Chapter VI: Preface (6)

II. Cold applied suddenly to the body, after it has been exposed to intense heat. Of this Dr. Girdlestone mentions many instances, in his Treatise upon Spasmodic Affections in India. It was most commonly induced by sleeping upon the ground, after a warm day. Such is the dampness and unwholesome nature of the ground, in some parts of that country, that "fowls (the doctor says) put into coops at night, in the sickly season of the year, and on the same soil that the men slept, were always found dead the next morning, if the coop was not placed at a certain height above the surface of the earth[48]." It was brought on by sleeping on a damp pavement in a servant girl of Mr. Alexander Todd of Philadelphia, in the evening of a day in which the mercury in Fahrenheit's thermometer stood at 90°. Dr. Chalmers relates an instance of its having been induced by a person's sleeping without a nightcap, after shaving his head. The late Dr. Bartram informed me, that he had known a draught of cold water produce it in a man who was in a preternaturally heated state. The cold air more certainly brings on this disease, if it be applied to the body in the form of a current. The stiff neck which is sometimes felt after exposure to a stream of cool air from an open window, is a tendency to a locked jaw, or a feeble and partial tetanus.

[48] Page 55.

III. Worms and certain acrid matters in the alimentary canal. Morgagni relates an instance of the former, and I shall hereafter mention instances of the latter in new-born infants.

IV. Certain poisonous vegetables. There are several cases upon record of its being induced by the hemlock dropwort, and the datura stramonium, or Jamestown weed of our country.

V. It is sometimes a symptom of the bilious remitting and intermitting fever. It is said to occur more frequently in those states of fever in the island of Malta, than in any other part of the world.

VI. It is likewise a symptom of that malignant state of fever which is brought on by the bite of a rabid animal, also of hysteria and gout.

VII. The grating noise produced by cutting with a knife upon a pewter plate excited it in a servant, while he was waiting upon his master's table in London. It proved fatal in three days.

VIII. The sight of food, after long fasting.

IX. Drunkenness.

X. Certain emotions and passions of the mind. Terror brought it on a brewer in this city. He had been previously debilitated by great labour, in warm weather. I have heard of its having been induced in a man by agitation of mind, occasioned by seeing a girl tread upon a nail. Fear excited it in a soldier who kneeled down to be shot. Upon being pardoned he was unable to rise, from a sudden attack of tetanus. Grief produced it in a case mentioned by Dr. Willan.

XI. Parturition.

All these remote and exciting causes act with more or less certainty and force, in proportion to the greater or less degrees of fatigue which have preceded them.

It has been customary with authors to call all those cases of tetanus, which are not brought on by wounds, symptomatic. They are no more so than those which are said to be idiopathic. They all depend alike upon irritating impressions, made upon one part of the body, producing morbid excitement, or disease in another. It is immaterial, whether the impression be made upon the intestines by a worm, upon the ear by an ungrateful noise, upon the mind by a strong emotion, or upon the sole of the foot by a nail; it is alike communicated to the muscles, which, from their previous debility and irritability, are thrown into commotions by it. In yielding to the impression of irritants, they follow in their contractions the order of their predisposing debility. The muscles which move the lower jaw are affected more early, and more obstinately than any of the other external muscles of the body, only because they are more constantly in a relaxed, or idle state.

The negroes in the West-Indies are more subject to this disease than white people. This has been ascribed to the greater irritability of their muscular systems, which constitutes a part of its predisposing cause. It is remarkable that their sensibility lessens with the increase of their irritability; and hence, Dr. Moseley says, they bear surgical operations much better than white people.

New-born infants are often affected by this disease in the West-Indies. I have seen a few cases of it in Philadelphia. It is known by the name of the jaw-fall. Its causes are:

1. The cutting of the navel string. This is often done with a pair of dull scissors, by which means the cord is bruised.

2. The acrimony of the meconium retained in the bowels.

3. Cold air acting upon the body, after it has been heated by the air of a hot room.

4. Smoke is supposed to excite it, in the negro quarters in the West-Indies.

It is unknown, Dr. Winterbottom informs us, among the native Africans in the neighbourhood of Sierra Leone.

I am aware that it is ascribed by many physicians to only one of the above causes; but I see no reason why it should not be induced by more than one cause in infants, when we see it brought on by so many different causes in grown people.

The tetanus is not confined to the human species. It often affects horses in the West-Indies. I have seen several cases of it in Philadelphia.

The want of uniform success in the treatment of this disease, has long been a subject of regret among physicians. It may be ascribed to the use of the same remedies, without any respect to the nature of the causes which produce it, and to an undue reliance upon some one remedy, under a belief of its specific efficacy. Opium has been considered as its antidote, without recollecting that it was one only, of a numerous class of medicines, that are all alike useful in it.

Tetanus, from all its causes, has nearly the same premonitory symptoms. These are a stiffness in the neck, a disposition to bend forward, in order to relieve a pain in the back, costiveness, a pain about the external region of the stomach, and a disposition to start in sleep. In this feeble state of the disease, an emetic, a strong dose of laudanum, the warm bath, or a few doses of bark, have often prevented its being completely formed. When it has arisen from a wound, dilating it if small or healed, and afterwards inflaming it, by applying to it turpentine, common salt, corrosive sublimate, or Spanish flies, have, in many hundred instances, been attended with the same salutary effects.

