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Title: Hypochondriasis - A Practical Treatise (1766)
Author: Hill, John, 1714?-1775
Language: English
As this book started as an ASCII text book there are no pictures available.


*** Start of this LibraryBlog Digital Book "Hypochondriasis - A Practical Treatise (1766)" ***


The Augustan Reprint Society

JOHN HILL

HYPOCHONDRIASIS

A Practical Treatise.

(1766)

Introduction by

G. S. ROUSSEAU



Publication Number 135
William Andrews Clark Memorial Library
University Of California, Los Angeles
1969



GENERAL EDITORS

  William E. Conway, _William Andrews Clark Memorial Library_
  George Robert Guffey, _University of California, Los Angeles_
  Maximillian E. Novak, _University of California, Los Angeles_


ASSOCIATE EDITOR

  David S. Rodes, _University of California, Los Angeles_


ADVISORY EDITORS

  Richard C. Boys, _University of Michigan_
  James L. Clifford, _Columbia University_
  Ralph Cohen, _University of Virginia_
  Vinton A. Dearing, _University of California, Los Angeles_
  Arthur Friedman, _University of Chicago_
  Louis A. Landa, _Princeton University_
  Earl Miner, _University of California, Los Angeles_
  Samuel H. Monk, _University of Minnesota_
  Everett T. Moore, _University of California, Los Angeles_
  Lawrence Clark Powell, _William Andrews Clark Memorial Library_
  James Sutherland, _University College, London_
  H. T. Swedenberg, Jr., _University of California, Los Angeles_
  Robert Vosper, _William Andrews Clark Memorial Library_


CORRESPONDING SECRETARY

  Edna C. Davis, _William Andrews Clark Memorial Library_


EDITORIAL ASSISTANT

  Mary Kerbret, _William Andrews Clark Memorial Library_



INTRODUCTION

     "When I first dabbled in this art, the old distemper call'd
     _Melancholy_ was exchang'd for _Vapours_, and afterwards for the
     _Hypp_, and at last took up the now current appellation of the
     _Spleen_, which it still retains, tho' a learned doctor of the
     west, in a little tract he hath written, divides the _Spleen_ and
     _Vapours_, not only into the _Hypp_, the _Hyppos_, and the
     Hyppocons; but subdivides these divisions into the _Markambles_,
     the _Moonpalls_, the _Strong-Fiacs_, and the _Hockogrokles_."


     Nicholas Robinson, _A New System of the Spleen, Vapours, and
     Hypochondriack Melancholy_ (London, 1729)


Treatises on hypochondriasis--the seventeenth-century medical term for a
wide range of nervous diseases--were old when "Sir" John Hill, the
eccentric English scientist, physician, apothecary, and hack writer,
published his _Hypochondriasis_ in 1766.[1] For at least a century and a
half medical writers as well as lay authors had been writing literature
of all types (treatises, pamphlets, poems, sermons, epigrams) on this
most fashionable of English maladies under the variant names of
"melancholy," "the spleen," "black melancholy," "hysteria," "nervous
debility," "the hyp." Despite the plethora of _materia scripta_ on the
subject it makes sense to reprint Hill's _Hypochondriasis_, because it
is indeed a "practical treatise" and because it offers the modern
student of neoclassical literature a clear summary of the best thoughts
that had been put forth on the subject, as well as an explanation of the
causes, symptoms, and cures of this commonplace malady.

