Chapter III: Part 3

Having, then consider’d these Medicines, I will suppose it granted me, that they are proper in this Case; I won’t say that they shall be Sufficient to Cure of themselves, (tho’ I don’t doubt but they may in some Constitutions do the Work themselves) but I will only suppose, that they do greatly dispose towards it, which _Postulatum_ will, I conceive, be readily granted me; I will suppose likewise, that Riding (the Exercise I propose in this Case) does likewise dispose towards a Cure, which _Postulatum_ will be granted too; I will suppose farther, that these two Courses are Compatible, and may be us’d together; as the Medicines help the Fluids, the Exercise helps both the Fluids and Solids; which _Postulatum_ cannot be deny’d me neither; what then naturally Results from this, but that they be both us’d in Conjunction? And is it not more than probable, that these two Methods joyn’d, shall effect that which neither of ’em can singly? Do not we see enough of this every Day in Natural Occurrences, where one, two or three things, indifferent in themselves, shall, when blended together, produce a valuable Effect, which none of ’em could alone? And shall these things be observ’d in lesser Arts, and be slighted when a Man’s Health is at Stake? Seeing we abound so in Compound Medicines, why may we not for once take up with a Compound Method of Cure, (if I may so speak) that is, if we cannot obtain Health by one sort of means alone, why may we not expect it from a Complication?

Thus I have run up these Arguments to a Head; I have shewn that the Medicines appropriated to this Case, ought to be very Mild and Temperate, upon the account of that less prevalent quality, there may be Hazard, lest they should not always prove equally effectual; and therefore to supply any such Defect, I substitute a most easie Natural Gymnastick Course, as a common Aid to the weakness of the Medicines, and an assistance to that part of the Oeconomy, which those Medicines can’t reach. Whether this is not most suitable to, and consistent with the even Tenour of Nature, tho’ it may not relish so much of the Magnificence of Art, I must submit to those who are best Judges; to me it seems to promise enough, and carry more Healing with it, than some things that are dignifi’d with the great Titles of _Gilead_ and _Peru_.

If after all there are any People who will think, I have taken too much upon me, in venturing to attack the _Balsamick_ Method, if they cannot think slightly of Medicines, which will give such present mitigation of a Cough, and which are so Fragrant and Costly, let ’em enjoy their Opinion, and persist in the use of them; and if they find ’em at any time not so effectual as they could desire, let ’em but superadd the Power of Exercise, and they will doubtless find ’em much improv’d; and if they come by that Means to succeed, I shall not envy their good Effects.

Besides these two main Indications, there is something more to be consider’d in the Cure of the Consumption; and that is, how we may obviate the Moisture of the Air; which is a very troublesome Enemy to Consumptive People, of what Constitution soever, who dare not make use of Generous Liquors to fence against it; for that Practice would be prejudicial upon another Account: Now what can be more Natural in this Case, than the raising the Spirits to resist this Moisture, by a gentle Motion of the whole Body, which at the same time, causes a greater Degree of Heat, and that equally diffus’d all over the Body, which must needs rarify in some measure, the moist Air, and besides, make the hot and acrimonious Particles in the Blood, supply the place of warm Internal Medicines, which in another Person would have been proper to have been given, to oppose the Moisture of the Air? Now this is much the same, that the Change of Air can effect in the Body of a Sick Person, for ’tis the equal Influence, the universal moderate Rarefaction of a warm Air, that makes it so beneficial, and if we will cast in the benefit of the Tension, which is caus’d by moderate Riding, together with the Equality of the Heat, it will appear to be very little short of what is usually expected from a Journey into a Foreign Air, and I could here give an Instance of a Gentleman, who, when he was in the South of _France_, found but little Relief, any longer than when he was on Horse-back; and who after his return to _England_, found that Riding supported him as much, as the Change of Air; So that upon the Consideration of the equal promoting of the insensible Perspiration, and the Benefit, which at the same time accrues to the Solid Parts, this Exercise which I have so much insisted on, may be allow’d to be almost, if not altogether, an Equivalent to a Warmer Climate.

_Lastly_, I shall urge but this one more Reason for this Exercise, which is not taken from a Natural, but a Prudential Consideration, from the particular Humour of most People in this Distemper, who are strangely inclin’d to think themselves in no great Danger, even tho’ the Distemper is far advanc’d; they don’t love to be told the Truth, tho’ it is ever so necessary; but an honest Physician is to them, as _Micaiah_ was to _Ahab_, he never has any thing good to say of ’em; they think they are strong enough in the Main; they’ll tell ye, they should be as well as ever, if their Scurvey Cough, or the weight on their Breast was but remov’d: Now the Genius of the Sick must be consider’d, and these People who have so good an Opinion of themselves, may in some Sense be indulg’d and wrought upon, to exert their Imaginary Strength in Gentle Riding, and then they may perhaps come to enjoy that which is real.

