A view of ehe [sic] science of life; on the principles established in the Elements of medicine, of the late celebrated John Brown, M.D. With an attempt to correct some important errors of that work; and cases in illustration, chiefly selected from the records of their practice, at the General Hospital, at Calcutta
Yates, William, active 1797
he mt os 5 Pec reieacy . - * ee abate ai see eee = cere a cies igs mieten ae ; pean Je nee eee she oe alt oem oa oes zy ace are, Sees Ber Riri ay pee oer as me Pherae s be Peeve pc phe etary ; Soken te 42 Acpwe dee Neeias Eee RRR AORTA ag ASIST SS RE a ee tno ee een eet er sorer + ait? SS eS . Oe ee ee ee a ie = . = . 2 " : . 4 * G onan ; bigots A ~ <a hale | a aes wif Peas hace boris 0 : yy ‘ ao om ”, =) at ie. = ~ a a he ‘ os ee uit ae ¥ Rte. Bet - i i Lay a s 9 ius ‘ aK ree ; ie = a8 Ry eat Nz Dy hy oe, big rear tui oe e (hie ie: A Vd & Ww SCIENCE*LIFE; ON THE PRINCIPLES ESTABLISHED \ IN THE ELEMENTS » MEDICINE) — OF THE LATE CELERRATED YOHN BROWN, M. D. WITH AN ATTEMPT TO CORRECT SOME IMPORTANT ERRORS OF THAT WOKK 5 \ AND CASES IN ILLUSTRATION, CHIEFLY SELECTED FROM THE RECORDS OF THEIR PRACTICE, AT THE GENERAL HOSPITAL, AT CALCUTTA. BY WILLIAM YATES & CHARLES MACLEAN. «“ Tuere are fome mcedern PraCtioners, who declaim againft ‘ medical Theory, in general, not confidering, that to think ** is to theorife ; and that no one can direct a Method of «* Cureto a Perfon labouring under Difeafe, without think. ‘ ing,—that is without theorifing ; and happy, therefore, ‘ isthe Patient, whofe Phyfician pofleffes the beft Theory.” na an a DARWIN’S ZOONOMIA.—PREFACE, P. 2 | JObitadelphia ; et ‘1797: ae i 4 PREFACE. Hofpital, at Calcutta, and having by Chance difcovered, that each of us entertained a De- fign of Attempting to promulgate the Doétrine of Brown, with fome modifications, in India; we thought it might be more conducive to the Endin View, to confider the Subject conjointly.—The Refult is now fubmitted to the Public. © WILLIAM. YATES. CHARLES MACLEAN. “ j ay 2. Pate : ; Di Psa SS . P et, ts oe & iw pte |. ADVERTISEMENT: H E who abandons Principles in Deference to po- pular clamour, and he who perfeveres in Error in bight of Conviction, may indeed obtain a momentary Celebrity ; but they are equally unqualified ya age Promotion of Science. As Truth, not an indifcriminate Affertion of any Doctrine, is the Object of this Publication, Mem- bers of the Profejfion, and others who may be fo in- clined, are invited to communicate Faéts, or Olbfer- : vations, whether they may tend to confirm, or refute the Principles which it avows. a Lhe Communications thus received, will be pub- | : lifbed, with Comments, with or without the Name ; of the Author, as may be moft agreeable to himfelf. ec Papers on this fubject, addrefed to Mr. Mac- LEAN, to Meffi’rs Tuomson & Ferris, Printers, Calcutta, or the Publi ifher, veer anh will ia ats tended to. VAat eoe pies ** * a a i . . sin ( . 7” e ; ry fs N fe SIR mee SEEN ioe) ees ets Ae ; won NE ea Weds oa Tee SR ee Tn ee a ane gee Moe ae ae eae at be WAS Ee 1 ‘ Wi a ~ Sioa i pO ae ey Viera’ suey s —) INDEX. nt Page EXCITABILITY, what, a alle 29 —— Accumulation of, : 30 ___ Middle or healthy flate of, 30 Exhauttion of, r ue 30 EXCITEMEN [ what, : - - =n a _____—. Exceffive does not exift, 4 46 EXHAUSTION, increafed by the abftraction of flimuli, 42 INFLAMMATION, always depends on a ftate of de- bility, direct or indirect, a 48 Cure of, depends on the applicati- on of ftimulant powers, - 51 LOCAL DISEASES, e 5 48 a Depend upon accumulation or exhauttion, of the excitability, a B My F 43 “MEDICINES, called cathartics are ftimulant, a 46 POISONS, effects of, id \ ae 32 PURGING, arifes from indirect debility, . 46 STIMULI, divifion of into ordinary and extraordinary, 32 STIMULANT, or exciting powers, what, — - Powers applied to a body ina flate of accumulation will produce exhauftion, 44 Ye Re a. ET eB NOR ea a Nt estan aoe se i Sec A a aT TE ES RRA ue | “CERRATA, Introduction, page 23d, line 13th, for fentiments read errors. Ditto 22d, for efed, read affed. Page 24th, line 15th, for molis, read moles. A i nate Jen ee aye! ae Bh ei habe Dy = ae “ : partes ae ba iv —— cod CASE of dyfentery, of high degree, cured by opium, in which falivation was produced by the me- dicine. - - - ——— Dyfentery cured by mercury and opium, = - —— Dyfentery, terminating fatally, in which fali- vation was not produced, after having ufed an immenfe quantity of mercury, Z Incipient confumption, cured by opium, pro- ducing a flight degree of falivation,. -—— Contufion and Concuffion, of uncommon degree, cured, not only without blood-letting, or other evacuations, but by the application of . ftimulant powers, aid. Typhus, cured by calomel, &c. given fo as not to produce evacuations, L i -—— Intermittent, cured by mercury ; fhewing that falivation arifes from indire& debility, and is to be cured by flimulant powers, aa -—— Anomalous, in its fymptoms, occurring in a pa- tient of plethoric habit, with a peculiar flow- nefs of pulfe, cured by opium and mercury, 69 75 77 Se ee ii INDEX. | Page. CASE, Peripneumony, in an advanced ftage, treated unfuccefsfully with mercury ; in which un- common adhefions, &c. of the thoracic vifcera © were found upon diffection, - is ge ——— Hepatitis, treated unfuccefsfully with opium, mercury, and other flimulant powers, with a defcription of the appearances upon diffec- tion, - - - 96 ——. Dyfentery, treated unfuccefsfully, with a de- {cription of the appearances upon diffetion, 100 ——- Dyfentery of high degree, treated {uccefs- fully, tie - - 108 —— Fever, &c. in which a great quantity of mer- cury wae ufed, fhewing that falivation arifes from the fubduction, or irregular application of that medicine. u 4316 —— Fever'cured by mercury, &c. in farther illuf- tration of the mode of applying that medicine, according to-principle, s m 121 CONTAGION, not the caufe of peftilential difeafes, 33 DEBILITY, direc&t,—difeafes of, 2 - 33 36 RAE ED Cure of, - les - Hot —— Indireét,—-difeafes of, :. - Gt 37 42 vee Proportion of, to difeafes of direct dibility, 37 42 —+-—_— _Difeafes of warm: climates, without ex- — ception, of this flate | < 37 4. Cure of ‘ 2 3% 40 DISEASES, definition of, ~ . i a 30 In what refpeéts they differ, os 30 —_—_—-—— Two cannot poffibly co-exift in the ete whole orany part ofaliving body, 31 ees Principles of cure, , aaah 31 ————-~--— Suppofed to have arifen from exceflive excitement, depend upon a flate of ex- hauftion, or indirect debility, 42 4.) PON examining the records of medicine, from the earlieft periods, it appears that phy- ficians have never confidered the living body as fubje&, like all other parts of the univerfe, to regular and immutable laws; but feem actually to have drawn an oppofite conclufion. It is. from. this circumflance principally, that the practice of medicine has hitherto acquired fo {mall a portion of certainty, as ftillto merit the appellation beftowed upon it, more than two thoufand years ago, of a “* conjectural art.” Tue various doctrines which have been pub- lifhed to the world, regarding the human body, are in general, nothing more than a mere al- femblage of words, without the power of con- veying any diftinct ideas. *Hypothefis has fuc- * As truth is but one, and the hypothefis, which may be formed upon any given fubject, infinite; fothe chance of any hypothefis being true, 1s as one isto an infinite number ; or the certainty of its being erroneous, abfolute. Every jult deduction of reafoning, is properly called theory. But thefe ferms are, to the great detriment of fcience, very generally confounded. Cc 18 INTRODUCTION. ceeded hypothefis, in the fame regular manner, that phyfician has fucceeded phyfician. Opi- nions have, been adopted, according to the chances of education; fupported by the au- thority of great names ; and religioufly adhered to, as fundamental axioms, into the truth of whichit would have been herefy to enquire. Tue mifchiefs arifing from this fource, «‘ sreatly extend their influence, and fpread in , “every poflible direction, when error acquires ‘‘ the patronage of authority, and the protection “of dignified names. It then takes its chair ‘¢in the fchools, and affumes the pompous “¢ titles of profound, refined, or liberal know- © ledge. Raifed to this eminence, the induf- ‘‘try of a fingle teacher, or author, may cor- Cay “rupt thoufands; that of a few, whole na- << tions; and the addition of a proportional ** number, ruin the education of a world. «© Tizrs univerfal diffufion of error, receives « fan@tion and eftablifhment from the progrefs << of time. It becomes venerable: and every ‘* attempt to detectit, is branded with the name “of profanity or madnefs.’’* Such has, un- happily, been too long the ftate of {cience. * Vide Introduction to the Outlines, &c. by John Brown, p- il. a F INTRODUCTION. 19 But, of-late years, every department of human knowledge has undergone a rapid improvement. The dawn of reafon has, in a particular degree, begun to enlighten the medical world ; and the practice to aflume a confiftency, which could only be founded on the difcovery of the laws, by which all living bodies are governed. Tuis difcovery, one of the grandeft efforts of the human mind, that ever dignified the page of fcience, the difcaveries of the immortal Newton himfelf not excepted, is contained in the Elements of Medicine, of the late celebrated John Brown. This difcovery, hitherto neg- leGted from ignorance, oppofed from the fhame of recantation, and calumniated from intereft, prejudice, and paflion, contains fo many unde- niable truths that, to an unbiafled mind, it only requires to be known, in order to be admired and adopted. The doétrine, although it has not yet been fanctioned by the medical {chools of Britain, has, however, been very generally re- ceived, in the other fchools of Europe, and in America. ‘* In the Univerfity of Pavia,’ fays Dr. Rafori, ‘“‘ undoubtedly one of the firft in «¢ Europe, there is hardly a ftudent endowed «* with talents, who is not a Brunonian. . The *‘ doctrine begins equally to fpread in. Ger- ‘©many. Many of the periodical publications | “¢ of that country have noticed it, ang the Ele- 20 INTRODUCTION. “menta have lately been publifhed there. A << friend at Genoa affures me, that feveral fur- ‘«‘ eons to French men of war have informed <¢ him, that Brown is known and much admired ‘Cin France. In the Univerfity of Pavia, ‘¢ Brown is in high efteem, even with fome of ‘“‘ the molt refpectable profeflors ; and in other “parts of Italy, I can affert, from my own *¢ Knowledge, that old phyficians have not refuf- “¢ ed their fanction to many of the Brunonian <¢ principles,’?