No reader of seventeenth- and eighteenth-century English literature
needs to be reminded of the interest of writers of the period in the
condition--"disease" is too confining a term--hypochondriasis.[2] Their
concern is apparent in both the poetry and prose of two centuries. From
Robert Burton's Brobdingnagian exposition in _The Anatomy of Melancholy_
(1621) to Tobias Smollett's depiction of the misanthropic and ailing
Matthew Bramble in _Humphry Clinker_ (1771), and, of course, well into
the nineteenth century, afflicted heroes and weeping heroines populate
the pages of England's literature. There is scarcely a decade in the
period 1600-1800 that does not contribute to the literature of
melancholy; so considerable in number are the works that could be placed
under this heading that it actually makes sense to speak of the
"literature of melancholy." A kaleidoscopic survey of this literature
(exclusive of treatises written on the subject) would include mention of
Milton's "Il Penseroso" and "L'Allegro," the meditative Puritan and
nervous Anglican thinkers of the Restoration (many of whose narrators,
such as Richard Baxter, author of the _Reliquiae Baxterianae_,[3] are
afflicted), Swift's "School of Spleen" in _A Tale of a Tub_, Pope's
hysterical Belinda in the "Cave of Spleen," the melancholic "I" of
Samuel Richardson's correspondence, Gray's leucocholy, the
psychosomatically ailing characters of _The Vicar of Wakefield_ and
_Tristram Shandy_, Boswell's _Hypochondriack Papers_ (1777-1783)
contributed to the _London Magazine_, and such "sensible" and
"sensitive" women as Mrs. Bennett and Miss Bates in the novels of Jane
Austen. So great in bulk is this literature in the mid eighteenth
century, that C. A. Moore has written, "statistically, this deserves to
be called the Age of Melancholy."[4] The vastness of this literature is
sufficient to justify the reprinting of an unavailable practical
handbook on the subject by a prolific author all too little known.[5]

The medical background of Hill's pamphlet extends further back than the
seventeenth century and Burton's _Anatomy_. The ancient Greeks had
theorized about hypochondria: hypochondriasis signified a disorder
beneath (hypo) the gristle (chondria) and the disease was discussed
principally in physiological terms. The belief that hypochondriasis was
a somatic condition persisted until the second half of the seventeenth
century at which time an innovation was made by Dr. Thomas Sydenham. In
addition to showing that hypochondriasis and hysteria (thought previously
by Sydenham to afflict women only) were the same disease, Sydenham noted
that the external cause of both was a mental disturbance and not a
physiological one. He also had a theory that the internal and immediate
cause was a disorder of the animal spirits arising from a clot and
resulting in pain, spasms, and bodily disorders. By attributing the
onset of the malady to mental phenomena and not to obstructions of the
spleen or viscera, Sydenham was moving towards a psychosomatic theory of
hypochondriasis, one that was to be debated in the next century in
England, Holland, and France.[6] Sydenham's influence on the physicians
of the eighteenth century was profound: Cheyne in England, Boerhaave in
Holland, La Mettrie in France. Once the theory of the nervous origins of
hypochondria gained ground--here I merely note coincidence, not historical
cause and effect--the disease became increasingly fashionable in England,
particularly among the polite, the aristocratic, and the refined. Students
of the drama will recall Scrub's denial in _The Beaux' Stratagem_ (1707)
of the possibility that Archer has the spleen and Mrs. Sullen's
interjection, "I thought that distemper had been only proper to people of
quality."

Toward the middle of the eighteenth century, hypochondria was so
prevalent in people's minds and mouths that it soon assumed the
abbreviated name "the hyp." Entire poems like William Somervile's _The
Hyp: a Burlesque Poem in Five Canto's_ (1731) and Tim Scrubb's _A Rod
for the Hyp-Doctor_ (1731) were devoted to this strain; others, like
Malcom Flemyng's epic poem, _Neuropathia: sive de morbis hypochondriacis
et hystericis, libri tres, poema medicum_ (1740), were more technical
and scientific. Professor Donald Davie has written that he has often
"heard old fashioned and provincial persons [in England and Scotland]
even in [my] own lifetime say, 'Oh, you give me the hyp,' where we
should say 'You give me a pain in the neck'"[7]; and I myself have heard
the expression, "You give me the pip," where "pip" may be a corruption
of "hyp." As used in the early eighteenth century, the term "hyp" was
perhaps not far from what our century has learned to call _Angst_. It
was also used as a synonym for "lunacy," as the anonymous author of
_Anti-Siris_ (1744), one of the tracts in the tar-water controversy,
informs us that "Berkeley tells his Countrymen, they are all mad, or
_Hypochondriac_, which is but a fashionable name for Madness." Bernard
Mandeville, the Dutch physician and author of _The Fable of the Bees_,
seems to have understood perfectly well that hypochondriasis is a
condition encompassing any number of diseases and not a specific and
readily definable ailment; a condition, moreover, that hovers
precariously and bafflingly in limbo between mind and body, and he
stressed this as the theme of his _Treatise of the Hypochondriack and
Hysteric Passions, Vulgarly Call'd the Hypo in Men and Vapours in Women_
(1711). The mental causes are noted as well in an anonymous pamphlet in
the British Museum, _A Treatise on the Dismal Effects of
Low-Spiritedness_ (1750) and are echoed in many similar early and
mid-eighteenth century works. Some medical writers of the age, like
Nicholas Robinson, had reservations about the external mental bases of
the hyp and preferred to discuss the condition in terms of internal
physiological causes:

     ...of that Disorder we call the Vapours, or _Hypochondria_; for
     they have no material distinctive Characters, but what arise from
     the same Disease affecting different Sexes, and the Vapours in
     Women are term'd the _Hypochondria_ in Men, and they proceed from
     the Contraction of the Vessels being depress'd a little beneath the
     Balance of Nature, and the Relaxation of the Nerves at the same
     Time, which creates that Uneasiness and Melancholy that naturally
     attends Vapours, and which generally is an Intemperature of the
     whole Body, proceeding from a Depression of the Solids beneath the
     Balance of Nature; but the Intemperature of the Parts is that
     Peculiar Disposition whereby they favour any Disease.[8]


But the majority of medical thinkers had been persuaded that the
condition was psychosomatic, and this belief was supported by research
on nerves by important physicians in the 1740's and 1750's: the Monro
brothers in London, Robert Whytt in Edinburgh, Albrecht von Haller in
Leipzig. By mid century the condition known as the hyp was believed to
be a real, not an imaginary ailment, common, peculiar in its
manifestations, and indefinable, almost impossible to cure, producing
very real symptoms of physical illness, and said to originate sometimes
in depression and idleness. It was summed up by Robert James in his
_Medicinal Dictionary_ (London, 1743-45):

     If we thoroughly consider its Nature, it will be found to be a
     spasmodico-flatulent Disorder of the _Primae Viae_, that is, of the
     Stomach and Intestines, arising from an Inversion or Perversion of
     their peristaltic Motion, and, by the mutual consent of the Parts,
     throwing the whole nervous System into irregular Motions, and
     disturbing the whole Oeconomy of the Functions.... no part or
     Function of the Body escapes the Influence of this tedious and long
     protracted Disease, whose Symptoms are so violent and numerous,
     that it is no easy Task either to enumerate or account for them....
     No disease is more troublesome, either to the Patient or Physician,
     than hypochondriac Disorders; and it often happens, that, thro' the
     Fault of both, the Cure is either unnecessarily protracted, or
     totally frustrated; for the Patients are so delighted, not only
     with a Variety of Medicines, but also of Physicians.... On the
     contrary, few physicians are sufficiently acquainted with the true
     Genius and Nature of this perplexing Disorder; for which Reason
     they boldly prescribe almost everything contained in the Shops, not
     without an irreparable Injury to the Patient (article on
     "Hypochondriacus Morbis").

This is a more technical description than Hill gives anywhere in his
handbook, but it serves well to summarize the background of the condition
about which Sir John wrote.

Hill's _Hypochondriasis_ adds little that is new to the theory of the
disease. It incorporates much of the thinking set forth by the writings
mentioned above, particularly those of George Cheyne, whose medical
works _The English Malady_ (1733) and _The Natural Method of Cureing the
Diseases of the Body, and the Disorders of the Mind Depending on the
Body_ (1742) Hill knew. He is also conversant with some Continental
writers on the subject, two of whom--Isaac Biberg, author of The
_Oeconomy of Nature_ (1751), and René Réaumur who had written a history
of insects (1722)[9]--he mentions explicitly, and with William
Stukeley's _Of the Spleen_ (1723). Internal evidence indicates that Hill
had read or was familiar with the ideas propounded in Richard
Blackmore's _Treatise of the Spleen and Vapours_ (1725) and Nicholas
Robinson's _A New System of the Spleen, Vapours, and Hypochondriack
Melancholy_ (1729).