The disease I have said is seated in the muscles, and, while they are preternaturally excited, the blood-vessels are in a state of reduced excitement. This is evident from the feebleness and slowness of the pulse. It sometimes beats, according to Dr. Lining, but forty strokes in a minute. By stimulating the wound, we not only restore the natural excitement of the blood-vessels, but we produce an inflammatory diathesis in them, which abstracts morbid excitement from the muscular system, and, by equalizing it, cures the disease. This remedy I acknowledge has not been as successfully employed in the West-Indies as in the United States, and that for an obvious reason. The blood-vessels in a warm climate refuse to assume an inflammatory action. Stimuli hurry them on suddenly to torpor or gangrene. Hence the danger and even fatal effects of blood-letting, in the fevers which affect the natives of the islands, a few hours after they are formed. But widely different is the nature of wounds, and of the tension of the blood-vessels, in the inhabitants of northern countries. While Dr. Dallas deplores the loss of 49 out of 50 affected with tetanus from wounds, in the West-India islands, I am sure I could mention many hundred instances of the disease being prevented, and a very different proportion of cures being performed, by inflaming the wounds, and exciting a counter _morbid_ action in the blood-vessels.

When the disease is the effect of fever, the same remedies should be given, as are employed in the cure of that fever. I have once unlocked the jaw of a woman who was seized at the same time with a remitting fever, by an emetic, and I have heard of its being cured in a company of surveyors, in whom it was the effect of an intermittent, by large doses of bark. When it accompanies malignant fever, hysteria, or gout, the remedies for those forms of disease should be employed. Bleeding was highly useful in it in a case of yellow fever which occurred in Philadelphia in the year 1794.

When it is produced by the suppression of perspiration by means of cold, the warm bath and sweating medicines have been found most useful in it. Nature has in one instance pointed out the use of this remedy, by curing the disease by a miliary eruption on the skin[49].

[49] Burserus.

If it be the effect of poisonous substances taken into the stomach, or of worms in the bowels, the cure should be begun by emetics, purges, and anthelmintic medicines.

Where patients are unable to swallow, from the teeth of the upper and lower jaw pressing upon each other, a tooth or two should be extracted, to open a passage for our medicines into the throat. If this be impracticable or objected to, they should be injected by way of glyster.

In the locked jaw which arises from the extraction of a tooth, an instrument should be introduced to depress the jaw. This has been done by a noted English dentist in London, with success.

As the habit of diseased action often continues after the removal of its causes, and as some of the remote causes of this disease are beyond the reach of medicine, such remedies should be given as are calculated, by their stimulating power, to overcome the morbid or spasmodic action of the muscles. These are:

1. OPIUM. It should be given in large and frequent doses. Dr. Streltz says he has found from one to two drachms of an alkali, taken in the course of a day, greatly to aid the action of the opium in this disease.

2. WINE. This should be given in quarts, and even gallons daily. Dr. Currie relates a case of a man in the infirmary of Liverpool, who was cured of tetanus, by drinking nearly a quarter cask of Madeira wine. Dr. Hosack speaks in high terms of it, in a letter to Dr. Duncan, and advises its being given without any other stimulating medicine.

3. ARDENT SPIRITS. A quack in New-England has lately cured tetanus, by giving ardent spirits in such quantities as to produce intoxication. Upon being asked his reason for this strange practice, he said, he had always observed the jaw to fall in drunken men, and any thing that would produce that effect, he supposed to be proper in the locked jaw.

4. The BARK has of late years been used in this disease with success. I had the pleasure of first seeing its good effects in the case of Colonel Stone, in whom a severe tetanus followed a wound in the foot, received at the battle of Germantown, in October, 1777.

5. The COLD BATH. This remedy has been revived by Dr. Wright of Jamaica, and has in many instances performed cures of this disease. In one of two cases in which I have used it with success, the patient's jaw opened in a few minutes after the affusion of a single bucket of water upon her body. The disease was occasioned by a slight injury done to one of her toes, by wearing a tight shoe. The signals for continuing the use of the cold bath, are its being followed by a slight degree of fever, and a general warmth of the skin. Where these do not occur, there is reason to believe it will do no service, or perhaps do harm. We have many proofs of the difference in the same disease, and in the operation of the same medicine, in different and opposite climates. Dr. Girdlestone has mentioned the result of the use of the cold bath in tetanus in the East-Indies, which furnishes a striking addition to the numerous facts that have been collected upon that subject. He tells us the cold bath uniformly destroyed life, in every case in which it was used. The reason is obvious. In that extremely debilitating climate, the system in tetanus was prostrated too low to re-act, under the sedative operation of the cold water.

6. The WARM BATH has often been used with success in this disease. Its temperature should be regulated by our wishes to promote sweats, or to produce excitement in the blood-vessels. In the latter case it should rise above the heat of the human body.

7. The OIL OF AMBER acts powerfully upon the muscular system. I have seen the happiest effects from the exhibition of six or eight drops of it, every two hours, in this disease.