I might now proceed farther, to consider in what degree of this Distemper Riding will be beneficial, whether any thing is to be expected from it in the second and last State of it; but this would be to run out beyond my Design of Brevity; only I shall take Notice, that it is no rare thing to meet with Consumptions, without any Putrid Fever, or any Reason to believe an Ulcer in the Lungs, or perhaps so much as Tubercles, but a continual Hectick, and a precipitate Wast of Nature by the Direful Acrimony and ill Quality of the _Serum_, as Doctor _Benet_, in his _Theatrum Tabidorum_ observes, _Pag. 109._ _Tabidorum languor sine pulmonum aut visceris cujuslibet corruptelâ tacitâ vi obrepens Anglis infestissimus est, & nisi primis obediverit remediis (quod rarissimè evenit) funestus._ In this Case I can’t but be of Opinion, that Riding well manag’d would be serviceable, tho’ undertook very late, if there is any tolerable Measure of Strength left to put it in Practice.

I must here again repeat, that when I here speak of Riding, I understand the Habit of Riding, the want of which Distinction, has made it ineffectual to many a Man; He that in this Distemper above all others rides for his Health, must be like a _Tartar_, in a manner always on Horse-back, and then from a weak Condition, he may come to the Strength of a _Tartar_. He that would have his _Life for a Prey_, must hunt after it, and when once he finds his Enemy give way, must not leave off, but follow his Blow, till he subdue him beyond the Possibility of a Return. He that carries this Resolution with him, will I doubt not experience the Happy Effects of the good old Direction, Recipe _Caballum_; he will find that the _English_ Pad is the most noble Medium, to be made use of for a Recovery from a Distemper, which we in this Nation, have but too much reason by way of Eminence to stile _English_.

OF THE _DROPSIE_.

The Second Distemper which I shall consider as subject to these Measures, is one _Species_ of the _Dropsie_; that is, the _Anasarcous_ Kind, from which likewise I except those, which are attended with a hard Liver, or a remarkable Obstruction of some of the _Viscera_.

This kind of _Dropsie_, thus circumstantiated, does at first View, seem not to need the Assistance of any extraordinary means to help towards a Cure, it being the most Curable of all Dropsies; and we have daily Instances of its giving way to Common Medicines, nevertheless there are such exceptions in this most Favourable Case, as give trouble enough to a Physician sometimes, and requires more than usual Application; as for Instance; sometimes a Person happens to be brought so low by an Unseasonable Purge, that afterwards Diureticks and Corroboratives will have no effect upon him, but the Case becomes deplorable, without the Rupture of any _Lympheducts_ or other the like Difficulty.

_Secondly_, when People decline in Years, there are some extraordinary means requisite to make the Remedies exert themselves with like Success, as they do in Younger Persons.

_Thirdly_, in Hysterick Women it is difficult to carry off the load of Water by common means, without some such Method as I shall hereafter mention; because their Spirits are so low, that they can bear no considerable Evacuation.

_Fourthly_, when a Dropsie comes upon an _Asthmatick_ Person, there are particular Difficulties arise, and the singular Advantages of constant and gentle Exercise in this Case are universally known.

These four different Circumstances of this Distemper, may suffice to shew that I have Colour enough for my calling in the Gymnastick Method into this Case, and ’tis the first of the Exceptions, I mean the ill Effects, which sometimes follow upon the Use of Purgatives, which have chiefly occasion’d me to inquire, whether we ought in this plain Case, thus circumstantiated to halt between two Opinions, between Purgatives and Diureticks, without endeavouring to establish a certain Praxis upon Just Foundations.

There are none will deny, but Diureticks are the most proper and natural Remedies in this Case, if they would always succeed, because directed to the proper Emunctory, the Kidneys, and because they can go hand in hand, with the Corroborative Medicines to be given at the same time; I take it for granted therefore, that whenever Purgatives are us’d in this Case, it is because the Diureticks don’t take quick enough, or in order to carry off the load of _Serum_, that the Diureticks may the sooner display their good effects, because it will be alledg’d that the _Serum_ becomes so Ropy and Glutinous in the Passages and Capillary Parts, that the Diuretick cannot always act upon it. But tho’ this is granted, it will not suffice to warrant the Use of the stronger Purgatives, because their manner of Acting cannot agree with this Distemper, and because those difficulties objected, may be overcome by other means.