* , One of his Italian critics, fuppofed to. be Profeflor Carminati, fays, ‘* Quaerenti miht “* caufas incredibilis prope illins commotionis ani- « morum, atque ingentis feré plaufus, quibus < nuperime fingularis illa hypothefis, cui novum *¢ Univerfes Medicine Syftema celebrifmus An- “* slice Scriptor et Medicus Bruno fuperftruxit, “ ab iis optime fpei adolefcentibus excepta effet, *¢ qui in florentiffimo,Ticinenfi Archigymnafio fa- ~¢ futaris artis ftudiis omnibus mecum incumbunt, ‘“* peraduum fane, non fuit eas **** invenire. Many tranflations and editions of this work, ‘and various criticifms upon it, have appeared in different parts of Europe, which it is by mo means neceflary to enumerate here. That * Vide Beddoes’ Life of Brown. IRPRODUCTION, Dt the knowledge of it has alfo made a confiderable progrefs, among the medical philofophers of America, is evident, from the frequent allufions made to it, ina late publication, by Dr. Ruth, of Philadelphia. ‘* The principle of the gradu- ‘¢ al application of ftimuli to the body, in all “the difeafes of indirect debility on the one «* hand, and of dire€ton the other, opens a ‘© wide field for the improvement of medicine. “© Perhaps all the difcoveries of future ages, will “¢ confit more ina new application of eftablith- ‘¢ ed principle, and in new modes of exhibiting *¢ old medicine, than in the difcoveries of new “¢ theories, or of new articles of the Materia &* Medicza.’’* } ANOTHER proof of the excellence of the doc- @rine, no lefs convincing, is deducible from the frequent plagiarifms of its fundamental princi- ples, by which fome men, defirous of pafling them upon the world as their own difcoveries, have lately endeavoured to eftablifh a reputation for fuperior genius. Any attempt to detect thefe, in their various and moft infinite ramifi- cations, would, as Dr. Beddoes + very juftly re- * Vide “ An Account of the bilious remitting yellow, Fe. ‘wer,’ —page 284. + It would be injuitice, upon this occafion, to pafs over, ‘without a tribute of applaufe, the laudable exertions of Dr. as INTRODUCTION. marks, be now unneceflary. Among the moft confpicuous, however, in this lift, we may par- ticularife Doctor Gritanner.—There is not a fingle idea in any of the papers, which he has publifhed upon that fubject, that is not borrow- ed from the Doétrine of Brown, or the different modifications of it, difcuffed in the Medical So- ciety of Edinburgh, and recorded upon its books. Thefe he has freely ufed, without the {fmalleft acknowledgment. His doédtrine, of the principle of irritability, is taken from a paper, written by a refpectable member of that Society. Dre. G. was a ftudent at Edinburgh, long af- ter the publication of the Elementa Medicine ; and atatime, when the principles of the doc- trine, were the fubje& of inveftigation, in the literary focieties of that Univerfity. His plagia-~ rifms mutt therefore have been wilful; and no acknowledgment, fubfequent to detection, can Beddoes, in promulgating the knowledge of Brown's doctrine, He is perhaps the only author in Britain, who has dared pub- lickly to affert the merits of it. This ingenious condu, and the liberal manner in which he ftepped forward, to benefit the unfortunate family of our illuftrious philofopher,* equally evince his fuperior mind, and univerfal philanthropy. *' Vide a new edition of the Elements of Medicine, of John Brown, M. D. with a biographical Preface by Thomas Bed- does, M. D. INTRODUCTIONy Be be confidered asanatonement. There is fome- thing fo flagitious in the attempt to rob departed genius of its honours—honours too, in the ac- quifition of which friendfhips, emolument, and eafe, were all facrificed,—that it cannot be too feverely reprobated. Ir is acommon and often a true obfervation, that “no manis a prophet in his own country.” Accordingly, it appears, that this doctrine wag longer neglected, and is ftill more anxioufly op- pofed in Britain, than in other nations. . Few men at an advanced period of life, have fufficient courage to relinquifh fentiments to which they have been habituated, from their early years ; fewer ftill have candour enough to acknowledge the truth of what they have ftrenuoufly oppofed ; and young men, although generally open to con- viction, feldom have fufficient confidence in them- felves, to ftem the torrent of general opinion, The rifing generation, however, in order to adopt the new dodtrine, will not have many facrifices to make. It will neither effect their intereft, nor wound their vanity. | TuHat the force of truth already begins to fi- lence the unmeaning clamour, which has hither- fo been made-again{t this doctrine in Britain, is evinced, by the reception of a late volumi+ nous publication, of which the chief merit con. . ae INTRODUCTION. fifts in, an occafional and imperfe& coincidence with the principles of Brown. It will readily be perceived, that we allude to the Zoonomia of Dr. Darwin,—a work which, from the excel- jent charaéter and reputed talents of its author,. had raifed confiderable expedtation in the public” mind. But difappointment, on the perufal, was in proportion to the previous expectation. In- ftead of important and luminous corrections of the doétrine, ‘which might have been looked for, at this time of day, from aman of abili- ties, purfuing the fame tract of inveftigation, a want of argument and correct reafoning, is found to pervade the whole. It is fuch a rudis indigefta- gue molis that, after wading through nearly fix hundred pages,* it feems impoflible to compre- hend the fcientific principles, upon which the author intended to