8. A SALIVATION has been often recommended for the cure of tetanus, but unfortunately it can seldom be excited in time to do service. I once saw it complete the cure of a sailor in the Pennsylvania hospital, whose life was prolonged by the alternate use of bark and wine. The disease was brought on him by a mortification of his feet, in consequence of their being frost-bitten.

9. Dr. Girdlestone commends BLISTERS in high terms in this disease. He says he never saw it prove fatal, even where they only produced a redness on the skin.

10. I have heard of ELECTRICITY having been used with advantage in tetanus, but I can say nothing in its favour from my own experience.

In order to ensure the utmost benefit from the use of the above remedies, it will be necessary for a physician always to recollect, that the disease is attended with great morbid action, and of course each of the stimulating medicines that has been mentioned should be given, 1st, in large doses; 2dly, in succession; 3dly, in rotation; and 4thly, by way of glyster, as well as by the mouth.

The jaw-fall in new-born infants is, I believe, always fatal. Purging off the meconium from the bowels immediately after birth has often prevented it from one of its causes; and applying a rag wetted with spirit of turpentine to the navel-string, immediately after it is cut, Dr. Chisholm says, prevents it from another of its causes which has been mentioned.

This disease, I have said, sometimes affects horses. I have twice seen it cured by applying a potential caustic to the neck under the mane, by large doses of the oil of amber, and by plunging one of them into a river, and throwing buckets of cold water upon the other.

I shall conclude my observations upon the tetanus with the following queries:

1. What would be the effects of _copious_ blood-letting in this disease? There is a case upon record of its efficacy, in the Medical Journal of Paris, and I have now in my possession a letter from the late Dr. Hopkins of Connecticut, containing the history of a cure performed by it. Where tetanus is the effect of primary gout, hysteria, or fever, attended with highly inflammatory symptoms, bleeding is certainly indicated, but, in general, the disease is so completely insulated in the muscles, and the arteries are so far below their par of excitement in frequency and force, that little benefit can be expected from that remedy. The disease, in these cases, seems to call for an elevation, instead of a diminution, of the excitement of the blood-vessels.

2. What would be the effect of _extreme_ cold in this disease? Mr. John Hunter used to say, in his lectures, "Were he to be attacked by it, he would, if possible, fly to Nova-Zembla, or throw himself into an ice-house." I have no doubt of the efficacy of intense cold, in subduing the inordinate morbid actions which occur in the muscular system; but it offers so much violence to the fears and prejudices of sick people, or their friends, that it can seldom be applied in such a manner as to derive much benefit from it. Perhaps the sedative effects of cold might be obtained with less difficulty, by wrapping the body in sheets, and wetting them occasionally for an hour or two with cold water.

3. What would be the effect of exciting a strong counter-action in the stomach and bowels in this disease? Dr. Brown of Kentucky cured a tetanus by inflaming the stomach, by means of the tincture of cantharides. It has likewise been cured by a severe cholera morbus, induced by a large dose of corrosive sublimate. The stomach and bowels, and the external muscles of the body, discover strong associations in many diseases. A sick stomach is always followed by general weakness, and the dry gripes often paralyze the muscles of the arms and limbs. But further, one of the remote causes of tetanus, viz. cold air, often shows the near relationship of the muscles to the bowels, and the vicarious nature of disease in each of them. It often produces in the latter, in the West-Indies, what the French physicians call a "crampe seche," or, in other words, if I may be allowed the expression, a tetanus in the bowels.

4. A sameness has been pointed out between many of the symptoms of hydrophobia and tetanus. A similar difficulty of swallowing, and similar convulsions after it, have been remarked in both diseases. Death often takes place suddenly in tetanus, as it does in hydrophobia, without producing marks of fatal disorganization in any of the internal parts of the body. Dr. Physick supposes death in these cases to be the effect of suffocation, from a sudden spasm and closure of the glottis, and proposes to prevent it in the same manner that he has proposed to prevent death from hydrophobia, that is, by laryngotomy[50]. The prospect of success from it appears alike reasonable in both cases.

[50] Medical Repository.

THE RESULT OF OBSERVATIONS

MADE UPON

_THE DISEASES_

WHICH OCCURRED IN

THE MILITARY HOSPITALS

OF THE UNITED STATES,

DURING THE REVOLUTIONARY WAR BETWEEN GREAT BRITAIN

AND THE UNITED STATES.

1. The army when in tents, was always more sickly, than in the open air. It was likewise more healthy when it was kept in motion, than when it lay in an encampment.

2. Young men under twenty years of age, were subject to the greatest number of camp diseases.

3. The southern troops were more sickly than the northern or eastern troops.

4. The native Americans were more sickly than the natives of Europe who served in the American army.

5. Men above thirty, and five and thirty years of age, were the hardiest soldiers in the army. Perhaps the reason why the natives of Europe were more healthy than the native Americans, was, they were more advanced in life.

6. The southern troops sickened from the want of salt provisions. Their strength and spirits were restored only by means of salted meat. I once saw a private in a Virginia regiment, throw away his ration of choice fresh beef, and give a dollar for a pound of salted bacon.