Hill's arrangement of sections is logical: he first defines the
condition (I), then proceeds to discuss persons most susceptible to it
(II), its major symptoms (III), consequences (IV), causes (V), and cures
(VI-VIII). In the first four sections almost every statement is
commonplace and requires no commentary (for example, Hill's opening
remark: "To call the Hypochondriasis a fanciful malady, is ignorant and
cruel. It is a real, and a sad disease: an obstruction of the spleen by
thickened and distempered blood; extending itself often to the liver,
and other parts; and unhappily is in England very frequent: physick
scarce knows one more fertile in ill; or more difficult of cure.") His
belief that the condition afflicts sedentary persons, particularly
students, philosophers, theologians, and that it is not restricted to
women alone--as some contemporary thinkers still maintained--is also
impossible to trace to a single source, as is his description (p. 12) of
the most prevalent physiological _symptoms_ ("lowness of spirits, and
inaptitude to motion; a disrelish of amusements, a love of solitude....
Wild thoughts; a sense of fullness") and _causes_ (the poor and damp
English climate and the resultant clotting of blood in the spleen) of
the illness.

Sections V-VIII, dealing with causes and cures, are less commonplace and
display some of Hill's eccentricities as a writer and thinker. He uses
the section entitled "Cures" as a means to peddle his newly discovered
cure-all, water dock,[10] which Smollett satirized through the mouth of
Tabitha Bramble in _Humphry Clinker_ (1771). Hill also rebelled against
contemporary apothecaries and physicians who prescribed popular
medicines--such as Berkeley's tar-water, Dover's mercury powders, and
James's fever-powders--as universal panaceas for the cure of the hyp.
"No acrid medicine must be directed, for that may act too hastily,
dissolve the impacted matter at once, and let it loose, to the
destruction of the sufferer; no antimonial, no mercurial, no martial
preparation must be taken; in short, no chymistry: nature is the shop
that heaven has set before us, and we must seek our medicine there"
(p. 24). However scientifically correct Hill may have been in minimizing
the efficacy of current pills and potions advertised as remedies for the
hyp, he was unusual for his time in objecting so strongly to them. Less
eccentric was his allegiance to the "Ancients" rather than to the
"Moderns" so far as chemical treatment (i.e., restoration of the humours
by chemical rearrangement) of hypochondriasis is concerned.[11] "The
venerable ancients," Hill writes, "who knew not this new art, will lead
us in the search; and (faithful relators as they are of truth) will tell
us whence we may deduce our hope; and what we are to fear" (p. 24).

Still more idiosyncratic, perhaps, is Hill's contention (p. 25) that the
air of dry, high grounds worsens the condition of the patient. Virtually
every writer I have read on the subject believed that onset of the hyp
was caused by one of the six non-naturals--air, diet, lack of sufficient
sleep, too little or too much exercise, defective evacuation, the
passions of the mind; and although some medical writers emphasized the
last of these,[12] few would have concurred with Hill that the fetid air
of London was less harmful than the clearer air at Highgate. All readers
of the novel of the period will recall the hypochondriacal Matt
Bramble's tirade against the stench of London air. Beliefs of the
variety here mentioned cause me to question Hill's importance in the
history of medicine; there can be no question about his contributions to
the advancement of the science of botany through popularization of
Linnaeus' system of bisexual classification, but Hill's medical
importance is summarized best as that of a compiler. His recommendation
of the study of botany as a cure for melancholics is sensible but verges
on becoming "a digression in praise of the author," a poetic _apologia
pro vita sua_ in Augustan fashion:

     For me, I should advise above all other things the study of nature.
     Let him begin with plants: he will here find a continual pleasure,
     and continual change; fertile of a thousand useful things; even of
     the utility we are seeking here. This will induce him to walk; and
     every hedge and hillock, every foot-path side, and thicket, will
     afford him some new object. He will be tempted to be continually in
     the air; and continually to change the nature and quality of the
     air, by visiting in succession the high lands and the low, the
     lawn, the heath, the forest. He will never want inducement to be
     abroad; and the unceasing variety of the subjects of his
     observation, will prevent his walking hastily: he will pursue his
     studies in the air; and that contemplative turn of mind, which in
     his closet threatened his destruction, will thus become the great
     means of his recovery (pp. 26-27).

Hill was forever extolling the claims of a life devoted to the study of
nature, as we see in a late work, _The Virtues of British Herbs_ (1770).
Judicious as is the logic of this recommendation, one cannot help but
feel that the emphasis here is less on diversion as a cure and more on
the botanic attractions of "every hedge and hillock, every foot-path
side, and thicket."

