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In conformity with this doctrine, it is incumbent upon me to acknowledge that in every case of pulmonary consumption which I have deemed a confirmed case, death has ensued, notwithstanding the most exact attention to regimen upon the principles I have laid down. In some, the benefit for a time, even for three or four months, was so striking as to give great hopes that the patients would receive a cure. But new symptoms, which it is needless to relate, supervened; and the issue was as I have said. It is right, however, and indeed it is necessary to add that none of these patients lived a twelvemonth. They were therefore very far gone before they came under my care. It by no means follows, then, that the same fatal issue would have taken place had they been treated at an earlier period.

I think it right also to acknowledge some change of sentiments with regard to symptoms, from what I have expressed in my Inquiry into the Origin of Constitutional Diseases. With the general doctrine which I have there maintained, that consumption is a constitutional disease of the whole body, and not a local disease confined to the lungs, and that the symptoms indicate the system to be under the influence of a constant and preternatural stimulation, I continue to be contented; and the more so, as it has been approved by enlightened men. But I have said (p. 137 of that work) that the symptoms of increased fever, and highly rapid pulse toward the close of the disease, is an index that the vitality of the body or sensorial power is not destroyed at this period. I suspect, however, that this is a mistaken view; and that, in particular, a pulse habitually raised much beyond its natural standard of rapidity, must be deemed an index of vital powers impaired, or nearly destroyed. It is certain that in this case no diet, however anti-stimulant, will bring the pulse down to its natural standard.

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There is often much difficulty in recognizing pulmonary consumption in its earlier stages; and at this period, the subjects of this disease are so little aware of their danger, that they are too often on the verge of the grave before they think themselves seriously ill. This renders it difficult to show that regimen possesses even a preventive power over this disease. most convincing argument in its favor is that, under the regimen of vegetables and pure water, the chest takes a more perfect and expanded form. A contracted chest is the strongest of all the external signs of a consumptive tendency. If it become expanded, the pulmonary circulation must become more

strong and full, in which, in most, perhaps in all, cases of consumption, there is a radical and constitutional weakness. There are likewise strong indications that this weakness is not confined to the pulmonary circulation, but that it pervades the whole arterial system; as is obvious from the general frame of body of those who are predisposed to the disease, and might be illustrated by a more particular examination of the symptoms.

But as the pulmonary consumption, like the cancer and other chronical diseases, which prove ultimately fatal, is subject to great variety in respect to the violence of its symptoms, and the length of its duration, opportunities can be of no rare occurrence, in which the disease may be so strongly marked as to admit of little doubt with regard to its nature, and to be at the same time in so early a stage as to afford a rational prospect of arresting its progress. Such a case is the following, the subject of which was a young woman under my own roof, which will, I hope, be considered as affording very satisfactory evidence on the subject.

September the 8th, 1813.-M. W., aged about thirty-three, had lived in my family some years as a female servant. She came to me when about twenty, and seemed to have no particular delicacy or defect of constitution. She was subject, however, to convulsive affections of the nature of hysteria. On the decline of the convulsions, I generally observed a degree of tension and soreness of the abdomen, and I therefore gave her aperient medicines, and she used soon to be well again. She was also subject to cough occasionally.

She came with my family to town, in 1803. She used the distilled water for her tea, and in other liquids, but did not put herself under any restraint as to fermented liquors. However, she continued to enjoy pretty good health, as she said, better in London than she had done in the country.

Toward the end of 1807, there appeared in this young woman strong signs of failing health. She lost her color, and looked wretchedly, though there appeared no fixed or determinate complaint. The appetite failed, and the muscular strength was impaired. I advised her to adhere strictly and solely to the pure water, and to renounce animal food. She excused herself on the plea that she could eat so little; that this small quantity therefore could not hurt her. But continuing to look extremely ill, she promised to go entirely without it every second day; and I believe that she conformed in some degree to this rule for about six months.

In November, 1808, she became extremely ill, so as to ex

cite apprehensions for her life. She had frequent faintings, great pulsations and pains, sometimes of the head, sometimes of the feet; but the symptoms were irregular and anomalous, so as hardly to admit a definite appellation. After a confinement of a fortnight or more, the greater part of the time to her bed, she was gradually restored to her former state of health.

As she had no cough that was fixed (though she had frequent occasional cough), nor made any complaints about her chest, I had hitherto made no particular inquiry into the state of the organs of respiration. But during her convalescence from this illness, I examined into this point minutely. I found the breath so straitened that she was unable to expand the chest, or take in a full and deep inspiration. She was unable at night to lie but on one side. She could not go up stairs, without stopping for want of breath. I found, also, that during the last year she had been frequently troubled with pains of the side.

