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Kitabı oku: «Popular Lectures on Zoonomia», sayfa 18

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In the same manner, when the body has been under the influence of violent grief, any sudden joy has been known to overpower the system, and even produce instant death. We have an instance in history, of a mother being plunged into the extreme of grief, on being informed that her son was slain in battle; but when news was brought her, that he was alive, and well, the effect upon her spirits was such, as to bring on instant death. This event ought to have been unfolded to her in the most gradual manner; she should have been told, for instance, that he was severely wounded; but that it was not certain he was dead; then that there was a report he was living, which should have been gradually confirmed, as she could bear it. The same observations may be made, with respect to hope and fear, or despair; the former is an exciting passion, the latter, a depressing one; but the one is only a lower degree of the other; for a moderate degree of hope produces a pleasant state of serenity of the mind, and contributes to the health of the body; but a diminution of it weakens; and a great degree of despair so accumulates the excitability of the system, as to render it liable to be overpowered by any sudden hope or joy afterwards applied. What proves that joy and hope act by stimulating, and grief and despair by withdrawing stimulant action from the body, is, that the former exhaust excitability, while the latter accumulate it. Joy, for instance, does not render the system more liable to be affected by hope, but the reverse; and the same may be said of hope. In the same way, heat does not render the body more liable to be affected by food, but the reverse. Both these are stimulants, and exhaust the excitability. But after heat has been applied, if it be followed by cold, a great degree of languor or weakness will take place; because we have here a direct debility, added to indirect debility. In the same way, grief succeeding joy, or despair succeeding hope, produce a greater degree of dejection, both of mind and body, than if they had not been preceded by these stimulant passions; because here, direct debility is added to indirect. The excitability is first exhausted, and then the stimulus is withdrawn.

We see then, that the passions of the mind act as stimulants to the body, that, when in a proper degree, they tend to preserve it in health; but when their action is either too powerful, or too small, they produce the same effects as the other powers. We should therefore naturally expect, that when there is a deficient action of this kind of mental stimulus, or when the mind is under the influence of the depressing passions, a predisposition to diseases of direct debility would take place, and even these diseases be produced. Accordingly we find a numerous class of nervous complaints originating from these causes. Indeed, the undue action of the mental stimulants, produces more quick alterations in the state of the excitement, than that of the other exciting powers. Violent grief, or vexation, will immediately suspend the powers of the stomach. If we suppose a person in the best health, and highest good humour, sitting down to dinner with his friends, if he suddenly receives any afflicting news, his appetite is instantly gone, he cannot swallow a morsel. If the same thing happens after he has made a hearty dinner, the action of the stomach is suddenly suspended, and the whole process of digestion stopped, and what he has eaten, lies a most oppressive load. But this is not all: the whole circulation of the blood becomes disturbed; the contraction and dilatation of the heart become irregular; it flutters, and palpitates; hence all the secretions become irregular, some of the glands acting too powerfully, others not at all; hence the increased action of the kidneys, and hence a burst of tears; hysterical affections, epilepsy, and syncope, frequently succeed, in which every muscle of the body becomes convulsed. Indeed, many terrible diseases originate from this source, which were formerly ascribed to witchcraft, and the possession of devils.

In slower, more silent, but longer continued grief, the effects are similar, but not so violent. The functions of the stomach are more gently disturbed, its juices vitiated; and acidity, and other symptoms of indigestion, will show themselves. Hence no bland and nutritive chyle is conveyed into the blood; whence emaciation and general debility must follow; and the patient will at last die, as it is said, of a broken heart.

Besides the disturbed state of the stomach, and bad digestion, there can be no sleep in this state of mind; for,

"Sleep, like the world, his ready visit pays,
Where fortune smiles; the wretched he forsakes;
Swift on his downy pinion flies from woe,
And lights on lids unsullied with a tear."

Hence the animal spirits will not be recruited, nor the worn out organs restored to vigour.

The minds of patients labouring under this division of nervous diseases, are likewise in general filled with over anxiety concerning their health; attentive to every feeling, they find, in trifles light as air, strong confirmations of their apprehensions.