7. Those officers who wore flannel shirts or waistcoats next to their skins, in general escaped fevers and diseases of all kinds.

8. The principal diseases in the hospitals were the typhus gravior and mitior of Doctor Cullen. Men who came into the hospitals with pleurisies or rheumatisms, soon lost the types of their original diseases, and suffered, or died, by the above-mentioned states of fever.

9. The typhus mitior always prevailed most, and with the worst symptoms in winter. A free air, which could only be obtained in summer, always prevented, or mitigated it.

10. In all those cases, where the contagion was received, cold seldom failed to render it active. Whenever an hospital was removed in winter, one half of the patients generally sickened on the way, or soon after their arrival at the place to which they were sent.

11. Drunken soldiers and convalescents were most subject to this fever.

12. Those patients in this fever who had large ulcers on their back or limbs, generally recovered.

13. I met with several instances of buboes, also of ulcers in the throat, as described by Doctor Donald Monro. They were mistaken by some of the junior surgeons for venereal sores, but they yielded to the common remedies of the hospital fever.

14. There were many instances of patients in this fever, who suddenly fell down dead, upon being moved, without any previous symptoms of approaching dissolution. This was more especially the case, when they arose to go to stool.

15. The contagion of this fever was frequently conveyed from the hospital to the camp, by means of blankets and clothes.

16. Those black soldiers who had been previously slaves, died in a greater proportion by this fever, or had a much slower recovery from it, than the same number of white soldiers.

17. The remedies which appeared to do most service in this disease were vomits of tartar emetic, gentle dozes of laxative salts, bark, wine, volatile salt, opium, and blisters.

18. An emetic seldom failed of checking this fever if exhibited while it was in a _forming_ state, and before the patient was confined to his bed.

19. Many causes concurred to produce, and increase this fever; such as the want of cleanliness, excessive fatigue, the ignorance or negligence of officers in providing suitable diet and accommodations for their men, the general use of linen instead of woollen clothes in the summer months, and the crowding too many patients together in one hospital, with such other inconveniences and abuses, as usually follow the union of the _purveying_ and _directing_ departments of hospitals in the _same_ persons. But there is one more cause of this fever which remains to be mentioned, and that is, the sudden assembling of a great number of persons together of different habits and manners, such as the soldiers of the American army were in the years 1776 and 1777. Doctor Blane informs us, in his observations upon the diseases of seamen, "that it sometimes happens that a ship with a long established crew shall be very _healthy_, yet if strangers are introduced among them, who are also _healthy_, sickness will be mutually produced." The history of diseases furnishes many proofs of the truth of this assertion[51]. It is very remarkable, that while the American army at Cambridge, in the year 1775, consisted only of New-Englandmen (whose habits and manners were the same) there was scarcely any sickness among them. It was not till the troops of the eastern, middle, and southern states met at New-York and Ticonderoga, in the year 1776, that the typhus became universal, and spread with such peculiar mortality in the armies of the United States.

[51] "Cleanliness is founded on a natural aversion to what is unseemly
and offensive in the persons of others; and there seems also to
be an instinctive horror at strangers implanted in human nature
for the same purpose, as is visible in young children, and
uncultivated people. In the early ages of Rome, the same word
signified both a stranger and an enemy." Dr. Blane, p. 225.

20. The dysentery prevailed, in the summer of 1777, in the military hospitals of New-Jersey, but with very few instances of mortality. This dysentery was frequently followed by an obstinate diarrh[oe]a, in which the warm bath was found in many cases to be an effectual remedy.

21. I saw several instances of fevers occasioned by the use of the common ointment made of the flour of sulphur and hog's lard, for the cure of the itch. The fevers were probably brought on by the exposure of the body to the cold air, in the usual method in which that ointment is applied. I have since learned, that the itch may be cured as speedily by rubbing the parts affected, two or three times, with the dry flour of sulphur, and that no inconvenience, and scarcely any smell, follow this mode of using it.

22. In gun-shot wounds of the joints, Mr. Ranby's advice of amputating the limb was followed with success. I saw two cases of death where this advice was neglected.

23. There was one instance of a soldier who lost his hearing, and another of a soldier who had been deaf who recovered his hearing, by the noise of artillery in a battle.

24. Those soldiers who were billetted in private houses, generally escaped the hospital fever, and recovered soonest from all their diseases.

25. Hospitals built of coarse logs, with _ground_ floors, with fire-places in the middle of them, and a hole in the roof, for the discharge of smoke, were found to be very conducive to the recovery of the soldiers from the hospital fever. This form of a military hospital was introduced into the army by Dr. Tilton of the state of Delaware[52].

[52] "It is proved, in innumerable instances, that sick men recover
health sooner and better in sheds, huts, and barns, exposed
occasionally to wind, and sometimes to rain, than in the
most superb hospitals in Europe." Jackson's Remarks on the
Constitution of the Medical Department of the British Army,
p. 340.

26. In fevers and dysenteries, those soldiers recovered most certainly, and most speedily, who lay at the greatest distance from the walls of the hospitals. This important fact was communicated to me by the late Dr. Beardsley of Connecticut.