These symptoms, connected with her impaired health for a twelvemonth before, will, I should think, be acknowledged to be nearly infallible signs of approaching pulmonary consumption. I therefore from this moment insisted upon her entirely relinquishing the use of animal food, and, in all other respects, conforming strictly to the regimen I recommended. Though I had failed in my attempts to cure confirmed cases, I had hopes of relieving this. Here was no fixed or confirmed cough, nor any exquisite hectic fever; the pulse was accelerated after dinner, but in the morning it was nearly natural. The regimen was entered upon strictly in December, 1808.

During the year 1809, she enjoyed a somewhat improved general state of health. She was without any serious attack of illness (unless it were temporary), and her appetite for food improved. But she still looked almost cadaverously pale. All the symptoms of the affection of the chest remained also stationary—I mean, the inability to take a full inspiration; to ascend the stairs without panting and resting; to take exercise without stopping; she could still lie down only on one side.

During the far greater part of 1810, the same symptoms persevered. She often thought herself a good deal better, but these were only transient intervals. I myself, having suffered some severe disappointments in my hopes of giving relief, became disheartened, and she frequently talked of going into the country. But toward the very end of the year the relief

became decisive. She became able to draw in her breath fully and freely; to hold it for a time after the inspiration; and she recovered the power of lying on either side without inconvenience. This was (as I have said) at the close of the year 1810, when she had used the regimen strictly for two years, and had greatly lowered her diet half a year

more.

The improvement continued during the year 1811, though the marks of disease continued strongly imprinted on her features. She became much more active. She, who the year before was unable to go up stairs without panting and stopping for breath, was able this year to run up like a young healthy person. Though she was in a lower state of health than previous to her illness, she was equal to all her duties as a domestic servant. Her appetite was quite re-established, and was become strong and hearty. She was still more pallid than formerly; but the cadaverous appearance, which shocked every one who saw her, daily wore off.

During 1812 she improved still more in her looks; and again became not void of the attractions of the sex. The health also became more firmly and regularly established. Her color, though not so strong as of a person in health, was about the same as before her illness. She was restored also to nearly the same state of constitution as before her illness. Her principal complaints were a return of the same convulsive paroxysms, to which she had been subject formerly; but these attacks were over in two or three days, and had no bad consequences,

Toward the end of September, 1812, she quitted her service rather abruptly, and went into the country. It appeared, in the sequel, that she was secretly pregnant; and she was in due season safely delivered. She now resumed the common habits of life; and I understood that in consequence her color quickly improved, and she became apparently more robust; but I have reason to think that there was no real amendment of the health. But having no opportunity of being correctly informed of her present situation, I must here close the account of the case.

I offer these facts with confidence, as convincing evidence that the symptoms of pulmonary consumption can be controlled by regimen, and its progress stopped. This is the case, in which the powers of life were the most impaired, of any in which this regimen has hitherto been applied with advantage. November 29th, 1814.-I have lately been informed that

this young woman continues apparently in good health. I must observe, however, that no conclusions of any consequence can be drawn from this circumstance. Had she been for the two years that elapsed, since she left her place, in another service, living as servants commonly do, I have little doubt that the effect would have been apparent. But, in fact, she has been in place, not above three or four months of this time. For the remaining part of the time, she has lived with her parents, cottagers, in the country, and has been in very reduced circumstances. There can be no doubt, then, that she has used during this time little or no animal food. It may be said, therefore, that her regimen has, in part, been continued, though in an imperfect and irregular manner, during the last two years.

CASE VI.

Asthma.

November, 1814.—I shall in this place introduce the case of a gentleman who has eminently distinguished himself by his exertions to diffuse the knowledge of the great benefit to be obtained from the strict attention to regimen, both through the medium of the press, and by exhibiting to all, who chose to apply, a beautiful family of children bred up, with regard to diet, on the principles I have labored to establish. These exertions were wholly disinterested on his part; and though they may have exposed him to the ridicule or the obloquy of the selfish or supercilious pretenders to exclusive knowledge, will ever, in the estimation of true philanthropy, do equal honor to his head and his heart, and entitle him to the noble distinction of a benefactor of mankind. He has already given a statement of the facts regarding his own disease, as they stood when I pub lished my Reports on Cancer," that is to say, in the beginning of 1809. In his own publication, entitled "The Return to Nature," he contented himself without referring to this statement. But as several unforeseen circumstances have occurred since that time, I have thought it right to bring forward at one view the whole chain of facts. In framing this statement, I shall take as my guide several letters, which are before me, some oral communications, and a few personal observations.

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