build his doétrine. From thefe ftri€tures, it ought not to be inferred, that we wifh to detract from the merits of the excel- Ient poet, who has fo elegantly fung the ‘* Loves of the Plants.” But juftice forbids that, out of refpe&t to character or reputation, one man fhould be allowed to affume to himfelf, any por- tion of that honour, which exclufively belongs to another. Science knows no perfonal diftinc- 7” e . e } * At the time this was written, the firft volume only, of Darwin’s Zoonomia, appeared in India. INTRODUCTION. ae tions. Theauthor of a grand difcovery, is, at leaft, entitled to pofthumous fame. THE orIGInN of this, like every other difcovery of importance, has been attempted to be traced _to hints thrown out by preceding authors. E- ven the vifionary fpeculations of Cullen, have been mentioned, as the fource, of fome of its fundamental principles :—with juft as much pro- priety mightthey he imputed to any ingenious fuggeftion in ‘* The life and Opinions of Trif- tram Shandy.’ Upon the whole, it may with confidence be afferted, that this doctrineis, in all its parts, original, as it is undoubted true, and important in its application. And thofe, who are difpofed to deny it this merit, fhould, in decency, adduce fomething like argu- -ment, inftead of the ebullitions of vanity, de- traction, or jealoufy. : AFTER this eulogy, the reader may perhaps expect, that the following pages containa mere verbal copy of Brown’s Elements of Medicine ; but he will foon perceive, that thisis not the cafe. For, although its fundamental principles are in- difputably true, there are feveral errors in the detail, and fome of them of very confiderable importance. His opponents, however, if truth had been their object, fhould have endeavoured to perfect the doctrine, by a correction of its “errors, inftead of ees affecting, on ac- Gi) INTRODUCTION. count of partial blemithes; to reje&t the whole, To the candid, liberal, and enlightened, ‘it will appear much lefs wonderful, that Brown fhould have fome times erred, than that he fhould have been fo pre-eminently fuccefsful, in firft pointing out, to the world, the right path of medical in- veltigation. Tue principal deviations, from the original dotrine, to be found in the following ** View *¢ of the Science of Life,’ are thefe: * af{t.—It is demonfirated, that difeafes of excef- five excitement cannot exift; and that all thofe, which have been fo called, are difeafes of in- direct debility. adly.—Atmost the whole of the difeafes, which were ranked, by Brown, and his follow- ers, among the difeafes of direct debility, are fhewn to be difeafes of indire& debility. adiy.—In the mode of applying the exciting powers, for the cure of difeafes of indirect debi- . debility. : _ Fromthis flatement, it appears, that the al- terations, here made in the doétrine, as they affect the method of cure, in more than one ‘half of the difeafes, to which living bodies are fubjeG@, are of the firft importance; and there- fore deferve a candid examination. ITRODUCTION. A be Ir may be proper to remark, that fome per- fons have affected to reject this doctrine, upon the very grave and folemn ground, of its being favourable tointemperance. To thofe however, who will take the trouble of making themfelves acquainted with its principles, it will only be neceflary to obferve, that fuch perfons do not underftand the fubject. In climates and countries where the tranfition, from health to difeafe, and from difeafe to death, ‘is often alarminglyrapid, and health always pre- © carious, the knowledge of a dottrine, which re- duces the practice of medicine to a degree of cer- tainty hitherto unknown, cannot but be attend- ed with great and evident advantages. To dif- fufe that knowledge in India, where the doétrine feems to have been but little cultivated, and to have acquired but a {mall degree of reputation- fo juftly due to ir, is the defign of this undertak- ing. The attempt is made with the greater con- fidence, from having experienced, in the appli- cation of the principles to practice, a degree of fuccefs, far beyond even the moft fanguine expec- tations, that had previoufly been formed intheory. If, however, this confidence fhould not, after a fair inveltigation, be juftified by the experience of others, the fubjeCt remains open for free dif- 28 INTRODUCTION. cuffion, by which alone the doétrine muft, final- ly, be either confirmed, or refuted. As it is, for obvious reafons, defireable, that a knowledge of medical fcience, fhould not be ex- clufively confined to medical men, we have en- tirely divefted our obfervations of the myfterious — garb, in which fuch knowledge is ufually con- veyed to the world, e Wee Bay OF THE SCIENCE ° LIFE. Cit bi Aa De Ue Ee Re Ey FUNDAMENTAL PROPOSITIONS. I, _A: living bodies poffefs a certain proper- ty, capable of being acted upon by external pow- ers, fo as to produce the phcenomena of life. + Tuis property is denominated EXCITABILITY.* I.—Tue external powers are all fuch objects as, applied to the whole, or a part of any living body, are capable of aGing upon the excitabili- ty. | THxzy are denominated sTIMULI, OF EXCITING POWERS. ; III.—Upon the application of the exciting pow- * Some recent modifiersof this doGtrine, are of opinion, _ that the exciting powersa&t upon the mufcular fibre only 3 _and therefore ufethe termirritABiLity. Butas the powers which produce, as well as thofe which remove difeafe, evident- ly affet the whole body, we think it fafer to retain the more comprehenfive term, adopted by the original author, 30 VIEW OF THE ers ina due, deficient, or exceflive degree, depend the different ftates of the excitability. IV.