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corrupt the air, by depraved and pestilential exhalations, but are likewise capable of producing putrid diseases and fevers."
Many other authorities .might be cited to the same purpose; since, in fact, there is hardly any physician of eminence, ancient or modern, with the exception of Cullen, who has not been sensible of the great influence of this element upon the animal economy. I do not think necessary to trouble my readers with numerous quotations from authors on this subject. I have myself little to add, in the way of reasoning, to what I have already laid before the public, in my " Inquiry into the Origin of Constitutional Diseases." Those who wish to be informed of the opinions of many other writers, I refer to Mr. Newton's publication, which he has entitled the "Return to Nature," in which he has brought together several very respectable authorities. Many others might be added to the list. As, however, I have seen it insinuated, that these are no more than antiquated notions, which have received no confirmation from the more accurate investigations of modern inquirers, and which have vanished before the correctness and precision of modern pathologists, I shall, in this place, introduce the sentiments of an enlightened French writer, the second edition of whose work (that which is before me) was published in 1805, the year in which I published my own "Inquiry." This writer is M. Cabanis, who says:
"Brackish waters, loaded with putrid vegetable matters, with earthy substances, or a considerable quantity of sulphate of lime, act in a very pernicious manner on the stomach and the other organs of digestion. The use of them produces different kinds of disease, both acute and chronic; all of them accompanied by a remarkable state of atony, and a great debility of the nervous system. Now, this atony or this debility is in its turn characterized by tormenting vaporous affections, which keep the mind in a continual state of agitation and lowness; or by an annihilation, almost absolute, of the functions, by a perfect state of imbecility. The waters called hard and crude, that is to say those which hold in solution a large quantity of sulphate of lime, and a small proportional quantity of oxygen, or rather of atmospheric air, make the deplorable enervation of the stomach and intestines pass with rapidity to the glandular system and the absorbent vessels; they load the glands, alter the lymph, and obstruct the different absorptions. From the obstruction of the glands, and the vitiation of the lymph, arise maladies, the effect of which is sometimes, I confess, to augment the activity of th3 brain, but most frequently to diminish it; maladies which may terminate by leaving it hardly that feeble degree of action, which is indispensable to carry on ths vital motions. From the defect of* the different absorptions follow new alterations of the organs and the faculties, which all tend to degrade, more and more, the tone of the fibres, and the vitality of the nervous system. These effects are the limit of those which can be produced by the use of hard and crude waters; and, to produce them completely, requires probably the concurrence of some other circumstances, which have not hitherto been determined with sufficient exactness. But when the disorders produced by the stricture of the absorbent system are characterized in a more feeble manner, and are confined to an obstinate obstruction of the different abdominal viscera, the result still is hypochondriacal and melancholic affections, the moral effects of which are sufficiently well known."
Again, the same writer observes:
"According to observations the most constant, we know that hard and crude waters can cause lymphatic obstructions; that stagnant and vapid waters blunt the sensibility, enervate the muscular force, and dispose to all cold and slow diseases. It is equally well known, that in many countries, otherwise fertile and rich, the inhabitants are forced to use these unwholesome waters. The incommodities which they produce, quickly extend their action to every point of the system; the languor speedily passes from the organs to the ideas; to the inclinations; in a word, to the morals. This influence then evidently depends upon local circumstances."
Cullen, we know, has maintained an opposite opinion; the arguments which could divert so penetrating a mind from the perception of the truth cannot but merit consideration; to weigh their force will serve to give us a clearer insight into the subject I have undertaken to treat.
"I lived," says he, "for many years in a large city, in which the waters very universally employed were very hard; and, although softer waters were within their reach, the most part of the people used only the hard. But among this people I found no endemic diseases; and at least none that I could impute to the water they drank; and certainly none that I did not find as frequent in a city which I also practiced in for many years, whose inhabitants very universally used no other than a very soft water."
This reasoning involves two suppositions, neither of which appear to be well founded. 1st. It presumes that the bad effects of water on the body are in consequence of its hardness, and in proportion to that quality. But the hardness of waters is communicated by the earthy salts; whereas it is the putrescent matter which is the most noxious principle of common water. This putrescent matter may be more abundant in soft waters than in hard; as is the case in the New River water, and still more in Thames water. 2dly. Dr. Cullen appears to have looked for some peculiar endemic diseases to be produced by the use of impure water; and, not finding any, to have concluded that the accusations against it are ill founded. But the real question is, What share does it bear in the production, not of any peculiar endemics, but of the common diseases which are infused throughout the community: a question, I apprehend, to be answered only by extensive observation, or by direct and appropriate experiments.