_First_, the very Nature of strong Purgers, makes against this Case, it seems very preposterous, to have recourse to such Deleterious Drugs, to those _Mortis Catapultæ_ (as _Ludovicus_ calls the _Esula’s_ and such like Purgatives) in Order to the Restoring an impoverish’d Blood; if they acted only by Stimulating the Intestines, something might be said; but since it is indisputable that they pass into the Blood, and act powerfully upon it, there is no doubt to be made, but they fuze and divide it, and break its Globules, and consequently make as much Water as they carry off, which is the very Reason why Sweating is laid aside, and Salivation, tho’ they both seem so proper to carry off Watery Humours; I know it may be alledg’d in Defence of these Medicaments, that the _36th_ and _37th Aphorisms_, of the _Second Section_ seem to imply, that a Sick Person would receive less Harm from ’em, than one that is in Health; but yet this will not excuse their Use in our Case, because tho’ the Viscousness of the _Serum_, may blunt the Particles of those Drugs for a time, and hinder ’em from working so quickly, yet when once they are throughly imbib’d, and begin to exert their Force, they ravage the very Principles of Life, and can by no means be fit for a Person in so low a condition. But admit that the Water is carry’d off by these means, the Blood will be left as poor at least as it was before the Dropsie first appear’d; and then how can we be sure the Waters will not rise again? Suppose an _Anasarca_ follows upon an _Hæmorrhage_, which is very common, and you draw off the Water by Purging; will not the Person be just in _Statu quo_, upon supposition that the Medicines in their working did not impair Nature? but that is not to be granted, because it is impossible to suppose, that such _Drastick_ Medicines, should not prey upon Nature, even while they are assisting her; and can we be assur’d that the Blood will not run into the same Colliquation it did before? Besides, may there not be some reason to suspect that the very quantity of the _Serum_, supposing it is not too Turgid indeed, may sometimes be serviceable, to the promoting the activity of the Diuretick, even as we find in the true _Ascites_, it is of some use in the Cavity of those Persons, because they often can’t spare it, without certain Ruine? We don’t know how much the confidence of the Fluid may conduce to the keeping its homogeneous Particles combin’d, and we ought to be very tender of doing any thing, that might tend to dissolve the _Crassamentum_, the Globules, which are as it were the very _Semen Sanguinis_ (if I may so speak); for how far Nature would endure such measures, before the Sanguification would be totally subverted, would require a Dissertation, longer than my Scope will permit; but that this is sometimes done is not improbable, and I take this to be the Case of a Young Fellow I knew, who falling into a slight Dropsie, goes to an _Empirick_ somewhere about _White-Chappel_, from whom he had a Dose of Pills, which gave him about 30 Stools, which sunk him so much that his Nails turn’d black, and he died in two or three days time; Here ’tis very likely the Signification was entirely extinct, and the Blood chang’d into a Preternatural Fluid, and all by the great Power of these Deleterious Drugs; and tho’ ’tis likely the Quack did not know the proper Dose of his Medicines, yet one would think, this was no more than what might be expected from Ten Grains of _Elaterium_, which yet has been allow’d by an Eminent Writer.

Besides the weak State of the Blood, the Ventricle is always more or less impair’d in this Distemper, and consequently unable to be put to bear the violent _Stimuli_ of the stronger Purgers, without Danger of having its Tone irrecoverably ruin’d.

It may likewise be Prudent to forbear Purging in this Case, left happily there should be some greater Obstruction in the Liver, than we are aware on, for then it might be follow’d with ill Consequences; ’tis true, if that Bowel is really _Schirrous_, it may be discern’d, or a great Tendency toward it, will shew it self sometimes in the Greeness and Virulency of the Bile mixt in the Excrements, together with other Indications; but a slight disorder there, is not always regarded, and Brick-colour’d turbid Urines are so common in all kind of Dropsies, that we may not discern that the Blood does abound too much with Bile, and so a Purge given at such a time may do a great deal of Mischief, for the Bile is of a light Nature in Comparison of the _Phlegm_, and moves easily, and no Man knows what he does when he rouzes it; I knew an ill accident happen once upon a Purge, given by a very Eminent Physician, to a Gentleman in a _Jaundice_, which put him into the most extravagant and fatal _Hypercatharsis_: thus bold Administrations to such weak Subjects, may be attended with Tragical Accidents, but the milder and gradual measures may succeed, without such dangerous Risks, if we consider what have been the Difficulties which have lay in the way, and hindred the Operation of our Diureticks.

The ill Success of our Diuretick Method in this Distemper, is very much owing to our giving those Medicines in so small a Quantity, and to our not changing ’em for some of a quite different Nature, when one sort us’d pertinaciously does not take; that the quantity must be encreas’d, there needs no better Argument, than what is brought for the use of Purgers; for if the Blood can dispense with the Particles of a Purgative, it will certainly bear a great quantity of those which are Diuretick only. What Wonders has that Golden Remedy of _Pythagoras_ done, the _Acetum Scylliticum_, when given to a proper quantity? And what may not be expected from the _Sal Succini_, which may be given to a Dose large enough to irritate the Fibres of the Stomach, and in some measure supply the place of a gentle Purger; but when it is come into the Blood it may prove Cordial as well as inciding? And now I am speaking of augmenting the Quantity of our Diureticks, I can here affirm a very strange Effect that follow’d upon an excessive Dose of _Millepedes_ in an odd kind of a Rheumatick Case, for the Cure of which, several things had been try’d in Vain, by very good Advice; the _Millepedes_ were given to a quantity scarce credible, to several Ounces, and gave a Relief in a little time that exceeded all expectation. This with other instances something of the like nature, every where to be met with, may convince, us that we ought to advance the quantity of these Medicines, to which if we apply the Use of Exercise, the highest Advantages may be expected: For to grant as much as the favourers of the Purging Method can demand, that by reason of the foremention’d Ropiness of the _Serum_, the Diureticks and Chalybeates will but distend the parts, and make the Juices grow Turgid. Is there no way to remove the Dam, but by shaking all Nature at the same time? Must we blow up the House to get the Enemy out? To what purpose do we talk so much of the Animal Oeconomy, if we reduce its Rules to Practice no more than we do? We are taught the Benefit arising from the Constriction of the Muscles upon the Vessels; and can there be any Case which does more apparently call for it than this? When it is hazardous to attempt by inward Violence to dislodge the Viscous Concretions, certainly it is high time to do it by Muscular Force. This _Hippocrates_ seems to be experimentally convinc’d of, by his frequent inculcating the Use of Exercises in this Distemper, Δεῖ ταλαιπωρέειν _you must labour_, is his constant Expression, whenever he speaks of the Dropsie; which, whoever considers the Conciseness that is in all the Writings of that Great Man, will be apt to imagine that it carries its Weight with it, and implies the absolute necessity of acting upon the Lentor of the Phlegm, by the playing of the Muscles. Besides Exercise will help to restore the Tone of the Parts, which is sometimes spoil’d by too great a Distension, even so much as to be in a manner benum’d, which _Helmont_ seems to lay much stress on, when he, according to his odd fantastick way, calls it the _Anger of the Archæus_, that won’t let the Waters pass; and if there is this kind of Spasmodick Affect in the Parts leading to the Kidneys, then certainly there is as much Reason for one in a Dropsie to get into a Coach upon his taking his Medicines, that the frequent jolting may assist their Operation, as there is for one in a Fit of the Gravel so to do. The Heat that is acquir’d by the Motion of the Body, must needs comfort the Parts, and rarifie a great deal of the Moisture, so that it may the more easily pass the Membranes, as they are dilated by Exercise; and if we can by squeezing, make Water pass through Leather, the whole Skin dry’d and prepar’d, may it not much more easily pass the Membranes of a living Animal, when work’d and stretch’d by Motion, and assisted by the Warmth which that Motion produces? These may be thought little things by some, but they will be found to be of great Consequence; by such minute Measures, Nature can produce great Effects; and by a Neglect of these things, many a great Life has been lost, in Dependence upon something of a greater Name, that has had no Relation to the Genuine proceedings of Nature.

