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previous indulgence. In the course of this year he became very pallid, so that by the end of it his face was of the color of marble. He had an obstinate inflammation, of a scrofulous nature, of the left eye and eyelid in the autumn, which left the vessels distended with blood from relaxation. The appetite also became very delicate and capricious, so that his dinner was (as was remarked by a physician who saw him frequently) more play than eating. Even many sorts of vegetables he disliked. In this state, without any positive disease upon him, but with the air and aspect of a child that would never reach manhood, I resolved to confine him to a strict vegetable regimen, early in the yoar 1806.
The consequence of this has been, that from that hour to the present (now seven years and a half), he has been free from all serious illness; and the health has every year become more firm and established. A very few slight indispositions he has had, which it is not worth while to relate at length, except one circumstance, which I propose to make the subject of a distinct account. But in this case, though the subject was so yoimg, the constitutional changes have been introduced very slowly; indeed, as slowly as in persons of advanced years.
In the autumn of 1806 the opthalmia returned, but much less severely, and since that time it has not appeared. But the vessels of the eyelids remained distended for three or four years, which gave the appearance of weakness in the part. For full as long a time he had a short hacking cough every successive winter. During the whole of the second year (1807), he continued to look exceedingly pallid, and far from healthy; and even at the end of four years he had, with a thin, pallid, and extenuated body, an extremely full, throbbing, and'what would be called an inflammatory pulse. But since that time it has become much softened.
Formerly, when eating animal food, the tongue was at all times covered with a white slimy crust. It is now, and has been for several years, perfectly clean. The smallness and delicacy of the appetite remained for full two years, after which it improved and became much less fastidious. He is now rather pallid, but has much more color than when he used animal food.
It was an observation of his own, when he was under ten years of age, that " When I ate meat, I was at night first too cold, and then a great deal too hot, so that I could not sleep; but now I sleep comfortably all night long." I doubt whether on any point more unexceptionable evidence was ever offered.
He is at present in very good health, the breath sound and strong, the appetite hearty, with color enough, and enjoying great activity of mind and body, with a greater flow of animal spirits than falls to the lot of most people. But he carries about him strong marks of a consumptive constitution; and I do not doubt that if the attention, which has been paid to him now for a series of years, were to be remitted for three or four years, he would become really consumptive.
Nov. 17,1814.—As this young man approaches manhood he appears to acquire more firm health, and the signs of his former delicate state are more completely effaced.
Distortion of the Chest, Pimples of the Face, General Debility, and Weak Eyes.
August 28, 1813.—Jti. L., aged nineteen, adopted the use of pure water in 1803, being then between nine and ten years of age. She had passed through the first years of her life without any dangerous illness, but was delicate and subject to congestions of the bowels; she was rather pallid, narrow in the chest, and had not the appearance of a child in good health. About the ninth year she appeared evidently to be growing awry. The health obviously improved by the use of the pure water, but not in such a degree as to furnish any precise observation, except that the tendency to crookedness was checked. At the time that this habit was persevered in, but while she used a mixed diet, the skin of the face became much deformed with the black spots that are called grubs, and the forehead in particular became almost covered and roughened with an aggregation of pimples. In 1805, she was still more pallid, heavy about the eyes, with a dark circle round them ; and the spirits were so tender that every little exertion was a toil, and on the most trifling occasion the eyes would overflow with tears.
About midsummer, 1809, I joined to the pure water a vegetable regimen. She went to school at Warwick, where her regimen was continued. About October, Dr. Winthrop, then a physician at Warwick, wrote to me, that her mistress was under considerable anxiety on account of this child; that she seemed in still worse health and spirits than before, which was attributed to the cnange of diet, which he feared would nevei agree with so delicate a subject.
I could not, however, attend to this well-intentioned advice, which, I believe, was such as would have been given by almost every other medical man. But I conceive that delicate subjects are those which afford the least resistance to morbific impressions, and from which, therefore, such impressions should be removed with the greatest care. Besides, I knew perfectly •well what had been the state of the health under the common regimen ; and what could be hoped from a recurrence to it, but a continuation of the same condition?
And all the prognostications of mischief from this change have been completely falsified by the event; for the truth is, that from that day to the present she has not had an hour ill health, nor scarcely the trifling indisposition of a single day. E,rery year the marks of weakness and delicacy wore oft•, and were at length completely effaced ; and she has grown up much more robust. The tenderness and lowness of spirits, the heaviness of the eye and languor of the countenance have been removed and have been succeeded by uniform cheerfulness, activity, and intelligence. The chest has expanded and assumed a perfect form; and a cough, which, in the first years of this course, gave strong apprehensions of a pulmo'nary taint has wholly disappeared. In a word, she is now, and has been, for several years, in perfect health.