27. Soldiers are but little more than adult children. That officer, therefore, will best perform his duty to his men, who obliges them to take the most care of their HEALTH.

28. Hospitals are the sinks of human life in an army. They robbed the United States of more citizens than the sword. Humanity, economy, and philosophy, all concur in giving a preference to the conveniences and wholesome air of private houses; and should war continue to be the absurd and unchristian mode of deciding national disputes, it is to be hoped that the progress of science will so far mitigate one of its greatest calamities, as to produce an abolition of hospitals for acute diseases. Perhaps there are no cases of sickness in which reason and religion do not forbid the seclusion of our fellow creatures from the offices of humanity in private families, except where they labour under the calamities of madness and the venereal disease, or where they are the subjects of some of the operations of surgery.

AN ACCOUNT OF THE INFLUENCE

OF THE

MILITARY AND POLITICAL EVENTS

OF THE

_AMERICAN REVOLUTION_

UPON THE

HUMAN BODY.

There were several circumstances peculiar to the American revolution, which should be mentioned previously to an account of the influence of the events which accompanied it, upon the human body.

1. The revolution interested every inhabitant of the country of both sexes, and of every rank and age that was capable of reflection. An indifferent, or neutral spectator of the controversy, was scarcely to be found in any of the states.

2. The scenes of war and government which it introduced, were new to the greatest part of the inhabitants of the United States, and operated with all the force of _novelty_ upon the human mind.

3. The controversy was conceived to be the most important of any that had ever engaged the attention of mankind. It was generally believed, by the friends of the revolution, that the very existence of _freedom_ upon our globe, was involved in the issue of the contest in favour of the United States.

4. The American revolution included in it the cares of government, as well as the toils and dangers of war. The American mind was, therefore, frequently occupied at the _same time_, by the difficult and complicated duties of political and military life.

5. The revolution was conducted by men who had been born _free_, and whose sense of the blessings of liberty was of course more exquisite than if they had just emerged from a state of slavery.

6. The greatest part of the soldiers in the armies of the United States had family connections and property in the country.

7. The war was carried on by the Americans against a nation, to whom they had long been tied by the numerous obligations of consanguinity, laws, religion, commerce, language, interest, and a mutual sense of national glory. The resentments of the Americans of course rose, as is usual in all disputes, in proportion to the number and force of these ancient bonds of affection and union.

8. A predilection to a limited monarchy, as an essential part of a free and safe government, and an attachment to the reigning king of Great-Britain (with a very few exceptions), were universal in every part of the United States.

9. There was at one time a sudden dissolution of civil government in _all_, and of ecclesiastical establishments in several of the states.

10. The expences of the war were supported by means of a paper currency, which was continually depreciating.

From the action of each of these causes, and frequently from their combination in the same persons, effects might reasonably be expected, both upon the mind and body, which have seldom occurred; or if they have, I believe were never fully recorded in any age or country.

It might afford some useful instruction, to point out the influence of the military and political events of the revolution upon the understandings, passions, and morals of the citizens of the United States; but my business in the present inquiry, is only to take notice of the influence of those events upon the human body, through the medium of the mind.

I shall first mention the effects of the military, and secondly, of the political events of the revolution. The last must be considered in a two-fold view, accordingly as they affected the friends, or the enemies of the revolution.

I. In treating of the effects of the military events, I shall take notice, first, of the influence of _actual_ war, and, secondly, of the influence of the military life.

In the beginning of a battle, I have observed _thirst_ to be a very common sensation among both officers and soldiers. It occurred where no exercise, or action of the body, could have excited it.

Many officers have informed me, that after the first onset in a battle, they felt a glow of heat, so universal as to be perceptible in both their ears. This was the case, in a particular manner, in the battle of Princeton, on the third of January, in the year 1777, on which day the weather was remarkably cold.

A veteran colonel of a New-England regiment, whom I visited at Princeton, and who was wounded in the hand at the battle of Monmouth, on the 28th of June, 1778 (a day in which the mercury stood at 90° of Fahrenheit's thermometer), after describing his situation at the time he received his wound, concluded his story by remarking, that "fighting was hot work on a cold day, but much more so on a warm day." The many instances which appeared after that memorable battle, of soldiers who were found among the slain without any marks of wounds or violence upon their bodies, were probably occasioned by the heat excited in the body, by the emotions of the mind, being added to that of the atmosphere.

Soldiers bore operations of every kind immediately _after_ a battle, with much more fortitude than they did at _any time_ afterwards.

The effects of the military life upon the human body come next to be considered under this head.

In another place[53] I have mentioned three cases of pulmonary consumption being perfectly cured by the diet and hardships of a camp life.

[53] Page 204.

Doctor Blane, in his valuable observations on the diseases incident to seamen, ascribes the extraordinary healthiness of the British fleet in the month of April, 1782, to the effects produced on the spirit of the soldiers and seamen, by the victory obtained over the French fleet on the 12th of that month; and relates, upon the authority of Mr. Ives, an instance in the war between Great-Britain and the combined powers of France and Spain, in 1744, in which the scurvy, as well as other diseases, were checked by the prospect of a naval engagement.