It is evident, that in these cases, a state of direct debility prevails, attended with a morbidly accumulated excitability; hence, those remedies afford relief, which produce a quick exhaustion of this principle, and thus blunt the feelings, and lull the mind into some degree of forgetfulness of its woes. Hence opium, tobacco, and the fetid gums are often resorted to; and in the hands of a judicious practitioner, they will afford great relief, provided he carefully watch the patient, and prevent their abuse; for, if left to the discretion of the patient, he finds that kind of relief which he has long wished for; his moderation knows no bounds, and he is apt to take them in such a manner, as to add indirect debility, to direct, and thus bring on a state of exhausted excitability, while there is still a diminished state of mental stimulants. This will cause his spirits to be more depressed than ever; he will therefore increase the dose, whether it be of opium, tobacco, or spirituous liquors, and thus he will be hurried on, adding fuel to the flame, till his exhausted excitability becomes irrecoverable, and he ends his days in a miserable state of imbecility, if not by suicide. Hence, though some of these narcotic stimulants, which exhaust the excitability, and blunt the feelings, may be employed with advantage, in order to prepare the mind for those changes, which the physician wishes to produce, they should be used with the greatest caution, and never left in any degree to the discretion of the patient. The cure, however, depends chiefly on regulating the state of the mind, or interrupting the attention of the patient; and diverting it, if possible, to other objects than his own feeling.

Whatever aversion to application of any kind we may meet with in patients of this class, we may be assured that nothing is more pernicious to them than absolute idleness, or a vacancy from all earnest pursuit.

The occupations of business suitable to their circumstances, and situations in life, if neither attended with emotion, anxiety, nor fatigue, are always to be advised to such patients; but occupations which are objects of anxiety, and more particularly such as are exposed to accidental interruptions, disappointments, and failures, are very improper for patients of this class.

To such patients exercise in the open air is of the utmost consequence. Of all the various methods of preserving health and preventing diseases, which nature has suggested, there is none more efficacious than exercise. It puts the fluids all in motion, strengthens the solids, promotes digestion, and perspiration, and occasions the decomposition of a larger quantity of air in the lungs, and thus not only more heat, but more vital energy is supplied to the body; and of all the various modes of exercise, none conduces so much to the health of the body, as riding on horseback: it is not attended with the fatigue of walking, and the free air is more enjoyed in this way, than by any other mode of exercise. The system of the vena portarum, which collects the blood from the abdominal viscera, and circulates it through the liver, is likewise rendered more active, by this kind of exercise, than by any other, and thus a torpid state, not only of the bowels, but of this system of vessels, and the biliary system, is prevented.

When a patient of this class, however, goes out for the sake of exercise only, it does not in general produce so good an effect, as might be expected; for he is continually brooding over the state of his health: there is no new object to arrest his attention, and he is constantly reminded of the cause of his riding. Exercise will therefore be most effectual when employed in the pursuit of a journey, where a succession of pleasant scenes are likely to present themselves, and new objects arise, which call forth his attention. A journey likewise withdraws the patient from many objects of uneasiness and care, which might present themselves at home.

With respect to medicines, costiveness, which often attends these diseases, ought to be carefully avoided, by some mild laxative. Calcined magnesia, and lemonade, have always seemed to me to answer the purpose; but the most effectual method is to acquire a regular habit, which may be done by perseverance, and strict attention.

Chalybeate waters have been frequently tried, and may in general be recommended with success, particularly, as the amusement and exercise generally accompanying the use of these waters, aid the tonic powers of the iron. The bark may likewise be exhibited with advantage.

There is yet another class of nervous diseases which we have to notice, which are by no means uncommon; yet they have, like the first class, escaped the attention of writers on this subject, and of medical practitioners in general: I mean those where the system is in a state of torpor, or exhausted excitability.

This state of the system may be brought on by various causes, but principally by the long continued use of opium, tobacco, or fermented liquors.

When these substances, which are powerful stimulants, have been taken for some time, they bring on a state of the system so torpid, that the usual exciting powers, and the usual occurrences, which in general produce pleasant sensations, do not occasion a sufficient degree of excitement, in those whose excitability is thus exhausted. They therefore feel continual languor and listlessness, unless when under the influence of the stimulus which brought on the exhaustion. Every scene, however beautiful, is beheld with indifference by such patients, and the degree of ennui they feel is insupportable: this makes them have recourse to the stimulus which has exhausted their excitability, which in some degree removes this languor for a time; but it returns with redoubled strength, and redoubled horror, when the stimulant effect is over: and as this repetition exhausts the excitability more and more, the stimulus is repeated in greater quantity, and thus the disease increases to a most alarming degree.

There is no way of curing this state of nervous torpor, but by leaving off the stimuli which caused the exhaustion; and if the patient have resolution to do this for a few weeks, though, at first, he will, no doubt, find his spirits a little depressed, he will ultimately overcome the habit, and will be rewarded by alacrity of spirits, such as he never experiences under the most powerful action of artificial stimulants.