—Upon the different ftates of the exit a bility depend all the phoenomena of health, and difeafe. | | V.—THERE are three ftates of the excitabi- lity. 1%.—Tue ftate of ACCUMULATION. When a portion of the ufual ftimuli is withheld, the excitability accumulates ; and the body be- comes fufceptible of impreflion, in the direct ratio of the fubduCtion. Tus ftate conftitutes difeafes of accuMuU- LATION, or of DIRECT DEBILITY. adly.—THE MIDDLE ftate. When the exci-_ tability is fuch, that the application of the accuf- tomed degree of exciting powers, produces TONE, or HEALTH. | gdly.— Tue ftate of zExuausTion. When the application of ftimuli, has been greater than that which produces healthy aétion, the excita- bility is exhaufted ; and the body. becomes lefs fufceptible of impreflion, in the direc ratio of the accefs. Tus ftate conftitutes difeafes of EXHAUSTION, or of INDIRECT DEBILITY, ® SCIENCE. OF LIFE, 31 Vi.—Tue ftates of accumulation, and exhauf- tion of the excitability, in their different degrees,. conttitute all the difeafes, to which living bodies are fubject. VII.— Diszasss differ from each other, only in the degree of accumulation, or exhaulftion of the excitability in the whole, or parts of the body. VUI.—ConsEQuEeNTLY, as two degrees of the fame ftate, or two different flates of the excitabi- jity, cannot take place at the fame time, in the whole, or any particular part of the body, two difeafes cannot poflibly co- cet in the whole, or a particular part. IX.—Tue cure of ail difeafes depend upon an application of ftimuli, in a degree proportionate to the accumulation, or sae saaasc of the exci- tability. X.—TuHeE degree of power, with which the funtions of life are performed, is exprefled by the term EXCITEMENT. Thus, there is a heal- thy excitement, when the fun@ions of ‘life are jultly performed, But in proportion as a deviati- on from health takes place either in. dire& or indire& debility, fo the funGions of life are per- formed with lefs power, or the excitement is. di- minifhed. 32 VIEW OF THE CHAPTER IL OF STIMULI, OR THE EXCITING POWERS. XI.—AL1 objeéts in nature, capable of pro- - ducing an effet upon living bodies, are ftimu- lant, (11.) | XII.—Srimvuut, may be divided into ordinary, and extraordinary. : 1ft.—OrpbinaryY ftimuli, areall fuch powers as are ufually applied to living bodies, ina ftat of health. | ; adly.—ExTRaorpDINary fltimuli, are fuch as are occafionally applied to living bodies, as-noxi- ous, or may be ufed, as curative powers. Of this defcription are all the aGtive fubftances that are or may be employed as medicines, whether animal, vegetable, or mineral. SUBSTANCES ufually called pPotsons, as their deleterious operation depends wholly upon their fupertor degree of ftimulant power, ought not to be diftinGly confidered. Any ftimulant, when ex- hibited in fufficient quantity to exhauft the exci- tability, acts as a poifon. SCIENCE OF LIFE, 33 ’ ContTacion has been enumerated as a caufe of peftilential difeafes. Butas the exiftence-of fuch a power is by no means proved, it ought not to be admitted in philofophical difquifitions. The grounds of diffent, from an opinion fo uni- verfally received, will be fully explained in ano- ther place. CHAPTER II. APPLICATION OF STIMULI, OR THE EXCITING POWERS, FOR THE CURE OF DISEASES. ‘ erent ant : 1. Difeafes of direct Debility, or of Accumulation. XII. As the body becomes fufceptible of im- preflion, in the dire&t ratio of fubdudtion of fti- muli (v. 1.), it follows that the force of ftimu- lus to be applied, in the cure of difeafes, of this {tate, fhould be inverfely as the accumulation. of the excitability. Thus in the cafe of perfons who have been expofed to great degrees of cold, heat fhould be applied, firft in a degree not much greater than the loweft temperature, to which the _ perfon has been expofed, and gradually increafed to the ufual ftandard. ah frozen limbs, the 24 IEW OF THE firft application fhould be fnow, then cold wa- ter, afterwards water lefs cold, and fo on, through the various degrees, until motion and fenfation are fully reftored. Whereas, by the immediate application of the accuftomed degree of heat, death would be produced in the whole, or thofe parts of the body, which had been expofed.— To perfons who may have remained long without food, nourifhment fhould be exhibited in the fame gradual manner. ‘The quantity ufually ta- ken at a meal would, in fuch a cafe, inftantly extinguifh life,—a fa&t of which there are many inftances upon record. The eyes of perfons, who have been long kept in darknefs, become exceedingly fenfible to the fmalleft degree of light. Thofe unfortunate beings, whom the mif- taken and perverfe policy of man has doomed to long confinement in dungeons, become, in the courfe of time, capable of diftinguifhing all the corners of their gloomy abode ; where, upon their firft entrance, they could diftinguith nothing. The impreflion of the full glare of a meridian light, upon organs in fuch a ftate of fufceptibility, would occafion inftant and irreco- verable blindnefs. A. perfon, fuddenly awoke in the night, can fcarcely bear even the fmall de_ gree of light, emitted from a common candle. It is only by