These are some of the Reasons which have convinc’d me of the Preference of the Diuretick Course, and which I think can’t be overthrown, by all the Examples of the Success of Purgers, because if we compute the Ill Effects of ’em likewise, and set ’em to balance the good, the very Cures done by ’em, will seem but as so many _Splendida Peccata_. We ought not hastily to quit safe Means for those which are dangerous, only because they are a little more expeditious; when a Case is within our Reach, we ought to Establish our Prognosticks upon sure ground, tho’ they may not be so quick as could be wish’d; we have other Dropsies that are dubious enough, but in this Case we ought to study to bring things to a certainty as much as possible; which how can we do unless our Methods are Uniform? It behoves the Patrons of Purgatives to assign some certain Rule, to render the Use of ’em alwayes safe, which seems impossible to be done; and it behoves those who are for insisting on Diureticks, to find out some such Measures, as may make these milder Medicines always Efficacious; which is what I have been attempting to do; and which, if I don’t flatter my self, I think I have made to appear plain and obvious; for if we can’t arrive at some comfortable certainty in this Case, I don’t know in what we can do so; for we are so happy as to have those things as will certainly act upon such a Crasis of the Blood, as will revive and enrich it, when decay’d, tho’ not always in the like space of time; and when they act too slowly, we can enforce their Virtue, by these ways I have been speaking of.

These things are no Figment of mine, they have been the Practice of Ancient Times, and are so natural a Result from a due Consideration of the Animal Oeconomy, that I cannot enough wonder that in so many Discourses upon those Fundamental Rules, there has been so little Notice taken of the Effects of the Motion of the whole individual, as superinduc’d to the internal Motions, that make up the Oeconomy; for if this had been duly regarded, it could not but have been reduc’d to Practice, and apply’d particularly to the Cure of this Distemper.

_Lastly_, I know these are hard Sayings to some People, who send for a Physician, as for one that deals in Charms, and can remove all their Afflictions, while they are wholly Passive; and they would take it very ill that they should be compell’d to a sort of Labour, while they carry about ’em a Load in their Limbs; but yet for all this, Nature will be Nature still; and if this be her Voice it must be obey’d. He that is in a Dropsie ought to be Alarm’d, and look upon himself as in something the like Case with those Criminals whom the _Dutch_, upon their refusing to Work, confine to a Cellar, and let the Water in upon ’em, that they may be in a Necessity either of Pumping or Drowning. And I believe there are but few, but who, upon their being convinc’d of the real and surprising Benefit of these Means, would readily undergo the Fatigue of ’em; and things may be so manag’d, that Exercise may not be so troublesome as the Sick imagine; an easie Pad will quickly grow familiar; and where the Legs happen to be so very much distended, that there may be some danger, lest the Skin should be rub’d off, a Chaise may serve the turn.

OF THE _Hypochondriacal DISTEMPER_.