While Hill's rules and regulations regarding proper diet (Section VII)
are standard, several taken almost _verbatim et literatim_ from Cheyne's
list in _The English Malady_ (1733), his recommendation (Section VIII)
of "Spleen-Wort" as the best medicine for the hypochondriac patient is
not. Since Hill devotes so much space to the virtues of this herb and
concludes his work extolling this plant, a word should be said about it.
Throughout his life he was an active botanist. Apothecary, physician,
and writer though he was, it was ultimately botany that was his ruling
passion, as is made abundantly clear in his correspondence.[13] Wherever
he lived--whether in the small house in St. James's Street or in the
larger one on the Bayswater Road--he cultivated an herb garden that
flattered his knowledge and ability. Connoisseurs raved about its
species and considered it one of the showpieces of London. His arrogant
personality alone prevented him from becoming the first Keeper of the
Apothecary's Garden in Chelsea, although he was for a time
superintendent to the Dowager Princess of Wales's gardens at Kensington
Palace and at Kew. His interest in cultivation of herbs nevertheless
continued; over the years Hill produced more than thirty botanical
works, many of them devoted to the medical virtues of rare herbs such as
"Spleen-Wort." Among these are _The British Herbal_ (1756), _On the
Virtues of Sage in Lengthening Human Life_ (1763), _Centaury, the Great
Stomachic_ (1765), _Polypody_ (1768), _A Method of Curing Jaundice_
(1768), _Instances of the Virtue of Petasite Root_ (1771), and _Twenty
Five New Plants_ (1773).[14] It is therefore not surprising that he
should believe a specific herb to be the best remedy for a complicated
medical condition. Nor is his reference to the Ancients as authority for
the herbal pacification of an inflamed spleen surprising in the light of
his researches: he was convinced that every illness could be cured by
taking an appropriate herb or combination of herbs. Whereas a few
nonmedical writers--such as John Wesley in _Primitive Physick_
(1747)--had advocated the taking of one or two herbs in moderate dosage
as anti-hysterics (the eighteenth-century term for all cures of the
hyp), no medical writer of the century ever promoted the use of herbs to
the extent that Hill did. In fairness to him, it is important to note
that his herbal remedies were harmless and that many found their way
into the official _London Pharmacopeia_. "The virtues of this smooth
Spleen-wort," he insists, "have stood the test of ages; and the plant
every where retained its name and credit: and one of our good
herbarists, who had seen a wonderful case of a swoln spleen, so big, and
hard as to be felt with terror, brought back to a state of nature by it"
(p. 37).[15] The greatest portion of Hill's concluding section combines
advertisement for the powder medicine he was himself manufacturing at a
handsome profit together with a protest against competing apothecaries:
"An intelligent person was directed to go to the medicinal herb shops in
the several markets, and buy some of this Spleen-wort; the name was
written, and shewn to every one; every shop received his money, and
almost every one sold a different plant, under the name of this: but
what is very striking, not one of them the right" (p. 42).

Treatises on hypochondriasis did not cease to be printed after Hill's in
1766, but continued to issue from the presses into the nineteenth
century. A good example of this is the tome by John Reid, physician to
the Finsbury Dispensary in London, _Essays on Insanity, Hypochondriasis
and Other Nervous Affections_ (1816), which summarizes theories of the
malady.[16] A bibliographical study of such works would probably reveal
a larger number of titles in the nineteenth century than in the previous
one, but by this time the nature and definition of hypochondria had
changed significantly.

If John Hill's volume is not an important contribution in the history of
medicine, it is a lucid and brief exposition of many of the best ideas
that had been thought and written on the hyp, with the exception of his
uninhibited prescribing of herbal medicines as cure-alls. An
understanding of this disease is essential for readers of neoclassical
English literature, especially when we reflect upon the fact that some
of the best literature of the period was composed by writers whom it
afflicted. It is perhaps not without significance that the greatest poet
of the Augustan age, Alexander Pope, thought it necessary as he lay on
his deathbed in May 1744 to exclaim with his last breath, "I never was
hippish in my whole life."[17]

  University of California,
  Los Angeles



NOTES TO THE INTRODUCTION


[1] The text here reproduced is that of the copy in the Library of the
Royal Society of Medicine, London. Title pages of different copies of
the first edition of 1766 vary. For example, the title page of the copy
in the British Museum reads, _Hypochondriasis; a Practical Treatise On
the Nature and Cure of that Disorder, Commonly called the Hyp and the
Hypo_. The copy in the Royal Society of Medicine contains, among other
additions, the words "by Sir John Hill" in pencil, and "8vo Lond.
1766," written in ink and probably a later addition.