the gradual approach of day, that the eye is enabled to bear the full force of the mid-day fun. : SCIENCE OF LIFE. 35 Scurvy feems to be a difeafe of dire& debili- ty, occafioned by the abfence of fomeof the ufual exciting powers, particularly nutritive food, heat, and the mental flimuli. Thefe powers mutt begradually applied, inorder to re-produce health. Upon this principleit is, that vegitables and vegi- table acids, as being lefs ftimulantthan freth ani- malfood, are found fo ufefulinthe cure of feurvy. Animmediateindulgence inthelatter, after along abftinence, would produce dangerous confequen- ces. In advanced {tages of this difeafe, a very {mall quantity of ftimulus, fuch as a glafs of ardent fpi- rits, oraftrong mental impulfe, hasbeen frequent- ly known to extinguith life. . That diminution of heat has a fhare inthe produtionof fcurvy, is evi- dent from its more frequent occurrence in cold, than in hot climates. And that the abfence of the mental ftimuli, is often a fource of this difeafe, is obvious from this,—that every circumitance that can occur, during a long voyage, calculated to roufe the mind to moderate exertion, will pro- ducean alleviation of the fymptoms;—the fight of anenemy—the fight of land—approach to. the de- _ftined port—the anticipation of the pleafures of the fhore, &c. This is farther corroborated by the frequency of {curvy among the enflaved Afri- cans, in their paflage to the Weft Intlies, where all the mental {timuli are as completely abftrac- ed, as can be fuppofed to happen in almoft any 26 VIEW OF THE . poflible fituation, The difeafe in this cafe affects the men, more than the women and children. The reafon is evident. With men, the tranfiti- on from liberty to flavery, is greater than with women and children, accuftomed, in their moft free ftate, to look up to them as their fuperiors. The minds of the latter too, from being lefs ex- ercifed, are the lefs capable of reflection, and become more eafily reconciled to their new fitua- tion; which ts alfo rendered lefs irkfome, by the indulgence ufually granted to them, even on. board of fhips, employed in the vile traffic of ilaveg civ: : Tue abfence of thofe objects, which were wont to excite pleafurable fenfation in the mind, pro- duce difeafes of this {tate—Such is the defpond- ence of a lover, in the abfence of the object be- loved: and that melancholy, with which fome -perfons are affected, when abfent from their na- tive country. , | XIV.—<As the fituations, in which the ordi- nary flimuli can be with-held, in any confidera- ble degree, are rare, the difeafes of this ftate are confequently fewin number ; and feldom be- come objects of medical treatment. — XV.—In all of them, the cure confifts ina eradual re-application of thofe exciting powers, SCIENCE OF LIFE. 37 the abftraction of which occafioned the difeafe ; or, in fituations where that is impracticable, by a fimilar application of other powers equivalent in force. | | 2.--Difeafes of indire® Debility, or of Exhau/tion. XVIL—As the body becomes lefs fufceptible of impreffion, in the dire@ ratio of the exceffive application of ftimuli (v. iii), it follows that ‘the force of fimulus to be applied, in the cure ‘of difeafes of this ftate, fhould be direétly as the - exhauftion of the excitability. XVII.—As all difeafes arife, either from accu- | mulation or exhauftion of the excitability, (vi.) and as the difeafes of accumulation have been fhewn to be extremely few (xiv), difeafes of in direét will probably be to thofe of dire& debility, in fome fuch proportion, as nine hundred and ninety nine toone. The difeafes of warm cli- mates may be confidered, without exception, as difeafes. of exhauftion, or of indireét debility. AVIN.—As the higheft excitement is the greatelt degree of health,. it is evident that, in difeafe, health is to be reproduced, by the ap- plication of fuch a degree of ftimulant power, as is calculated to fupport the higheft {tate of ex- citement, of which the body, at the time, is yu Lays t NES nm ‘ 2 ‘ad 38 VIEW OF THE capable. Let the middle ftate of the excitability for inftance, be reprefented by 20, and the appro- priate degree of ftimulus, producing healthy ex- citement, by 20 alfo (vide Table) ; let the dimi- nifhing or increafing fum of ftimulus, in propor- tion to the accumulation or exhauftion of the ex- citability, be reprefented by numbers, asin the annexed table. Ifthe excitability is exhaufted to 10, the fum of ftimulus to be applied, in or- der to produce the greateft excitement, which the ftate of the body will allow, will be as 30. Every degree of ftimulus, beyond that, will exhauft the body ftill farther, and every degree, below it, will retard the cure. Thus 35 degrees of flimu- lus will be toomuch, 25 too little. XIX.—As the production of the healthy {late is always gradual and progreflive, and is effected by the powers of life; it follows that, in proportion to the degree, in which thefe powers can be maintained, the cure will be accelerated. There is no other mode of fupporting them, but by an application of {timuli, proportionate to the fufceptibility of impreflion. XX.—As the fum of the powers, producing difeafe, cannot pofflibly be afcertained, the degree of itimulus to be applied, for the reproduction of health, muft be entirely regulated by obfervation ee SCIENCE OF LIFE. F 39 of the effects, arifing from the application of me- dicines. XXI.