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bring the mouth to the earth requires a strained and a painful effort. Moreover, the mouth is flat and the nose prominent, circumstances which make the effort still more difficult. In this position the act of swallowing a fluid is so painful and constrained that it can hardly be performed. He has therefore no organ which is naturally suited to drinking. He cannot even convey a fluid into his mouth without the aid of some artificial instrument. The artifice is very simple, it is true. But still .the body must be nourished anterior to all artificial knowledge. Nature seems therefore fully to have done her part toward keeping men from the use of liquids. And doubtless on a diet
I of fruits and recent vegetables there would be no.thjrst, and no
^ necessity for the use of liquids.
If it be true therefore that other animals require water, it would not follow that man, whose organization is different, would require it likewise. But we, in fact, know very little of the habits of animals. Our common domestic animals certainly drink. But it appears, as far as my information extends, that common water has the same effect upon them as upon man; and that they are more or less healthy, according to the purity of the water which they use.*
* Many writers have observed the deleterious effect of water on our domestic animals. The following passage, from the Encyclopedia Methodiquo, is quoted in Sir John Sinclair's Code of Health, vol. iii.: " Vitruvius informs us that the ancients inspected the livers of animals, in order to judge of the nature of the water of a country, and the salubrity of ils nutritive productions. From this source they derived instruction respecting the choice of the most advantageous situations for building cities. The size and condition of the liver is, in fact, a pretty sure indication of the unhealtliiness of particular grounds, and of the deleterious quality of the water, which, especially when it is stagnant, produces in cows, and particularly in sheep, fatal diseases that have often their seat in the liver; as, for instance, the rot, which frequently destroys whole flocks in marshy countries. The spleen is also a viscus very apt to be affected by these qualities."—Halle, Hygiene.
, In.a work on agriculture, by Hogg, the Ettric Shepherd, it is asserted v '' r ^e 'r'e<i to rear young lambs in the winter, upon hay and water, they, for the most part, die. But if they are supplied with fresh succulent food, they live and thrive.
CASES AND OBSERVATIONS.
In the foregoing remarks I have considered the effects of our aliment in general, without any regard to the immediate condition of the system as to health or disease. If many of the substances so applied are morbific causes, though only ultimately and remotely, it cannot but belong to prudent foresight and prospective wisdom to-avoid them. But the rules for the preservation of health and avoiding diseases, though always esteemed a branch, and a most important branch of medicine, are rarely demanded of the physician, except in cases of obvious and imminent hazard. As there can be no doubt that on these highly interesting subjects many gross errors and many deep-rooted prejudices pervade the mass of mankind, hopes may be entertained that, as the understandings of men become enlightened, beneficial changes may be introduced into the general habits of society. This is, however, a remote, and not a very cheering prospect. But to do all that is within the feeble powers of individual exertion to diffuse knowledge, and the blessings which follow in its train, is no more than striving to pay that immense debt which every one owes to the community, who has received from the sufferance of his fellow-men the exemption from servile and laborious occupations, and the inestimable advantage of mental cultivation.
It belongs more to the immediate duty of the physician to consider how far the principles which have been laid down warrant a change in the treatment of diseases, particularly those which are chronical, and upon which medicine has little influence, and to determine what are the advantages which experience authorizes us to expect from the proposed change.
Whatever may be the effects upon the human body of the substances which, though received at short successive intervals, are continually applied to the organs, in the form of food and drink, it is obvious chat they cannot be estimated as we would calculate the forces, and percussions, and motions of inert matter. The bodv is a self-moving machine, subject to its own peculiar laws, and though to keep up the succession of motions and sensations, and the integrity of the powers which are essential to and which constitute a living system, the application of the peculiar stimuli of the various organs is necessary, still there are inherent properties of the body as a whole, of each peculiar onran. the totality of which constitute that whole, and even of every individual molecule of the living mass. Upon a machine so constituted and so complicated do the stimuli act; and to gam any insight into their effects, we must consider the properties of the substance acted upon, as well as the nature of the agents.
The living body itself is not only endowed with peculiar properties at anv ^iven moment of its existence, but it is also in a constant state of change, both in its powers and in its materials. The irritabflitv, mobility, and sensibility of the various organs are never uniform during any two successive portions of time; and at periods considerably distant the change is more strongly marked. The whole mass of the system, the materials of which the body is composed, are likewise in a constant state of flux, so that after a certain lapse of time there is a total change of matter wider an identity of form. I suspect that the laws according to which these changes take place have not been sufficiently adverted to, and Chat some insight may be gained into the origin, phenomena, and periods of diseases by a more strict consideration of them.
