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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 little 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 the most 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

clearly enough that the weakness which many experience from abstaining 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 nearly three years afterward that I became fully convinced of the absolute necessity of a strict vegetable regimen in chronie 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 results 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 my 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 eauses 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, is obvious, from the little satisfaction to be gained on these subjects from the writings of the most esteemed authors.

CASE I.

Weak Eyes, Pimples of the Skin, Dyspepsy, Sick Headache, Constipation, Depression of Spirits, and Gout.

THOUGH the materials of the following case are taken from experience, in my own person, I have thought it better to give the narrative in the third person. I have begun the thread of

the history from a distant period, being convinced that the physical life of every individual consists of a series of phenomena, none of which are absolutely insulated and independent; that each occurrence is a sort of consequence of those which have preceded, and is closely linked to those which are to follow. Thus the disease which ultimately proves fatal often shows itself in early life, and might perhaps be traced by an attentive observer even to the first periods of existence. It grows with our growth, and strengthens with our strength.' We have an infinite number of histories of diseases, that is, of solitary attacks or single illnesses. But the histories of a diseased life, so that we may see at a single view the order and succession of events, are rare and very imperfect. To proceed, however, with my narrative.

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August 9th, 1813. A physician, in the forty-ninth year of his age, passed the first eighteen years of his life without disease. But there were some peculiarities of constitution, which were observable at this time. He could never bear with ease a strong light, and the whole head was more than commonly tender. At eight years old he received, by a fall from a horse, a severe wound in the forehead. The cicatrix of this wound was always so tender, that he could never afterward bear the pressure of the edge of a hat upon it; on which account, he always wore the hat close upon the eyes. He was of a lax fibre, with a feeble pulse, thin, pale, delicate, and with very light hair.

At about eighteen, he began to have many pimples over the face, neck, shoulders, and breast; and these continued unremittingly upward of twenty years, being very troublesome, producing considerable deformity, and most of them, after suppuration, leaving pits in the skin. About the same time, too, he began to have some trifling uneasy feelings of the stomach, and slight dyspeptic symptoms.

At the age of twenty-four or five, he was often seized with sudden lameness, not very violent, and lasting only a short time. He was told by a very old sufferer from gout, that these lamenesses portended severe attacks of that disease. However, they left him before the age of twenty-eight, and they have only been brought to his recollection by subsequent

events.

He arrived, however, at the age of thirty-two or three, without any serious or dangerous illness. He was dyspeptic, had often sick headaches, the eyes impatient of light, and had sometimes slight lumbago or rheumatism. But he had no confine

ment nor violent attacks. On exposure to cold, or other occasions of disease, the stomach was the principal sufferer. With coughs or colds he was almost unacquainted.

About the period above mentioned, he perceived a degree of confusion about the head; reading caused a degree of dizziness, so that intellectual exertion or study, which had been a source of great pleasure, became less agreeable. About the same time, too, but the exact period he cannot fix upon, he found the head so heated at night that even a nightcap was uneasy, and he always threw it off before morning; a symptom that became permanent.

In some short time afterward, he found the dyspeptic symptoms greatly aggravated, the digestion imperfect, and, for the first time, the secretion by the bowels became irregular. Artificial methods of evacuation, both by medicine and by injections, gave considerable relief, and brought away many scybala, and much offensive excrement. But the benefit was only temporary; after the operation of medicine, the necessity for them occurred; natural evacuations, though not suspended, seemed ineffectual and unsatisfactory; nor was he ever easy and comfortable when the use of medicines was intermitted for any length of time. The mind, too, fell into that disagreeable state, in which the attention is greatly fixed upon the bodily feelings; in health, these are hardly noticed, but the attention is absorbed by things that are external and foreign to the body.

At this period of his life, he thought that inflammation of the bowels was caused by obstruction, and that the prevention or removal of this obstruction would obviate such disease. He was, therefore, extremely attentive to preserve a regularity of the intestinal evacuations by the regular use of gentle aperient medicines. But notwithstanding all his precautions, he was seized, in January, 1799, with a very severe inflammation of the bowels. The pain was chiefly seated in the right epigastric region, and though the violence of the disease was subdued in eight or ten days, the pain at that part continued to be felt for a twelvemonth; and after that attack, he never walked out in the cool of the evening, without feeling a slight tenderness and uneasiness over the whole abdomen.

For a year or two, however, after this attack, he enjoyed, upon the whole, a better state of health than before it. But still the dyspeptic symptoms and irregularity of the bowels continued to trouble him. The stomach never felt easy; he was oppressed with flatulence, and it continued necessary to

have recourse to art to procure regular evacuations. These symptoms kept slowly increasing. To these were joined, toward the close of 1802, fits of low spirits and hypochondriacal feelings, which it is impossible to describe, and the horrors of which can be known to those only who have felt them. They were not very lasting, and were succeeded by intervals of cheerfulness and good spirits.

In the beginning of 1803, the uneasiness of the stomach was more aggravated. It was not acute, but constant and wearing. It was not a fortnight before he conceived the idea which led to its relief, that he said in despair to one who was the sharer of all his thoughts, "What can it be that occasions this constant uneasiness of the stomach?" He was more than commonly temperate, lived in a small healthy country town, and from the nature of his profession used much exercise, though it seldom amounted to great fatigue. Still he found himself unable to ward off severe illness, and the dread of still more dangerous attacks.

The only thing which had afforded any permanent relief to the stomach was substituting water to beer as a common beverage. This has been serviceable, but without effecting a cure.

In the month of May, 1803, he saw reason to believe that deleterious matter was introduced into the body with the water that is habitually employed; and he determined therefore to try the effect of using none but what was made perfectly pure by distillation. The motives for this opinion he has detailed at length in a work entitled An Inquiry into the Origin of Constitutional Diseases. He believes that the views he took in that work are essentially correct, but that the hypothesis he adopted was too limited. He reserves, however, what he may have to say on this head to a more proper place and opportunity.

When he found that the uneasy state of the stomach was abated by this simple expedient, the delight received from the discovery may be more readily conceived than described. And indeed the real benefit produced was very considerable. He found a considerable improvement of muscular strength. In about nine months his sick headaches left him; and from that time to the present hour he has not experienced this great inconvenience once. * The constant uneasiness of the stomach soon became soothed, and in about fifteen months it was hardly sensible. All the dyspeptic symptoms were relieved, the sto

* He has been informed by others of sick headaches having been relieved by distilled water, particularly by a gentleman more than sixty years of age.

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