I must not, however, forget to notice, that there is a nervous state, or ennui, originating from a wrong direction of mental exertion, which exhausts the excitability to a great degree, and brings on a state of depression scarcely to be born.

When a person has by habit made his mind constantly dependent on dissipation, on gaming, and on frivolous, but not inactive pursuits, in order to produce pleasurable sensations, and at the same time neglected that culture of the understanding which will enable him to retire into himself with pleasure, and receive more enjoyment from the exercise of this cultivated understanding than he does in the most noisy, or fashionable circle of dissipation: I say, when there is this vacancy of mind, whenever it is not engaged in such pursuits as I have mentioned, a languor and weariness is experienced, which is intolerable, and which prompts the person so circumstanced, to fly continually to the only scenes which interest his mind. Hence, the passion for gaming, in which the anxiety attending it causes an interest in the mind, which takes off the dreadful languor experienced, when it is not thus employed.

It is owing to wealth, admitting of indolence, and yielding to the pursuit of transitory and unsatisfying amusements, or to that of exhausting pleasures only, that the present times exhibit to us so many instances of persons suffering under this state: it is a state totally unknown to the poor, who labour for their daily bread, and to those whose minds are actively employed in study or business. It can only be cured by cultivating the understanding, and applying to some art or science, which will engage and interest the attention. I have received the thanks of many for recommending the study of philosophy, and particularly of chemistry, to their attention. This affords a rational and interesting pursuit, which, if entered into with ardour, and if the person actually works, or makes experiments himself, he will soon experience an enjoyment and an interest, such as he never experienced at the gaming table, or at any other place of fashionable amusement. Nay, I will venture to say, that all elegant amusements will be enjoyed with much greater relish by one who employs himself in some rational pursuit, and only resorts to such amusements as a relaxation, than by one who makes these amusements a business.

From the view we have taken of these complaints, it is evident, that they are like other general diseases of the sthenic, or asthenic kind; they seem to constitute a state of the body between predisposition and disease; and they differ from most diseases in this, that in most complaints the increase, or diminution of the excitement is unequal in different parts of the body, and this gives rise to the different forms of disease; but in nervous complaints the excitement seems much more equably affected in different parts. These complaints, as we have seen, may be divided into three classes; sthenic; those of accumulated excitability; and those of exhausted excitability: but though they are evidently distinguishable in this manner, and require different modes of cure, I have never seen any account of more than one kind in any medical writer: the same remedies were prescribed for all, however different they might be.

Though medicines may relieve complaints of this kind, and particularly those of the second class, yet from what has been said, it must be evident, that much more may be done by regulating the action of the common exciting powers. Indeed, this is the case in most chronic diseases. Exercise and temperance will do infinitely more than medicine. By their means, most diseases may be overcome; but without them we may administer drugs as long as we please.

Voltaire sets this advice, which I have frequently inculcated, in so strong a light, that it may perhaps carry more conviction than any thing I can say. Ogul was a voluptuary, ambitious of nothing but good living: he thought that God had sent him into the world for no other purpose than to eat and drink: his physician, who had but little credit with him, when he had a good digestion, governed him with despotic sway, when he had eaten too much.

On feeling himself much and seriously indisposed by indolence and intemperance, he requested to know what he was to do, and the doctor ordered him to eat a basilisk, stewed in rose water, which he asserted would effect a complete cure. His slaves searched in vain for a basilisk; at last they met with Zadig, who was introduced to this mighty lord, and spoke to him in the following terms.

"May immortal health descend from Heaven to bless all thy days! I am a physician: at the report of thy indisposition, I flew to thy castle, and have now brought thee a basilisk, stewed in rose water. But, my lord, the basilisk is not to be eaten; all its virtue must enter through thy pores. I have enclosed it in a little ball, blown up and covered with a fine skin. Thou must strike this ball, with all thy might, and I must strike it back for a considerable time: and by observing this regimen for a few days, thou wilt see the effects of my art." The first day Ogul was out of breath, and thought he should have died with fatigue; the second he was less fatigued, and slept better. In eight days he recovered all the strength, all the health, all the agility and cheerfulness of his most agreeable years. Zadig then said unto him, "there is no such thing in nature as a basilisk; but thou hast taken exercise, and been temperate, and hast recovered thy health." In the same manner I say, that temperance and exercise are the two great preservers of health, and restorers of it when it is lost; and that the art of reconciling intemperance and health is as chimerical, as washing the Ethiopian white.

It will easily be perceived that the system of animal life which I have investigated, may be applied to all other general diseases, as well as the gout and those called nervous: I have merely given a view of these by way of specimen of its application.