The circumstances to which I have adverted create a considerable difficulty in conducting an inquiry, by the way of experiment, on the effects of regimen, or peculiar modes of living, upon the body, either in disease or health. This difficult}' is increased by the original varieties of the human constitution, so that, upon the whole, it becomes extremely hazardous to transfer the result of one trial to other cases of a different nature, or even of the same, and where the appearances are very similar. But still in this, as in every other physical inquiry, the foundation of all knowledge must be laid in experience; to that the appeal must be made in examining the truth or falsehood of principles, and the usefulness or the futility of all new proposals for the improvement of the treatment of diseases. If the varieties of different constitutions are endless, and the forms of disease unlimited, still there are analogies and resemblances sufficiently striking and definite to serve as a guide in the intricate
mazes of investigation. The differences of result of the same treatment upon different habits, and under various circumstances, may be expected to be rather differences in degree than in kind; and in circumstances more accidental and of inferior importance, than in the more marked changes, which may afford a just basis for correct reasoning, and an encouragement for new efforts toward relief.
I proceed, therefore, now to relate some cases of disease in which I have applied in some of them with the strictest accuracy; in all with as much as I could effect, the principles, the justness in which I have labored to establish in the preceding pages, and in my former writings. Of the propriety of the general principle of removing in chronic diseases, if possible, all the causes of disease, whether these causes be immediate or remote, there can, I conceive, be no dispute. The only question is, what, in fact, are these causes? I have extended them to almost all the ingesta; but particularly to common water, to fermented liquors, and to animal food, fish, eggs, in short, to every thing except the matter which is the direct produce of the earth, and of such a kind as experience has shown to be wholesome and nutritive.
Of vegetable matter I do not know that any great nicety of selection is necessary; the palate will be a sufficient guide. There can be littles doubt that vegetables, which are raised in the country where the land is not too highly manured, are preferable to those which are raised in the gardens of great towns, and particularly near the metropolis. But any evil which may be supposed to arise from this cause, being for themost part unavoidable, it is nugatory to give directions about it. Of vegetable matter, I consider fruit, and what is unchanged by culinary art, as the most congenial to the human constitution; and in consequent advise as much to be taken in this form as is consistent with comfortable feeling. In the sort of vegetable matter employed there may possibly be material differences on the constitution. We know that animals cannot with impunity deviate very much from the species of food which is most adapted to their natures. But as on this subject I am without any information on which I can fully depend, I think it best to leave it to be determined by time and future observation. Vinous and fermented liquors I forbid. The water used in every article in which water is taken into the stomach, I enjoin to be artificially purified by distillation.* This is the Peculiar
'Pure rain water, such as it is when coming from the clouds and received in a clean vessel, in short, rain water that is kept free from the enough that the weakness which maDy experience from 'from animal food, and the other mischiefs attributed to vegetables, might arise from a different cause than any thing really debilitating in vegetable food. It was not, however, till aearir three vears afterward that I became fully convinced of the absolute necessity of a strict vegetable regimen in chronic diseases, from an attentive consideration of the facts which I have elsewhere detailed.
In the relation of the following cases, I shall not follow any artificial or scientific order, but shall put down the facts nearly in the order of time in which they occurred. Thus, the resalts of those cases which have gone on long enough to enable me to speak with confidence of the effects of the treatment, will be a sort of cover to the defects of others, which, if they stood alone, would not justify a similar language. I shall also, in general, give a name to each individual case of disease, exercising on this point mv best judgment. For though I consider nosological arrangements to be of very little practical utility, yet some names are necessary to convey to others a general conception of things, and those, therefore, which are the most generally received are the best suited to this end.
I shall venture, in the course of my narrative, to draw such conclusions as the facts seem to warrant. Perhaps, here and there, I may offer some conjectures upon the more hidden causes of the phenomena of diseases. If in these I err, I doubt not that I shall be excused in the opinion of candid and ingenious men; since it is obvious that these causes, that is to say, the internal changes in the human body that form the more open and prominent phenomena of diseases, have, for the most part, eluded the research of pathological inquirers; this, I say, B obvious, from the little satisfaction to be gained on these subjects from the writings of the most esteemed authors.