The American army furnished an instance of the effects of victory upon the human mind, which may serve to establish the inferences from the facts related by Doctor Blane. The Philadelphia militia who joined the remains of General Washington's army, in December, 1776, and shared with them a few days afterwards in the capture of a large body of Hessians at Trenton, consisted of 1500 men, most of whom had been accustomed to the habits of a city life. These men slept in tents and barns, and sometimes in the open air during the usual colds of December and January; and yet there were but two instances of sickness, and only one of death, in that body of men in the course of nearly six weeks, in those winter months. This extraordinary healthiness of so great a number of men under such trying circumstances, can only be ascribed to the vigour infused into the human body by the victory of Trenton having produced insensibility to all the usual remote causes of diseases.

Militia officers and soldiers, who enjoyed good health during a campaign, were often affected by fevers and other diseases, as soon as they returned to their respective homes. I knew one instance of a militia captain, who was seized with convulsions the first night he lay on a feather bed, after sleeping several months on a mattrass, or upon the ground. These affections of the body appeared to be produced only by the sudden abstraction of that tone in the system which was excited by a sense of danger, and the other invigorating objects of a military life.

The NOSTALGIA of Doctor Cullen, or the _home-sickness_, was a frequent disease in the American army, more especially among the soldiers of the New-England states. But this disease was suspended by the superior action of the mind under the influence of the principles which governed common soldiers in the American army. Of this General Gates furnished me with a remarkable instance in 1776, soon after his return from the command of a large body of regular troops and militia at Ticonderoga. From the effects of the nostalgia, and the feebleness of the discipline, which was exercised over the militia, desertions were very frequent and numerous in his army, in the latter part of the campaign; and yet during the _three weeks_ in which the general expected every hour an attack to be made upon him by General Burgoyne, there was not a single desertion from his army, which consisted at that time of 10,000 men.

The patience, firmness, and magnanimity with which the officers and soldiers of the American army endured the complicated evils of hunger, cold, and nakedness, can only be ascribed to an insensibility of body produced by an uncommon tone of mind excited by the love of liberty and their country.

Before I proceed to the second general division of this subject, I shall take notice, that more instances of apoplexies occurred in the city of Philadelphia, in the winter of 1774-5, than had been known in former years. I should have hesitated in recording this fact, had I not found the observation supported by a fact of the same kind, and produced by a nearly similar cause, in the appendix to the practical works of Doctor Baglivi, professor of physic and anatomy at Rome. After a very wet season in the winter of 1694-5, he informs us, that "apoplexies displayed their rage; and perhaps (adds our author) that some part of this epidemic illness was owing to the universal grief and domestic care, occasioned by all Europe being engaged in a war. All commerce was disturbed, and all the avenues of peace blocked up, so that the strongest heart could scarcely bear the thoughts of it." The winter of 1774-5 was a period of uncommon anxiety among the citizens of America. Every countenance wore the marks of painful solicitude, for the event of a petition to the throne of Britain, which was to determine whether reconciliation, or a civil war, with all its terrible and distressing consequences, were to take place. The apoplectic fit, which deprived the world of the talents and virtues of Peyton Randolph, while he filled the chair of congress, in 1775, appeared to be occasioned in part by the pressure of the uncertainty of those great events upon his mind. To the name of this illustrious patriot, several others might be added, who were affected by the apoplexy in the same memorable year. At this time a difference of opinion upon the subject of the contest with Great-Britain, had scarcely taken place among the citizens of America.

II. The political events of the revolution produced different effects upon the human body, through the medium of the mind, according as they acted upon the friends or enemies of the revolution.

I shall first describe its effects upon the former class of citizens of the United States.

Many persons, of infirm and delicate habits, were restored to perfect health, by the change of place, or occupation, to which the war exposed them. This was the case in a more especial manner with hysterical women, who were much interested in the successful issue of the contest. The same effects of a civil war upon the hysteria, were observed by Doctor Cullen in Scotland, in the years 1745 and 1746. It may perhaps help to extend our ideas of the influence of the passions upon diseases, to add, that when either love, jealousy, grief, or even devotion, wholly engross the female mind, they seldom fail, in like manner, to cure or to suspend hysterical complaints.

An uncommon cheerfulness prevailed every where, among the friends of the revolution. Defeats, and even the loss of relations and property, were soon forgotten in the great objects of the war.

The population in the United States was more rapid from births during the war, than it had ever been in the same number of years since the settlement of the country.

I am disposed to ascribe this increase of births _chiefly_ to the quantity and extensive circulation of money, and to the facility of procuring the means of subsistence during the war, which favoured marriages among the labouring part of the people[54]. But I have sufficient documents to prove, that marriages were more fruitful than in former years, and that a considerable number of unfruitful marriages became fruitful during the war. In 1783, the year of the peace, there were several children born of parents who had lived many years together without issue.

[54] Wheat, which was sold before the war for seven shillings and
sixpence, was sold for several years _during_ the war for four,
and in some places for two and sixpence Pennsylvania currency
per bushel. Beggars of every description disappeared in the year
1776, and were seldom seen till near the close of the war.