The third and last Case, which I shall expresly consider, is the _Hysterick_ or _Hypochondriacal_ Case; in the Cure of which the several Exercises, which I shall hereafter Recommend, may all be us’d. This Distemper falls the most under a Gymnastick Method, because the least proper to be treated with much Internal Physick; this is a Distemper which will not drive, as we say, but if kindly treated will lead, that is, will not be expell’d by Purging, Bleeding, Sweating or the like, but must be treated by more gentle and leisurely Methods; ’tis a Distemper of the Spirits, and the Vessels which immediately convey ’em; and therefore those means by which they are more immediately affected, are the most likely to prove beneficial. Here it is, if ever, strictly true, that a little Matter gives the turn, but then that little matter must be equally apply’d; we must give an equal lift to all the Parts of the Oeconomy at the same time, we must not apply to the Fluids, and neglect the Solids. ’Tis the want of this Distinction, which I take to be the Ground of all our mistakes in the Cure of this Distemper; we cure but half the Man, When I meet with a Languid Hysterick Pulse, I can easily raise it, and give a full Beat to the Artery, by Anti-Hysterick Medicines; but then what becomes of the Nerves, they are not much help’d by this, But sometimes impair’d by it? but then let the same Person have Recourse to some moderate Exercise, his Pulse shall rife as high as upon the use of Internals, but with this Difference, that the Nerves as well as the Blood partake of the Benefit. For we may distinguish between this natural advance of the Bodily heat, which is procur’d by Exercises, and that which is acquir’d by Medicines, just as we may between the Effects of the Kindly Heat of the Sun, and those of an Artificial Fire: Now in the matter of the Vegetation of Plants, and the Management of some sorts of nicer Workmanship, tho’ the greatest Care and Industry be us’d to raise a gentle heat, which to our Senses and even to the Measure of the Thermometer, may seem equal to that of the Sun, yet it shall never be able to produce the same exquisite effects, as the heat of the Sun does. And so we see in this Case the mildest and seemingly most agreeable Gumms prove Purgers to some of these People, others again can’t bear _Castor_, without some troublesome inconveniences; and how much soever some People may be Rapt up with their _Sal Volatile_, and such like Preparations, I can perhaps give an instance of more wonderful Relief given in this Case, by a more Common Cordial, than ever those splendid Medicines could produce; it may not be amiss to relate it in this place, because it serves to illustrate my Design in shewing that nothing that has the least seeming Violence in it, or rather that nothing, which is not very mild and agreeable to Nature, can be of very great moment in the Cure of this Distemper. The Instance then I mean, was communicated to me by an Eminent Physician, and very Learned Writer, and is this; He was call’d to see a Maid which had been severely Tormented with Hysterick Fits for several days, and had taken plenty of the Remedies usual in that Case, without any effect; upon which he was resolv’d to try, what a good large Dose of a true generous Wine would do, considering she was a Servant, and consequently could not be suppos’d to be accustom’d to that Liquor, which would have render’d his attempt fruitless; he therefore prescrib’d some Pouders of no Efficacy, to obviate the Phancy of the By-standers, and order’d the Apothecary to ply her with some Wine of his own procuring, that he could depend upon, till she had taken a quantity, which to her might be reckon’d very large; this succeeded like a Charm, after a good Sleep, she was freed of all her terrible Symptoms the next Morning, tho’ before she could scarce stir her head from the Pillow, but she fell into a Fit. And I have twice had the Occasion, to see something of the like nature my self; the first was, where a large Dose of Wine took off some very ill Symptoms, occasion’d by strong Purgers, erroneously repeated in a certain Nervous Case. But the Person had not been us’d to drink Wine, otherwise it could not have produc’d such a happy effect. I instance in these things only to shew, that the Remedies which are most proper and adequate to this Case, must be such as have something of an inimitable Mediocrity in ’em; and that Exercises do produce Alterations in the Body, which resemble the effects of such a singular and Noble Mean, is not improbable, in regard they act so equally (as I observ’d before) both upon the Solids and Fluids. And one would think the Ill Success of any thing, but like Violence, should lead us to some such Measures as these. One would be apt to think that when a Distemper, which carries as little, or may be, the least danger of Life in it, of any whatsoever, tho’ so very troublesome, when this nevertheless becomes one of the most difficult to be perfectly rooted out, one would think, I say, that this odd Circumstance, so like to Contradiction, should prompt us to look out for the real Reason of it.

Upon these Considerations I can’t but admire, that the same Administrations, or with very little difference, (excepting the Chalybeates which may be allow’d in both Cases) are thought proper for Temperate Women, and Men of Intemperance, when they happen to fall into the Hypochondriacal Affect, as is frequently enough known; one would think that when the Disorder in these latter is owing to the excess of a Liquor, both wholsom enough and Cordial enough in it self, which by its too frequent use has relax’d the Nerves, and consequently impair’d the Spirits, there should be little likelyhood it should be remov’d, and taken off by hot Medicines in a Solid form, which perhaps don’t differ so much as most People imagine, in their real intrinsick Energy from that Noble Liquid, to which these Gentlemen owe their Malady; I say, one would think that some such surmises as these, should naturally lead us to an immediate attempt, upon the parts affected, _viz._ the Nerves, which must be done by means suitable to ’em, that is by Exercise.