—As the varieties of difeafes that occur, from the higheft degree of accumulation, to the loweft degree of exhauftion, of excitability; fo is the variety, inthe degree of ftimulus, neceflary to be applied, for the cure. ) XXU.—Tuis variety is of very great extent. The ufual mode, therefore, of prefcribing certain fixed dofes of medicines, in every diieafe, what- ever may be the degree of it, is and muft be | nugatory and inefficacious ; excepting when thefe _dofes happen, by mere chance, to correfpond with the ftate of excitability.—In afcertaining thefe degrees, and proportioning the ftimuli, confift the judgment of the phyfician. : 3 : XXIl.—Ir, for example, opium, ether, vo- latile alkali, the preparations of mercury, wine, bark, &c. exhibited in the ufual dofes, do not produce effects, which indicate an approximation to health,—fuch as a diminution of frequency,* and an increafe of ftrength, in the pulfe, a cool- nefs of the fkin, moifture of the tongue, refrefh- ing fleep, and the other familiar figns of increaf- * There is fometimes a peculiar flownefs, which is equal- ly a fign of debility, with a quicknefs of pulfe. Vide Cafe Sth. 4o VIEW OF THE ing excitement,—it is evident that the dofes are infufficient, and fhould be increafed, until thefe effects are produced. XXIV.—Tue dofes fhould be repeated in fuch a manner, as to maintain the higheft degree of excitement, of which the body, at the time- is capable. But in proportion as the excitability accumulates, or the body approaches to the ftate of health, the dofes fhould be gradually and pro- portionally diminifhed, until at length, health being eftablifhed, nothing more than the action of the ordinary exciting powers is required. XXV.—Artt the difeafes enumerated by Brown, as difeafes of accumulation or dire& debi- lity, with perhaps the fingle exception of fcur- vy, are difeafes of exhauftion.” Typhus, Inter- mittents, Dyfentery, andfome other difeafes, as they appear to be occafioned by expofure to cold, and moifture, adeficiency of nutriment and of other ftimuli, have been ranked, by him, in the clafs of difeafes of accumulation. But as the fum of the powers, which are concerned in the pro- duction of any particular difeafe, cannot be afcer- tained, the nature of it can only be determined by the effects of the ftimulant powers, applied for the cure. And,as the cure of thefe difeafes de- pends upon the application of the moft powerful _ ftimuli, it neceflarily follows that, they are difeaf- es of indirect debility. SCIENCE OF LIFE. | 40 Tus error feems to have arifen from an opi- nion, that upon the abftraétion of flimeli from (or in the the words of Brown, the application of dire@ly -debilitating powers to) a body ina {late of exhauftion, the irritability would accu- mulate; or that direct would be fuperinduced on Andireé& debility. - But this opinion is evidently erroneous. If from a perfon labouring under plague, malagnant fever, or gangrenous fore throat, all the ufual remedies are with-held, and only cold water given, no accumulation of the excitability willtake place; but on the contrary, the exhauftion will rapidly proceed, to the ex- tindtion of life. Ifa perfon, previoufly exhauf- ted by expofure to exceflive heat, drinks large- ly of, or plunges himfelf into cold water, the” exhauftion will not be removed; but on the contrary, thofe greater degrees of it produced, conftituting Tetanus, Spafmsof the ftomach, &c. And that thefe are all difeafes of indirect debility, the mode of cure, which confifts intheapplication of a very high decree of ftimulant power, is a fuf- ficient proof. Gout is a familiar inflance in point. - _ The ftate of body liable to this difeafe, is produc- ed by along continued application of food and drink, flimulant in too high a degree. Let a gouty perfon be expofed to cold and moifture, anda paroxyfm will readily be produced. Le him fuddenly refrain from his ufual quantity of Ny 4 42 VIEW OF THE food and drink, his ftomach or head will be af- fected; and the moft powerful ftimuli, as Zither, Brandy, &c. will be requifite to re- lieve him. ' XX VI.—HeEnce it follows that, in difeafes of exhauftion, the irritability does not accumulate upon the abftraction of flimuli; but on the contrary, the ftate of exhauftion is, thereby, in- creafed. | XXVII.—Ir follows alfothat, inthe produ@ion of Typhus, Intermittents, Dyfentery, and fuch other difeafes as have appeared to arife from ex- pofure to cold, moifture, &c. and have therefore been ranked by Brown, among the difeafes of direct debility, the body muft have previoufly been in a ftate exhauftion. By a fubduétion of exciting powers, froma body in fuch a ftate, the previous degree of exhauftion mult be in- creafed, and the difeafes of that {tate confequent- ly induced. | XXVIUI.—Mosrt of the difeafes of exhauftion appear to be produced in this manner. Cy ASP CE Reeve OF DISEASES DENOMINATED BY BROWN, DIEAS- ES OF EXCESSIVE EXCITEMENT.* X XIX .—Asthere are three ftates of the excita- bility, (v. 1, 2, 3) fo there arethree correfpond- ing ftates of excitement. * Vide Lynch’s Table, prefixed to Beddoes’s edition of Brown’s Elements of Medicine. SCIENCE OF LIFE. 43 ift.—Tue ftate of diminifhed excitement, from. a deficient application of ftimuli, corref- ponding with the ftate of accumulation, or di- rect debility. adly.—Tue ftate of high excitement, from a due application of ftimuli, correfponding with the middle ftate of the excitability or health. | 3dly.