Mr. Hume informs us, in his History of England, that some old people, upon hearing the news of the restoration of Charles II, died suddenly of joy. There was a time when I doubted the truth of this assertion; but I am now disposed to believe it, from having heard of a similar effect from an agreeable political event, in the course of the American revolution. The door-keeper of congress, an aged man, died suddenly, immediately after hearing of the capture of Lord Cornwallis' army. His death was universally ascribed to a violent emotion of political joy. This species of joy appears to be one of the strongest emotions that can agitate the human mind.

Perhaps the influence of that ardour in trade and speculation, which seized many of the friends of the revolution, and which was excited by the fallacious nominal amount of the paper money, should rather be considered as a disease, than as a passion. It unhinged the judgment, deposed the moral faculty, and filled the imagination, in many people, with airy and impracticable schemes of wealth and grandeur. Desultory manners, and a peculiar species of extempore conduct, were among its characteristic symptoms. It produced insensibility to cold, hunger, and danger. The trading towns, and in some instances the extremities of the United States, were frequently visited in a few hours or days by persons affected by this disease; and hence "to travel with the speed of a speculator," became a common saying in many parts of the country. This species of insanity (if I may be allowed to call it by that name) did not require the confinement of a bedlam to cure it, like the South-Sea madness described by Doctor Mead. Its remedies were the depreciation of the paper money, and the events of the peace.

The political events of the revolution produced upon its enemies very different effects from those which have been mentioned.

The hypochondriasis of Doctor Cullen occurred, in many instances, in persons of this description. In some of them, the terror and distress of the revolution brought on a true melancholia[55]. The causes which produced these diseases may be reduced to four heads. 1. The loss of former power or influence in government. 2. The destruction of the hierarchy of the English church in America. 3. The change in the habits of diet, and company, and manners, produced by the annihilation of just debts by means of depreciated paper money. And 4. The neglect, insults, and oppression, to which the loyalists were exposed, from individuals, and, in several instances, from the laws of some of the states.

[55] Insania partialis sine dyspepsia, of Doctor Cullen.

It was observed in South-Carolina, that several gentlemen who had protected their estates by swearing allegiance to the British government, died soon after the evacuation of Charleston by the British army. Their deaths were ascribed to the neglect with which they were treated by their ancient friends, who had adhered to the government of the United States. The disease was called, by the common people, the _protection fever_.

From the causes which produced this hypochondriasis, I have taken the liberty of distinguishing it by the name of _revolutiana_.

In some cases, this disease was rendered fatal by exile and confinement; and, in others, by those persons who were afflicted with it, seeking relief from spiritous liquors.

The termination of the war by the peace in 1783, did not terminate the American revolution. The minds of the citizens of the United States were wholly unprepared for their new situation. The excess of the passion for liberty, inflamed by the successful issue of the war, produced, in many people, opinions and conduct which could not be removed by reason nor restrained by government. For a while, they threatened to render abortive the goodness of heaven to the United States, in delivering them from the evils of slavery and war. The extensive influence which these opinions had upon the understandings, passions, and morals of many of the citizens of the United States, constituted a form of insanity, which I shall take the liberty of distinguishing by the name of _anarchia_.

I hope no offence will be given by the freedom of any of these remarks. An inquirer after philosophical truth should consider the passions of men in the same light that he does the laws of matter or motion. The friends and enemies of the American revolution must have been more, or less than men, if they could have sustained the magnitude and rapidity of the events that characterised it, without discovering some marks of human weakness, both in body and mind. Perhaps these weaknesses were permitted, that human nature might receive fresh honours in America, by the contending parties (whether produced by the controversies about independence or the national government) mutually forgiving each other, and uniting in plans of general order, and happiness.

AN INQUIRY

INTO

THE RELATION OF

_TASTES AND ALIMENTS_

TO EACH OTHER,

AND

INTO THE INFLUENCE OF THIS RELATION

UPON

HEALTH AND PLEASURE.

In entering upon this subject, I feel like the clown, who, after several unsuccessful attempts to play upon a violin, threw it hastily from him, exclaiming at the same time, that "there was music in it," but that he could not bring it out.

I shall endeavour, by a few brief remarks, to lay a foundation for more successful inquiries upon this difficult subject.

Attraction and repulsion seem to be the active principles of the universe. They pervade not only the greatest, but the minutest works of nature. Salts, earths, inflammable bodies, metals, and vegetables, have all their respective relations to each other. The order of these relations is so uniform, that it has been ascribed by some philosophers to a latent principle of intelligence pervading each of them.

Colours, odours, and sounds, have likewise their respective relations to each other. They become agreeable and disagreeable, only in proportion to the natural or unnatural combination which takes place between each of their different species.

It is remarkable, that the number of original colours and notes in music is exactly the same. All the variety in both, proceeds from the difference of combination. An arbitrary combination of them is by no means productive of pleasure. The relation which every colour and sound bear to each other, was as immutably established at the creation, as the order of the heavenly bodies, or as the relation of the objects of chemistry to each other.

But this relation is not confined to colours and sounds alone. It probably extends to the objects of human aliment. For example, bread and meat, meat and salt, the alkalescent meats and acescent vegetables, all harmonize with each other upon the tongue; while fish and flesh, butter and raw onions, fish and milk, when combined, are all offensive to a pure and healthy taste.