[2] Melancholy, hypochondriasis, and the spleen were considered in the
seventeenth and eighteenth centuries to be one complex condition, a
malady rather than a malaise, which is but a symptom. Distinctions among
these, of interest primarily to medical historians, cannot be treated
here. As good a definition as any is found in Dr. Johnson's _Dictionary_
(1755): "Hypochondriacal.... 1. Melancholy; disordered in the
imagination.... 2. Producing melancholy...." The literature of
melancholy has been surveyed in part by C. A. Moore, "The English
Malady," _Backgrounds of English Literature 1700-1760_ (Minneapolis,
1953), pp. 179-235. In medical parlance, "hypochondria" means the soft
parts of the body below the costal cartilages, and the singular form of
the word, "hypochondrium," means the viscera situated in the
hypochondria, i.e., the liver, gall bladder, and spleen.

[3] See Samuel Clifford's _The Signs and Causes of Melancholy, with
directions suited to the case of those who are afflicted with it.
Collected out of the works of Mr. Richard Baxter_ (London, 1716) in the
British Museum.

[4] _Backgrounds of English Literature_, p. 179.

[5] See my forthcoming biography, _The Literary Quack: A Life of 'Sir'
John Hill of London_, and John Kennedy's _Some Remarks on the Life and
Writings of Dr. J---- H----, Inspector General of Great Britain_
(London, 1752).

[6] For some of this background see L. J. Rather, _Mind and Body in
Eighteenth Century Medicine: A Study Based on Jerome Gaub's De Regimine
Mentis_ (London, 1965), pp. 135-90 _passim_.

[7] _Science and Literature 1700-1740_ (London, 1964), pp. 50-51.

[8] _A New Theory of Physick_ (London, 1725), p. 56.

[9] Biberg was a Swedish naturalist and had studied botany under
Linnaeus in Uppsala; Réaumur, a French botanist, had contributed papers
to the _Philosophical Transactions_ of the Royal Society in London.

[10] _The Power of Water-Dock against the Scurvy whether in the Plain
Root or Essence...._ (London, 1765), had been published six months
earlier than _Hypochondriasis_ and had earned Hill a handsome profit.

[11] I have treated aspects of this subject in my article, "Matt Bramble
and The Sulphur Controversy in the XVIIIth Century: Medical Background
of _Humphry Clinker_," _JHI_, XXVIII (1967), 577-90.

[12] See, for example, Jeremiah Waineright, _A Mechanical Account of the
Non-Naturals_ (1707); John Arbuthnot, _An Essay Concerning the Effects
of Air on Human Bodies_ (1733); Frank Nichols, _De Anima Medica_ (1750).

[13] Hill's correspondence is not published but shall be printed as an
appendix to my forthcoming biography.

[14] I have discussed some of these works in connection with the medical
background of John Wesley's _Primitive Physick_ (1747). See G. S.
Rousseau, _Harvard Library Bulletin_, XVI (1968), 242-56.

[15] It is difficult to know with certainty when Hill first became
interested in the herb. He mentions it in passing in _The British
Herbal_ (1756), I, 526 and may have sold it as early as 1742 when he
opened an apothecary shop.

[16] Reid's dissertation at Edinburgh, entitled _De Insania_ (1798),
contains materials on the relationship of the imagination to all forms
of mental disturbance. Secondary literature on hypochondria is
plentiful. Works include: R. H. Gillespie, _Hypochondria_ (London,
1928), William K. Richmond, _The English Disease_ (London, 1958),
Charles Chenevix Trench, _The Royal Malady_ (New York, 1964), and Ilza
Vieth, _Hysteria: The History of a Disease_ (Chicago, 1965), and "On
Hysterical and Hypochondriacal Afflictions," _Bulletin of the History of
Medicine_, XXX (1956), 233-40.

[17] Joseph Spence, _Observations, Anecdotes, and Characters of Books
and Men_, ed. James M. Osborn (Oxford, 1966), I, 264.