Should these lectures contribute in any degree to lessen the future sufferings of my hearers, or any of their friends, I shall not have delivered them in vain. To be assured of this, would be the greatest pleasure that I could receive.

THE END

From the Press of the Royal Institution of Great Britain, Albemarle Street, London: W. Savage, Printer.

INDEX

A

Air, its properties – its components Animals, specific temperature of Appetite, artificial Arteries, their structure and office Assimilation, from the blood Attention, fixed on new objects

B

Banks, Sir Joseph, his almost fatal experience of cold

Beddoes, Dr. his remarks on temperature,

Bile, its properties

Blood, difference between arterial and venous

contains iron

changes produced on, by the different gases

assimilation from

Bones, mechanism of

structure of

Brown, Dr. John, his example followed

declines a definition of excitability

denies the existence of sedatives

his cure of diseases of exhaustion objected to

his theory will be as durable as Newton's philosophy

not aware of the extent of his own theory

C

Camera obscura Colour of different nations Cooper, Mr. Astley, successfully perforates the tympanum of the ear Circulation of the blood through the lungs through the liver affected by centrifugal force discovered by Harvey, and derided Cullen, Dr. his system defective Currie, Dr. his treatment of typhus

D

Darwin, Dr. quoted

Digestion, organs of

process of

diseases affecting

Diseases

sthenic

asthenic

fallacy of symptoms

Diseases, method of cure

spasmodic, of extreme vess.

classification of

nervous and bilious (so called)

of the poor

Dollond, Mr. his achromatic lenses, first suggested by Dr. David

Gregory

E

Ear, description of

diseases of

tympanum perforated

Electricity, phenomena of

useful in gout

Excitability, or vital principle

how affected by heat, food, air, &c.

accumulated by sleep

three states of

its accumulation, and exhaustion illustrated

an unknown indefinable somewhat

connected with oxygen

hypothesis respecting this connexion

scale of

how to be regulated in gout

Exercise

on horseback, best

Eye, description of

vertical section of

its accommodating power

F

Food, animal and vegetable in gout

G

Galvanism, its identity with electricity

accompanies oxydation

Gaming, &c. deplorable effects of, on the mind

Gases, their proportions in the atmosphere

changes they produce on the blood

Gastric Juice, dissolves food

proved by experiment

Gout

denied to be salutary, or incurable

not to be cured by drugs

not hereditary

mode of attack

depends not on morbific matter

its inflammation asthenic

its symptoms and description

its remissions accounted for

the terms retrocedent, atonic, &c. misapplied

mode of cure

electricity useful

Dr. Darwin's advice

Diet and medicine in

Gravity, the circulation affected by it

H

Habit, its power Harvey, discovers the circulation of the blood, and is opposed Health previous to disease, investigated point of, on the scale Heart, description of Heat, its combinations animal, accounted for its effects on the system how it affects vegetables its debilitating effects exemplified Hunger and thirst Hunter, Mr. John, dissects torpedo, and electrical eel

I

Inflammation, illustrated

sthenic

asthenic

of gout asthenic

Iron, contained in the blood

L

Lacteals, described Life, principle of Light, its properties its exciting power Lungs, circulation through Lymphatics described

M

Muscles, mechanical action of Music, its effects

N

Nerves, their distribution

Nervous and bilious, terms sometimes used without ideas

diseases (so called)

diseases really so

Newton, his query about elastic fluid misapplied

even his conjectures important

discovers the laws of sound

his reason why the crystalline is densest in the middle

knew not the cause of gravitation

Nonnaturals, misapplication of that term

Nosology

O

Odours, extreme subtilty of Haller, &c. fail in classing them convey nourishment Opium, its intoxicating effects its use in gout Organs, digestive Oxygen, experiments with connected with excitability

P

Pain encreases mental energy Passions of the mind, their effects Pendulums, laws of Peristaltic motion Physiology, its importance Pulse, the phenomena of

R

Respiration, organs of

how performed

analogous to combustion

chemically explained

S

Schools, their temperature ill regulated

Sensation

organs of

more acute by pain

Senses, general account of

external and internal

Skin

Sleep, accumulates excitability

Smell

different in different animals

Blumenbach's opinion on

diseases of

Sound, production of

media of

illustrated

velocity of

musical

reflection of

Spallanzani, his experiments on digestion

Spirituous liquors, their effects

a singular mode of correcting the abuse of

Squinting, &c.

method of cure

Stomach

diseases of

Study, debilitating effects of

T

Taste diseases of Temperancc Temperature of animals, specific and uniform Touch the basis of the other senses Typhus, Dr. Garnett's treatment of Dr. Currie's ditto