—Tue ftate of diminifhed excitement, from an exceffive application of ftimuli, corref- ponding with the ftate of exhauttion, or indi- rect debility. XXX.—ALTHovcH the ftimulant powers may be applied, in an exceflive degree, to the middle or healthy ftate of the excitability, it is evident that excitement never can be exceflive; for eve- ry degree of ftimulant power, greater than is ne- ceflary to produce health, muit occafion a de- gree of exhauftion proportionate to the excefs, (v. 3); and every degree of ftimulant power, lefs than is neceflary to produce health, muft oc- cafion adegree of accumulation, proportionate to the deficiency. (v. 1.) XXXI.—TueEreE are, therefore, no difeafes of exceflive excitement. From whence it follows that thofe, which have been fo denominated by Brown, muft be difeafes, either of direct, or indire&t debelity (vi.) | 4A : ‘VIEW OF THE XXXI----Tuat they are all difeafes of indi- rect debility, feldom conftituting a very high de- gree of exhauftion; is proved, both by. the pow- ers that are known to induce them, and the remedies that are found moft fuccefsful in their cure. CATARRH, pneumonia, acute rheumatifm, and other difeafes of this clafs, are occafioned by the application of aconfiderable degree of heat, after the body has been previoufly expofed to cold ;—or vice verfa. The temperature of warm rooms is, in general, greater than is fufiicient to fupport healthy excitement. If the body there- fore has been previoufly expofed to a confidera- — ble degree of cold, the irritability muft be accu- mulated (v. 1); andthe application of a high degree of heat, toa body in that fate, muft in. evitably produce exhauftion. Ir, on the contrary, a perfon has been previ- oufly expofed toa degree of heat, beyond what is neceflary to fupport healthy excitement, and cold be fuddenly applied, the fame effects will be produced (xxv.)—In moft of thefe difeafes, a lo- | cal affe€tion takes place, which evidently arifes, from fome parts being more expofed to the exci- ting powers, than other parts of the body ;—as the mucous membrane of the nofe and fauces, in \ SCIENCE OF LIFE. : 45 catarrh ; the bronchice and lungs, in pneumonia ; and the extremities, in rheumatifm. The mode in which the cure of thefe difeafes is effected, viz. by warmth, fmall quantities of opium, wine, &c. and the application of fomentations, rubefacients, _and blifters to the local affection, is a proof that 8 are difeafes of indireét debility. Tue langour, inability to motion, want of ap- petite, naufea, coftivenefs, &c. which occur in thefe difeafes, are evidently incompatible with fucha ftate, as that of exceflive excitement. Could fuch a ftate poffibly exift, the functions of the body would be invigorated, in the exa&t degree of the excels. In convalefcence from thefe difeafes, it is well. known, that a greater degree of nutritious food, wine, and other ftimuli, are neceflary, than in a ftate ofhealth. But if they depended upon a {tate of exceflive excitement, the cure could not otherwife be effected, than by perfevering in an abftraCtion’of ftimuli, until health was re-eftablith- ed. The exhibition of ftimulant powers would Produce an increale of difeafe. ei vok and meazles are of this kind, and to be cured only by flimulant powers. Tue mode in which Brown fell into error, in 46 VIEW OF THE confidering fome difeafes as depending upon a {tate of exceflive excitement, was probably this. Having ftill, (altho’ contrary to one of his own fundamental principles ‘* that all powers applied to living bodies are ftimulant,’’—in other words *¢ that there is not a fedative in nature,”’) retained an idea, that thofe medicines, called evacuants, are debilitating ; and having found that, under a moderate application of them, together with the other parts of the ufual treatment, patients gene- rally recovered from thefe difeafes, he was led to conclude, that they depended upon a ftate of ex~ ceflive excitement. Tue mode of action, however, of thofe me- dicines, feems to have been univerfally mifun- derftood. As all objects, capable of producing an effect upon living bodies, are ftimulant (x), thofe which produce evacuations mutt necefflarily beincluded. Ifa certain quantity of calomel, in- fufion of fenna, falts, or any other cathartic medi- cine, be taken, its immediate effect, like that of opium, camphor, er any other acknowledged ftimulus, will be an increafed f{trength of pulfe, a fenfe of general invigoration, and all the ufual fymptoms of increafed excitement, in proportion to its degree. And this will continue as long as the operation of the medicine. If the dofe is fufficient to produce a high degree of excitement, ee SCIENCE OF LIFE. | Ay a difcharge of natural foeces, when thefe have previoufly been long retained, will be the confe- quence. Is there any other mode, by which the inteftines' may be made to perform their fundti- ons, and to expel their contents, but by increafing their excitement? Certainly not —But if a greater quantity be given than is neceffary, to en- able the inteftines to expel, with facility,. their contents, anew difeafe is produced ;—indirect debility is} eftablifhed ; and a difcharge of mucus, and fometimes of blood, accompanied by dif- agreeable fenfations, follows; fymptoms which are only to be removed by opium, and other ftimuli.—lIt is not therefore with an intention of evacuating, that thofe medicines fhouldbe given. 