I am indebted to A. D. Morris, M.D., F.R.S.M., for help of various sorts
in writing this introduction.



BIBLIOGRAPHICAL NOTE

The text of this facsimile of _Hypochondriasis_ is reproduced from a
copy in the Library of the Royal Society of Medicine, London.



     HYPOCHONDRIASIS.

            A

  PRACTICAL TREATISE, &c.



HYPOCHONDRIASIS.


SECT. I.

The NATURE of the DISORDER.


To call the Hypochondriasis a fanciful malady, is ignorant and cruel. It
is a real, and a sad disease: an obstruction of the spleen by thickened
and distempered blood; extending itself often to the liver, and other
parts; and unhappily is in England very frequent: physick scarce knows
one more fertile in ill; or more difficult of cure.

The blood is a mixture of many fluids, which, in a state of health, are
so combined, that the whole passes freely through its appointed vessels;
but if by the loss of the thinner parts, the rest becomes too gross to
be thus carried through, it will stop where the circulation has least
power; and having thus stopped it will accumulate; heaping by degrees
obstruction on obstruction.

Health and chearfulness, and the quiet exercise of mind, depend upon a
perfect circulation: is it a wonder then, when this becomes impeded the
body looses of its health, and the temper of its sprightliness? to be
otherwise would be the miracle; and he inhumanly insults the afflicted,
who calls all this a voluntary frowardness. Its slightest state brings
with it sickness, anguish and oppression; and innumerable ills follow
its advancing steps, unless prevented by timely care; till life itself
grows burthensome.

The disease was common in antient Greece; and her physicians understood
it, better than those perhaps of later times, in any other country; who
though happy in many advantages these fathers of the science could not
have, yet want the great assistance of frequent watching it in all its
stages.

Those venerable writers have delivered its nature, and its cure: in the
first every thing now shews they were right; and what they have said as
to the latter will be found equally true and certain. This, so far as
present experience has confirmed it, and no farther, will be here laid
before the afflicted in a few plain words.



SECT. II.

Persons Subject to it.


Fatigue of mind, and great exertion of its powers often give birth to
this disease; and always tend to encrease it. The finer spirits are
wasted by the labour of the brain: the Philosopher rises from his study
more exhausted than the Peasant leaves his drudgery; without the benefit
that he has from exercise. Greatness of mind, and steady virtue;
determined resolution, and manly firmness, when put in action, and
intent upon their object, all also lead to it: perhaps whatever tends to
the ennobling of the soul has equal share in bringing on this weakness
of the body.

From this we may learn easily who are the men most subject to it; the
grave and studious, those of a sedate temper and enlarged understanding,
the learned and wise, the virtuous and the valiant: those whom it were
the interest of the world to wish were free from this and every other
illness; and who perhaps, except for this alloy, would have too large a
portion of human happiness.

Though these are most, it is not these alone, who are subject to it.
There are countries where it is endemial, and in other places some have
the seeds of it in their constitution; and in some it takes rise from
accidents. In these last it is the easiest of cure; and in the first
most difficult.

Beside the Greeks already named, the Jews of old time were heavily
afflicted with this disease; and in their descendants to this day it is
often constitutional: the Spaniards have it almost to a man; and so have
the American Indians. Perhaps the character of these several nations may
be connected with it. The steady honour, and firm valour of the
Spaniard, very like that of the ancient Doric nation, who followed the
flute not the trumpet to the field; and met the enemy, not with shouts
and fury, but with a determined virtue: it is the temper of the
Hypochondriac to be slow, but unmoveably resolved: the Jew has shewn
this mistakenly, but almost miraculously; and the poor Indian, untaught
as he is, faces all peril with composure, and sings his death-song with
an unalter'd countenance.

Among particular persons the most inquiring and contemplative are those
who suffer oftenest by this disease; and of all degrees of men I think
the clergy. I do not mean the hunting, shooting, drinking clergy, who
bear the tables of the great; but the retir'd and conscientious; such as
attend in midnight silence to their duty; and seek in their own cool
breasts, or wheresoever else they may be found, new admonitions for an
age plunged in new vices. To this disease we owe the irreparable loss of
Dr. YOUNG; and the present danger of many other the best and most
improved amongst us. May what is here to be proposed assist in their
preservation!

