know are more easily acquired by complying with the world, than attempting to reform it: but it must be somebody equally indifferent to both, as I am, who will venture to tell such truths as are more likely to recoil and hurt the author, than to convince and con­ciliate the bulk of mankind.