Wherever there is a Dejection of the Mind, and a Propensity to Phantastick and Imaginary Fears, there is reason to suspect the Solids, that is, the Nerves are more in fault than we think for; we may consider that when a Man is Drunk, he seldom loses his intellectual Faculties to any great degree, till the Nerves are quite stress’d with the Load of Wine, and his Feet go commonly before his Reason; and if this were a proper place, perhaps, I could shew some Reasons for us to suspect the same, in the Deliriums of People in a Feaver, that the intense heat must first evidently impair the whole body of the Nerves, before the Understanding will be quite lost. We don’t know what a great deal of Rotation and irregular Agitation the Spirits strictly taken will bear, without any Damage receiv’d; but when the Nerves, the Container of those Spirits, are considerably affected, the Spirits contain’d must partake of the Mischief. We know but little of that inconceivable connexion of Soul and Body, but the wonderful Bond of Union, seems to terminate very much in the Fibre. For we may observe, that those Poisonous Vegetables which intoxicate, and attack the Rational Faculty, do chiefly display their Power on the Nerves, ’tis in their very Nature, and in the least quantity to hurt the Nerves; and when Wine, tho’ in its Quality most agreeable, is by the Quantity and Repetition of it, made to be prejudicial to the Nervous System, I can’t imagine, how other Cordial Medicines, which must still in some Measure keep up the Stress upon the weakned Nerves can be the adequate Remedy of this Disease, but that the Nerves, must be assisted after their own way, after a manner suitable to their Nature, that is by Exercises; for it is, and ever will be one of the Properties of a Fibre, to be the stronger for Motion, the better for wearing; and it is but a Law of Nature, arising from the Necessity of the Constitution, that while the Fluids are continually wasting and running off the faster, for the Motion of the whole Individual, the other part of the Constitution, the Solids, the Fibres should by the same Means reap some Advantages proper, and in some measure sufficient to Balance the Consequences of such a _Dispendium_.

All this receives certain weight from the Argument which is so Naturally suggested to us, by the familiar and daily Observations, which every one cannot but make on the Health of the Poorer sort of People, especially their immunity from this Distemper. That it is matter of wonder that the Spasms, the Tremors, the Shiverings, the Watchings, and all the very numerous Plagues of an Hysterick Person, should not be able to rouze People into a Quest of Health, upon Measures suitable to the Causes of things; that such Painful experience should not animate ’em, into a Resolution to exchange the Pains of a sedentary, for the Indolence at least, not to say, the Pleasures of an Active Life. I am confident no one could forbear making these Inferences, and reducing ’em to practice, who has been any considerable time infested with this Distemper, were it not for the present Comfort and false Hope, which are conceiv’d from some Palliative Remedies, in too much use in this Case; I mean Vinous Spirits, and Compositions Distill’d upon ’em, which because in the beginning of this Distemper, they are found to be comfortable and really useful, entice People to have recourse to the use of ’em, oftner than they ought to do, and in time seduce ’em so much by that Delusive flash of Ease, which they give in the first Moments of their Drinking, that they cannot have a due Regard to the Evil Consequences of such a Practice; these Liquors prove a meet Charm, they creep into the Understanding, and teach People to impose upon themselves, and fansie Excuses for the use of ’em, till they come to be so blinded as to think that Health it self, is scarce an equivalent for the Pleasures which must be deny’d, in the Abstinence from ’em. They who have brought themselves to such a Custom, are not unlike some of our Debtors, who after they have been some time in a Prison, and learn’d the way, of living an Idle Life upon other Folks Cost, tho’ under Confinement, they lose all sense of Liberty, and never desire to subsist again, upon the severe Conditions of Industry and Labour; and so those who have learn’d to sip of this Spirituous _Lethe_, quite forget the value of Health and Strength; they can drown their Vapours, blunt their Pains, and rub on without great danger a good while, and therefore as for brisk Exercise, the Cold Bath, and the like, they desire to be excus’d; there’s too much Danger in the Practice, there’s a _Lyon in the Way_; and thus a sickly complaining Life they lead, because they will not take Courage, to use the Just endeavours after a real State of Health. These I take to be some of the Reasons, why this Distemper is so seldom totally extirpated, and is become the _Opprobrium_ both of the Patient and Physician; for else it would be impossible, that People should generally resist the Consequence of that Observation which I hinted before: For if the Labour of the Poor generally secures ’em from this Distemper, and if this Distemper, whenever it seizes, is of so nice and tender a Nature, that it will scarce allow of any of the common Methods us’d in the Cure of other Distempers, certainly it behoves the Persons so griev’d, to try whether those Means which are Preservative to others, may not prove Curative to them; which, by reason that the Subject of the Distemper, _viz._ the Spirits and Nerves are primarily affected by Exercise, proves highly probable. For why there should be such dependance on Internals universally, and even in this Case, I can’t see; to me it seems almost as Ridiculous, as if a Workman should use but one sort of Tool in working on Wood, Stone, Brass, and all other Materials.

I need not here take Notice of any of the particular Symptoms of this variable Disease, they all being liable to the same Regimen; I have already in another place hinted what Relief may be procur’d by this Method in the Hysterick Colick, and in the obstinate Watchings, which will scarce submit to the use of _Laudanum_, or at least without ill Consequences. Therefore I shall conclude they all fall under the Power of a Resolute COURSE of EXERCISE.

The Exercises most proper here are _Riding_, and the use of the _Cold Bath_; the first prepares for the second; which Rule if some People, who are the most weakly, wou’d observe, they might secure themselves, from some of those few Accidents that have befel the too rash entrance into the Cold Bath. Instead of Riding on horse-back, Women may take a Chaise, which will allow of swift Motion, and comes little short of the Horse for Agitation of the Body; tho’ I can’t see any breach of _Decorum_, if a Lady, attended with a Servant, should ride on Horse-back daily for Health, if she like it best; as for those, who upon the Account of their being very Fat, have some Reason to be cautious, how they go into the Cold Bath, lest some Apoplectick Symptoms should ensue, they may have recourse to another of those Exercises, which I shall treat of, _viz._ the use of the _Brush_, or _Chafing_, which if us’d in good earnest, will not prove so trivial as perhaps some People imagine it to be.