On this head I shall add but one or two observations to those which I have already offered in the work to which I have above referred. It is a matter of common experience that water, according to its different qualities, affects the stomach with a peculiar feeling, which we call weight; that the purest water feels the lightest; and what is reckoned, and, I believe, justly reckoned, the worst, feels the heaviest on the stomach. In healthy persons this sensation is little regarded; but in disease it becomes very distinct, and is often very tormenting. Sometimes the stomach feels as if it would burst; sometimes the sensation is as if a cord were tied round the middle of the body. In another place I have cited an example of this sensation being removed by the use of pure water.
Now it is impossible that this sense of weight and oppression can be caused by the mere difference of specific gravity between waters of different qualities. This is too trifling to be felt; and substances specifically heavier than these waters, solids for example, or even fluid mercury, may be received into the stomach, without occasioning any sensation of weight in the organ. This must be deemed therefore to be a sensation sui generis, the specific effect of the putrescent matter, or what I have termed the Septic Poison of the water; and it is probably complicated of the sensation resulting from the irritation of the mucous surface of the stomach, and that attached to the atony of the muscular fibres, yielding to the air developed by an imperfect digestion, and, at the same time, resisting the divellent force. Here then we have the direct proof of the pernicious effect of this matter upon the living fibre; and there can be no difficulty in believing that the same action which it exerts upon the stomach in the first instance, will be exerted upon every other living fibre, to which it is applied. It is, however, applied to all; it accumulates in the body; and the more as the powers of elimination become more feeble, the action is continued, unceasing; and there is, therefore, no degree of injury, even to the complete destruction of the system, which it may not readily be conceived ultimately to produce.
I would observe further, that, with regard to the noxious and the deleterious effect of the stagnant water of marshes, there has been but one common sentiment among all writers, from the days of Hippocrates to the present hour, in assigning to this cause a portion of the remarkable insalubrity of such situations. Examined hydrostatically, it is found to possess the greatest specific gravity; and it is the most loaded with foreign matter. But the peculiar noxious principle of these waters is nothing but the corrupted animal and vegetable matters with which they are impregnated. These matters are, therefore, poisonous. In consequence, they ought to be suspected whereever they are found. In inquiring therefore into the salubrity of waters in general, or into that of any particular example, it is this impregnation which I conceive ought to be the chief object of research. Simple earthy matter (though much has been said against it) has never been shown to be particularly unfriendly to the human system. Metallic matter, of all kinds, is a more just object of suspicion. But the putrid or putrescent matter, the animal or vegetable substances in a state of decomposition, is that which is actively mischievous. It is immediately and directly deleterious. It is astonishing to consider how greatly the influence of this matter has been overlooked, even by writers who were fully aware of the general importance of the subject.*
It cannot, I think, be doubted that the inconveniences which have been found to result from the use of water alone, as a common beverage, have been the principal motive, which has induced men to have recourse to spirituous and fermented liquors as a substitute. By these means some of these inconveniences have been partially obviated or counteracted, but at the expense, probably, of still greater evils. But I return to a few more general considerations.
* It is a remarkable fact that in the western country animals generally —some say always—have diseased livers; so much so that this part is never used for food. The inhabitants too, who suffer generally so much from fevers, doubtless have all diseased livers to a greater or less extent. There is every reason to believe that the bad water which is so common throughout that country, is a prominent cause of the diseases of both man and animals in those parts.—S.
la disease essential to the nature of man ?—The locality of particular diseases exemplified in remittent and intermittent fevers.—The hypothesis of l.imiaus.—Contagions, Scurvy, Bronchocele, and Cretinism.—General Conclusions.
The belief in the existence of a first and supreme Cause, and the persuasion that benevolence forms a part of his nature, and entered, as it were, into the original scheme and intention of the Creator, in the formation of the universe, are so deeply impressed upon the human mind that to dissent from them is regarded as a species of impiety, and to avow this dissent as Do better than downright madness.
It has been taught, both by ancient and modern philosophers, that the universe is, upon the whole, a perfect work, or the best that could have been possibly made. It has been hard, however, to reconcile the existence of evil with this hypothesis; and those who have attempted to solve this knotty problem have contented themselves with supposing that it has been the result of some inevitable necessity. One of the ancient sages adopted this explanation to account for the diseases of men. Crysippus was of opinion, that it could never have been the aim or first intention of the author of nature and parent of all good to make men obnoxious to diseases; but that while he was producing many excellent things, and forming his work in the best manner, other things also arose, connected with them, that were incommodious, which were not made for their own sakes, but were permitted as necessary consequences of what was best.
This certainly does not appear to be entertaining very exalted notions of divine power. To suppose either that diseases are not real evils, or to feign any hypothetical necessity for their existence, and to pronounce it impossible for Omnipotence itself to preserve the human body from them (for this account involves, I think, one of these suppositions), appears an equal extravagance.
When we consider the tendency of nature to perfection in all her works, and that this tendency is in nothing more apparent than in the structure of animal bodies, it appears indeed a strange anomaly that the human frame, the masterpiece of the creation, should be so liable to derangement and disease. If I