It would be agreeable to trace the analogy of sounds and tastes. They have both their flats and their sharps. They are both improved by the contrast of discords. Thus pepper, and other condiments (which are disagreeable when taken by themselves) enhance the relish of many of our aliments, and they are both delightful in proportion as they are simple in their composition. To illustrate this analogy by more examples from music, would lead us from the subject of the present inquiry.

It is observable that the tongue and the stomach, like instinct and reason, are, by nature, in unison with each other. One of those organs must always be disordered, when they disagree in a single article of aliment. When they both unite in articles of diet that were originally disagreeable, it is owing to a perversion in each of them, similar to that which takes place in the human mind, when both the moral faculty and the conscience lose their natural sensibility to virtue and vice.

Unfortunately for this part of science, the taste and the stomach are so much perverted in infancy and childhood by heterogeneous aliment, that it is difficult to tell what kinds, and mixtures of food are natural, and what are artificial. It is true, the system possesses a power of accommodating itself both to artificial food, and to the most discordant mixtures of that which is natural; but may we not reasonably suppose, that the system would preserve its natural strength and order much longer, if no such violence had been offered to it?

If the relation of aliments to each other follows the analogy of the objects of chemistry, then their union will be influenced by many external circumstances, such as heat and cold, dilution, concentration, rest, motion, and the addition of substances which promote unnatural, or destroy natural mixtures. This idea enlarges the field of inquiry before us, and leads us still further from facts and certainty upon this subject, but at the same time it does not preclude us from the hope of obtaining both; for every difficulty that arises out of this view of the subject, may be removed by observation and experiment.

I come now to apply these remarks to health and pleasure. I shall select only a few cases for this purpose; for if my principles be true, my readers cannot avoid discovering many other illustrations of them.

1. When an article of diet is grateful to the taste, and afterwards disagrees with the stomach, may it not be occasioned by some other kind of food, or by some drink being taken into the stomach, which refuses to unite with the offending article of diet?

2. May not the uneasiness which many persons feel after a moderate meal, arise from its having consisted of articles of aliment which were not related to each other?

3. May not the delicacy of stomach which sometimes occurs after the fortieth or forty-fifth year of human life, be occasioned by nature recovering her empire in the stomach, so as to require simplicity in diet, or such articles only of aliment as are related? May not this be the reason why most people, who have passed those periods of life, are unable to retain or to digest fish and flesh at the same time, and why they generally dine only upon one kind of food?

4. Is not the language of nature in favour of simplicity in diet, discovered by the avidity with which the luxurious and intemperate often seek relief from variety and satiety, by retreating to spring water for drink, and to bread and milk for aliment?

5. May not the reason why plentiful meals of fish, venison, oysters, beef, or mutton, when eaten alone, lie so easily in the stomach, and digest so speedily, be occasioned by no other food being taken with them? A pound, and even more, of the above articles, frequently oppress the system much less than half the quantity of heterogeneous aliments.

6. Does not the facility with which a due mixture of vegetable and animal food digests in the stomach, indicate the certainty of their relation to each other?

7. May not the peculiar good effects of a diet wholly vegetable, or animal, be occasioned by the more frequent and intimate relation of the articles of the same kingdoms to each other? And may not this be the reason why so few inconveniences are felt from the mixture of a variety of vegetables in the stomach?

8. May not the numerous acute and chronic diseases of the rich and luxurious, arise from heterogeneous aliments being distributed in a _diffused_, instead of a _mixed_ state, through every part of the body?

9. May not the many cures which are ascribed to certain articles of diet, be occasioned more by their being taken alone, than to any medicinal quality inherent in them? A diet of oysters in one instance, of strawberries in another, and of sugar of roses in many instances, has cured violent and dangerous diseases of the breast[56]. Grapes, according to Doctor Moore, when eaten in large quantities, have produced the same salutary effect. A milk diet, persisted in for several years, has cured the gout and epilepsy. I have seen many cases of dyspepsia cured by a simple diet of beef and mutton, and have heard of a well-attested case of a diet of veal alone having removed the same disease. Squashes, and turnips likewise, when taken by themselves, have cured that distressing complaint in the stomach. It has been removed even by milk, when taken by itself in a moderate quantity[57]. The further the body, and more especially the stomach, recede from health, the more this simplicity of diet becomes necessary. The appetite in these cases does not speak the language of uncorrupted nature. It frequently calls for various and improper aliment; but this is the effect of intemperance having produced an early breach between the taste and the stomach.

[56] Vansweiten, 1209. 3.

[57] Medical Observations and Inquiries, vol. VI. p. 310, 319.

Perhaps the extraordinary cures of obstinate diseases which are sometimes performed by persons not regularly educated in physic, may be occasioned by a long and steady perseverance in the use of a single article of the materia medica. Those chemical medicines which decompose each other, are not the only substances which defeat the intention of the prescriber. Galenical medicines, by combination, I believe, frequently produce effects that are of a compound and contrary nature to their original and simple qualities. This remark is capable of extensive application, but I quit it as a digression from the subject of this inquiry.