The roughness of the forehead, occasioned by the swarm of pimples, did not begin to yield till after more than two years, when they gradually disappeared. If, at present, there is an occasional pimple on the face or chin, she observes that it is much more painful than formerly, which is a sufficiently clear index that the general sensibility of the system is much greater or more acute than formerly.
I have chosen to assume a symptom that is in itself very trifling (though by no means so in the estimation of young women), as the denomination of the condition of the subject of this relation. The narrow form of the chest, or the habitual tenderness of spirits, formed a more prominent feature of the case. But I choose the cutaneous disease, in order to evince the connection that subsists between all the forms of disease, from the most trifling to the most severe.
The color in this example is not so high as is customary with the eaters of animal food. But she is much less pallid than when she conformed to the common habits of life.
It may be worth while to observe that though in this subject there were many signs of constitutional weakness, yet there has never been any deficiency of muscular strength ; on the contrary, the muscular power is, and has been, rather •greater than usually is the lot of persons of her age and sex. I am inclined to infer from this circumstance, that the disposition to grow awry, which is so common in growing girls, is founded more in a weakness of the cartilaginous and ligamentous parts of the body, than of the muscles. If any portion of these parts is deficient in power, and the muscles have at the same time their due, or more than their due tension, the body inclines where there is the least resistance, and the symmetry of the parts is destroyed.
Nov. 19th, 1814.—In the spring of the present year this young person complained of a sense of weight, which was referred to the stomach; the pulse became rapid, rising to 120 in the minute, and the muscular strength was depressed. These symptoms lasted three or four days, and then declined. But they again recurred, and she continued in this condition, not so ill as to be confined, but enough to affect her strength and spirits for about three weeks. Then the symptoms went off, and she regained her usual health.
We had here, what I think may be properly called the embryo of some disease, and probably of a very severe one. I cannot positively pronounce even what was its seat. But I have not thought it right to keep back any fact which may be thought by some to militate against my own principles.
Disposition to Hydrocephalus and Apoplexy.
Nov. 21st, 1814.—A. L., aged 14, had marks in her first year of some irregularity of the functions of the brain. These were more evident in the second and third years. Her life, at this early period, was a continued storm of passion, though the natural disposition seemed good. She was plethoric, high colored, and the respiration thick. The front teeth, particularly the two anterior incisors of the upper jaw, were wholly incrusted with black matter.
The use of the pure water was adopted for this child in the spring of 1803. Its effects upon the respiration were very striking. Before this, she could never bear being tossed with any quickness, as we are apt to do when playing with j'oung children, without evident marks of terror and uneasiness. But in some time after using the distilled water, the same degree of violence had no longer the same effect, nor did it cause any apparent uneasiness.
In the course of the ensuing winter she had a fit of sleepiness, which lasted a day and a half. In the spring following (1804), she had scarlatina very severely, but recovered from it perfectly. She continued to use the mixed diet for nearly three years and a half. During this time it was observed that benights were very restless; she often screamed with violence in her sleep. She had also frequent pains of the head, which, when they affected her, caused a heaviness and peculiar appearance of the eyes, so that it was easy, from the countenance, to judge when the head was affected. She continued to have a very high florid color; she grew much, but the chest was narrow, and the abdomen so protuberant as to be very observable. The spirits were also irregular; she was easily offended, took little delight in play, but rather affected solitude. The pulse was frequent and irregular. The tongue was always covered with a thick white crust. The thyroid gland was also large, and seemed inclined to swell.
Under these circumstances she was confined to a vegetable diet in November, 1806, and has regularly adhered to it to this time. For a very considerable time there was hardly any perceptible difference in her constitutional affections. When she had been confined to this diet a year and a half, she had one night such violent screaming in her sleep, that she brought out of their beds the family at whose house she was. In the spring, 1809, she retained her high florid color, and it was very nearly as strong as when she used animal food. In the autumn of this year she had a mild inflammatory fever, which confined her to her room, and reduced her a good deal. All this time the symptoms of the diseased state of the head, the screamings at night, the pains frequently recurring, and the dullness and heaviness of the eyes, and the other circumstances I have mentioned, continued to harass her. Even at the end of four years they were so strong as to attract the observation of those with whom she conversed. But now, that is to say, at the end of eight years, and, indeed, for the last three years, the whole habit is changed, and with it the marks of constitutional disease removed. The high florid color of the face is gone, though she is at present far from pallid. The chest has become expanded, and the tumefaction of the abdomen is re