These are the Chief Exercises which I would recommend in this Case, and which if us’d with Prudence and Application, I doubt not are able to effect a compleat and Eradicative Cure of this Distemper, as certainly as more violent internal Means are expected to succeed in any other Case, the Spirits and Nerves being not so much more untractable, than the Blood and Humours, if treated after a manner suitable to their Nature.

What I have said of these three Cases, may serve to illustrate the necessity of this Method in some few other Cases, which I need only Name; as the _Scorbutick Rheumatism_, which being a Nervous Case, will admit of the three Exercises I have mention’d, which if strenuously put in Practice at proper Seasons, will do Wonders in the removing of those Pains. The _Nervous Atrophy_ is another Case, which may be remov’d by a Gymnastick Method, when all the Pompous Internal Medicines will not avail.

_Lastly_, there is one more Case, to which Riding seems to be in a peculiar manner appropriated, and that is, that Decay of Nature which is occasion’d by Passions of the Mind, which we commonly call, Breaking the Heart; here the Spirits are broke, and ruined by the stress of Thought, the Mind drinks up the Vital Fluids, and the Ravage proceeds so fast, that nothing can avail, but what can in some Measure interrupt the Eagerness of Thought, and repair in Proportion to the wast of the Spirits, which Riding seems most likely to do, because it gives an Alacrity beyond that of Wine; because the Briskness of the Motion, must take a Man off from close thinking, and such Exercise continued long, even to some Journeys, must by Tiring incline to Rest, and break off those voluntary Wakings and anxious Thoughts, which are so pernicious; and if some intervals of Ease can be gain’d in this Case, there is hopes that Reason or Religion may take place, and the Passions may be laid: For ’tis the first Fury that is the most Dangerous and Violent; if that can be manag’d, the Point is gain’d, and there is nothing like Hurrying the Body, to divert the Hurry of the Mind.

These are most of, if not all, the Cases which fall under the Power of Exercise as Curative; as for the Benefit which may be obtain’d by Exercise, in the Gravel, the Gout, and the like, it is purely Palliative, and therefore out of the Scope of my intention in this Treatise: I shall now proceed to consider briefly, those several Sorts of Exercise, which seem proper to my Design.

And here I shall not insist upon the various Exercises of the Ancients, or all those in Use now in our Days, but shall make choice of but a few, that seem most Compatible with the Weakness and Infirmities of Sick People, and the particular Circumstances of those Distempers which I have already mention’d, and I shall begin with the chief of ’em, which is that of RIDING.

OF THE EXERCISE OF RIDING.

Upon several Accounts, this may be esteem’d the best and Noblest of all _Exercises_ for a Sick Person; whether we consider it with Respect to the Body or the Mind; if we Enquire after what manner it affects the Body, we shall find that it is a kind of mixt Exercise, partly _Active_ and partly _Passive_; the lower parts of the Body, being in some measure employ’d, while the upper parts are almost wholly Remiss or Relax’d; nay, where a Man is easie, is sure of his Horse, and rides loose, there is very little Action on his Part, but he may give himself to be as careless almost as if he were Seated on a Moving Chair; so that he may be said to be Exercis’d rather than to Exercise himself; which makes the Case widely different from almost all other sorts of Exercise, as Walking, Running, Stooping, or the like; all which require some Labour, and consequently more Strength for their Performance; in all which, the Muscular Parts must be put to some Stress, and some of the Secretory Vessels made to throw off too much, while others throw off too little; whereas in Riding, the Parts being incomparably more relax’d, there is a better Disposition towards an equal Secretion of the Morbisick Particles, and a less Expence of the Animal Spirits, the chief Agents in all regular Secretions; so that a Sick Person may by this means be greatly reliev’d and not tir’d, whereas by other more violent ones, it is possible he may be tir’d and not reliev’d.

