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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.

CASE IV.

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

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any quickness, as we are apt to do when playing with young children, without evident marks of terror and uneasiness. 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 her nights 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.

In the

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. 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

moved. I have a right, therefore, to say, as I have already done, that this high florid color, so far from being a sign of health, is a sign of disease. The tongue is become quite clean, and the teeth are without any incrustation. Indeed, the use of the pure water alone took off the remarkable foulness of the front teeth. The swelling of the thyroid gland has disappeared.

If I were to say that the affection of the head is wholly removed, I should say what is certainly not true. But it is so much removed, that she has every external appearance of good health; nor could it be discovered that she has at present any complaints about the head, without a minute and critical examination. The common observer would pronounce her in perfect health.

The similitude between the circumstances of this disease and the pains of the head related in the first case (see p. 151), are sufficiently obvious. This case again warrants the conclusion that, in deep-seated constitutional disease, the effect of vegetable diet is slowly, but progressively and regularly, to diminish the intensity of the paroxysms which form its external sign and character.

And when I consider the early period at which these signs of disease in the most important organ of the system appeared, and the great pertinacity with which they have continued for a series of years, I think myself fully warranted in the supposition that, under common circumstances, these symptoms must have been continually aggravated; that they would have led to a fatal disease of the brain, probably under the form of the hydrocephalus internus; and that it is very unlikely that she would have reached puberty, or even that period of life at which she is now arrived.

Though this child has now for several years been in a very good general state of health, she has commonly, at least once a year, a mild febrile attack which confines her for two or three days. The head is always the part most affected.

Three other young people, members of the same family as those whose cases have been related, have used the same regimen for about the same period of time. They are and have been, since its adoption, without any thing like serious diseases. The oldest (now in her nineteenth year) has a better general state of health than in the early period of life; but there are no circumstances worthy of relation, except it be, that, notwithstanding the attention paid to her diet, she has some thickness about

the throat. The thyroid gland is large, and the whole throat is larger than in common, or than is perfectly natural. The gland has not the size which can be called bronchocele, and is in texture, as far as can be determined by the feel, sound and healthy; but it is obviously the embryo or germ of a bronchocele. The second, aged thirteen, had some indisposition of a few days, when she had left off animal food nine months. She also lost her color, which was fine, so as to be a considerable ornament to her person. This occasioned much regret. But, with the above trifling exception, she has enjoyed a complete and uninterrupted state of health. Her color improves a little, but she is still a pallid girl. The third, aged twelve, likewise lost his color; but has scarcely had any indisposition, even of half an hour, now for eight years. His color is of late years much improved; but it is not nearly so high as when he used animal food.

I cannot help noticing a fact which occurred to the second of these children, the girl of thirteen. It is so trifling and common an occurrence, that nothing but the inference to which it obviously leads can justify the mention of it. But we are really apt to overlook, by attempting to think too deeply, the just consequences of what we are seeing every hour.

In this child then, in the spring of the year 1814, a nail came off one of the fingers. There was no accident; but it exfoliated, and, in course of time, was reproduced. Of course,

this was not unattended with pain and suffering.

Now what happens on the surface, we must, of necessity, suppose may happen in any other part of the body. A part may have naturally imperfect powers of conservation. It may, therefore, perish, and be reproduced. This would be a disease; and, further, it would happen in defiance of any regimen or any method of treatment whatever. Was it some such event as this that caused the derangement of health which occurred in Case III., mentioned at p. 165 ?

CASE V.

Pulmonary Consumption.

Ir we except the first of the preceding cases, the facts which I have hitherto related are of young people, the general state of whose health rather indicated a feeble and defective constitu

tion, than disease completely formed. They are not, as I apprehend the less valuable on that account; for as many diseases, in their perfect form, exclude all hopes of relief, it is the more important to attend with care to the symptoms which are the precursors of them. In those cases which are to follow, the symptoms of disease, for the most part, were more definite and strongly marked.

The difficulty of an investigation, such as is the object of this work, is greatly increased by the endless varieties of the human constitution, which produces a corresponding variety in the symptoms and progress of diseases. If, for example, I cite in evidence of the justness of my own conclusions an instance of a patient with a large ulcerated cancer having lived four years, it may be answered that the same disease has continued a longer time in persons living according to the common fashion of the country. And it is indeed certain that this species of evidence can have little weight, except as applied to the particular case in question; the extent of the disease, the stage in which it was taken up, the habit of the patient, and other circumstances applicable to this case, and to no other, make the deductions from the duration of the disease either just or nugatory; and our reliance upon them depends more upon our opinion of the judgment of the observer than upon the fact itself.

The same variety makes it almost, if not quite, impossible to fix upon certain and definite pathognomic signs of diseases, and more particularly in their early stages. But if these diseases are such as to afford very slight hopes of success to any method of treatment whatever in their more advanced and exquisite form, it is more especially incumbent on us to observe attentively their incipient stages, and to attempt to arrest them at this period.

Pulmonary consumption is such a disease.

As it is, when arrived at a certain stage, necessarily fatal, this stage should be regarded as the extreme effect of the morbific causes applied to the body.

These extreme effects, when they are such as commonly precede dissolution at no very remote period, it is in vain to expect to remove by the removal of the remote causes of disease. In such cases the vitality of the body is radically impaired, and the powers of restoration are destroyed. This I apprehend to be universally true, whatever is the form of the disease; though the signs of this impaired vitality may be highly diversified, and in some cases may be hardly cognizable by the senses.

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