As for the Parts which are more immediately acted upon by this Exercise; it is very plain they are the whole Contents of the Lower Belly, so that the Glands of the _Mesentery_ and the Intestines, so frequently accus’d of Obstructions, may in a special manner be clear’d, and their Tone recovered by such repeated Agitation; which is a thing so manifest and allow’d, that it would be needless to multiply Words in the explaining of it. But there is another sort of Assistance communicated to the Intestines, which is not so much heeded, and that is the great Alteration, which is made by this Agitation, in some of the Morbifick Particles, as they come to be squeez’d out of their several Glands into the Intestines, which in the time of Riding is doubtless in a much greater quantity than at other times. These Particles must not be suppos’d to be barely carryed off as Excrementitious, but to undergo a Change in their Texture, to be several times in a manner Cohobated, from Acid and Acrimonious, to be Volatiliz’d, and in some measure render’d inflammable; that there is some such Alteration made in the more liquid part of the Contents of the Intestines, before they come to grow hard in a true State of Health is easie to prove, and I believe agreed on by most Enquirers into the Oeconomy of Nature, and that there is some Defect in these Operations of the Bowels, in some sick People, is evident from the Consistence, Smell, and other Qualities of these Contents, different from what they are found in a State of Health; and that this Defect may be remov’d by this Exercise, seems not improbable, if we consider how immediately Riding affects those parts, that it acts as a Topick, by those infinite Succussions coming close upon one another, which must needs cause a greater Heat than ordinarily, and a better Mixture of some of the Similar Particles, and a Rarefaction of others, which after they are thus differently Modefi’d and alter’d, are many of ’em as it were chaf’d in again by that continual Agitation, and the Steam of their inflammable Parts is of Use, to keep Nature even under the Exercise; that there is something like this to be observ’d in the actions of the Bowels might be confirm’d, by what Glysters are known to do. I would not willingly verge towards the Fraud of an Hypothesis; I may be allow’d to have had some more than Common Occasion, to put me upon making these Observations, having some time ago been so unhappy as to labour under as severe a Flux, as perhaps ever was known, which held me about a Year and a Half, attended with Vomitings, and most unsupportable Nervous Symptoms; during all which time nothing reliev’d me, in the greatest Paroxisms of it, like gentle Riding, in so much that at last I was forc’d to be in a manner always on Horseback, to have the Pressure on my Bowels rebated, and my Spirits a little refresh’d. The Comfort which I found by that means, I think must be attributed to some such _Phænomena_ as I have above mention’d; for tho’ I will grant, that Riding was more beneficial to me under those Circumstances, than it would be to another, because of those Nervous Symptoms; yet how Particles so exquisitely Pungent and Acrimonious, should be retain’d and blunted and made useful, as appears from the Evil Consequences of too many Evacuations; how this should come about, but after such a manner as I have above hinted, I cannot understand; ’tis easie for those who think in hast and superficially, to be deceiv’d with the first appearance of things; but when once Men are calm enough, or under a Necessity to think closer, they are more likely to come to the Truth of such _Phænomena_ as these; and to those who do allow themselves to deliberate before they are Positive, I doubt not but what I have asserted, will appear reasonable; and perhaps I should not be so much out of the way, if I should add, that some of the _Stercoraceous_ parts of the Contents of the Intestines, are not in a strict Sence to be reckon’d Excrementitious or useless, since tho’ I don’t believe Digestion is perform’d by Putrefaction, yet I believe Putrefaction is a great Medium for the opening of Bodies, and the extracting inflammable Parts out of ’em; as we see a little Greenish _Hay_, when it comes to be Putrefi’d, shall become inflammable; and there being inflammable Particles in the Intestines, ’tis probable they may owe their Origine to some such Cause, and not to the first Chylification in the Ventricle. I would not be thought to bring these Reasons, as if I believ’d Riding would Cure a Flux, I don’t believe any such thing, unless upon some very singular Circumstances, and therefore I have not plac’d it among those Distempers, which appear to be Curable by Exercise; but I only draw this Consequence from the Palliative Relief, which Riding will afford in the time of a long Flux, that some pernicious and disagreeable Particles, may receive such an Alteration while in the Intestines, as to become fit to be re-absorb’d by the several Vessels of those parts, and convey’d with great Advantage into the Blood again, which is making things to go on in a Round towards a Cure; Nature her self doing the Work, without forcible Evacuations, which tho’ never so gentle in some fine Constitutions, can scarce be born, and without much Physick, the very Morbifick Matter being so alter’d and dispos’d in one part of the Body, as to be useful in another. I have insisted the longer on this Point, that I might make it as plain as possible, because I think it is of so great Moment in some Distempers and some Constitutions.

What relates to the Breast, I have had occasion to Explain before; and for the Head, tho’ I can’t say it is immediately affected by this Exercise as the Lower Belly is, yet there is one Benefit accrues to it from Riding, which by reason of the Disuse of Exercise in Cases of Sickness, is not taken Notice of, and it is this, the great inclination to Sleep, which a Sick Man finds if he lies down on his Bed as soon as he comes off his Horse; for as the Motion of a Coach does more or less dispose all People to Sleep, and the swifter it goes, the more we are inclin’d to Doze; So the Motion of a Horse being swifter, and the Posture relax’d as to the Head and upper Parts, tho’ a Man does not perceive any thing of such an inclination, while he is Riding and upon his Guard, without any thing to lean on, yet there is so much of the Impression of that Motion remains upon him, for sometime after he lights off his Horse, that if he throws himself presently upon his Bed, especially if he drinks some small Draught of wholsom Ale or Wine first, he will quickly be in a Sleep, which upon several Accounts must then be very Beneficial; this is a Truth so certain and so valuable to distressed, infirm People, whose Nights are often more troublesome than the Days, that it is a wonder what should keep Men from attending to Nature, and falling into such just Measures that Art it self cannot afford. What can be more applicable to all the Circumstances of Consumptive People, than after that by Moderate Riding, they have dispos’d the Humours for each Secretion, they should by such short and Refreshing Sleeps compleat those Secretions? When moreover by these Means, they may be enabled to deny themselves those latter or Morning Sleeps, in which they are so apt to run into Colliquations; I know some may please to be so witty as to call this Nursery, rather than a Management worthy of a Physician; but yet I will appeal to any that are Sober, Calm, and free from Prejudice, whether if they allow that this Exercise, does dispose to Sleep as I affirm, upon this Supposal, any thing can more exactly hit the miserable Circumstances of those Persons. To the Sick, these little things are of great Moment, and in such seemingly little things as these, the Accurate Management of the Ancients consisted, by which they were sometimes enabled to accomplish, that which we, for want of those Measures, do sometimes fall short of.