The Geometrician or the learned Philosopher of whatever denomination,
whose course of study fixes his eye for ever on one object, his mind
intensely and continually employed upon one thought, should be warned
also that he is in danger; or if he find himself already afflicted, he
should be told that the same course of life, which brought it on, will,
without due care, encrease it to the most dreaded violence.

The middle period of life is that in which there is the greatest danger
of an attack from this disease; and the latter end of autumn, when the
summer heats have a little time been over, is the season when in our
climate its first assaults are most to be expected. The same time of the
year always increases the disorder in those who have been before
afflicted with it; and it is a truth must be confessed, that from its
first attack the patient grows continually, though slowly, worse; unless
a careful regimen prevent it.

The constitutions most liable to this obstruction are the lean, and dark
complexioned; the grave and sedentary. Let such watch the first
symptoms; and obviate, (as they may with ease) that which it will be
much more difficult to remove.

It is happy a disease, wherein the patient must do a great deal for
himself, falls, for the most part, upon those who have the powers of
reason strongest. Let them only be aware of this, that the distemper
naturally disposes them to inactivity; and reason will have no use
unless accompanied with resolution to enforce it.

Though the physician can do something toward the cure, much more depends
upon the patient; and here his constancy of mind will be employed most
happily. No one is better qualified to judge on a fair hearing what
course is the most fit; and having made that choice, he must with
patience wait its good effects. Diseases that come on slowly must have
time for curing; an attention to the first appearances of the disorder
will be always happiest; because when least established it is easiest
overthrown: but when that happy period has been neglected, he must wait
the effects of such a course as will dilute and melt the obstructing
matter gradually; for till that be done it is not only vain, but
sometimes dangerous, to attempt its expulsion from the body.

The blood easily separates itself into the grosser and the thinner
parts: we see this in bleeding; and from the toughness of the red cake
may guess how very difficult it will be to dissolve a substance of like
firmness in the vessels of the body. That it can thus become thickened
within the body, a Pleurisy shews us too evidently: in that case it is
brought on suddenly, and with inflammation; in this other, slowly and
without; and here, even before it forms the obstruction, can bring on
many mischiefs. Various causes can produce the same effect, but that in
all cases operates most durably, which operates most slowly. The watery
part of the blood is its mild part; in the remaining gross matter of it,
are acrid salts and burning oils, and these, when destitute of that
happy dilution nature gives them in a healthy body, are capable of doing
great mischief to the tender vessels in which they are kept stagnant.



SECT. III.

The SYMPTOMS of the DISORDER.


The first and lightest of the signs that shew this illness are a lowness
of spirits, and inaptitude to motion; a disrelish of amusements, a love
of solitude and a habit of thinking, even on trifling subjects, with too
much steadiness. A very little help may combat these: but if that
indolence which is indeed a part of the disorder, will neglect them;
worse must be expected soon to follow.

Wild thoughts; a sense of fullness, weight, and oppression in the body,
a want of appetite, or, what is worse, an appetite without digestion;
for these are the conditions of different states of the disease, a
fullness and a difficulty of breathing after meals, a straitness of the
breast, pains and flatulencies in the bowels, and an unaptness to
discharge their contents.

The pulse becomes low, weak, and unequal; and there are frequent
palpitations of the heart, a little dark-coloured urine is voided at
some times; and a flood of colourless and insipid at others; relieving
for a moment, but increasing the distemper: there is in some cases also
a continual teazing cough, with a choaking stoppage in the throat at
times; then heartburn, sickness, hardness of the belly, and a costive
habit, or a tormenting and vain irritation.

The lips turn pale, the eyes loose their brightness and by degrees the
white grows as it were greenish, the gums want their due firmness, with
their proper colour; and an unpleasing foulness grows upon the teeth:
the inside of the mouth is pale and furred, and the throat dry and
husky: the colour of the skin is pale (though there are periods when the
face is florid) and as the obstruction gathers ground, and more affects
the liver, the whole body becomes yellow, tawny, greenish, and at length
of that deep and dusky hue, to which men of swift imagination have given
the name of blackness.

These symptoms do not all appear in any one period of the disease, or in
one case, but at one time or other all of them, as well as those which
follow: the flesh becomes cold to the touch, though the patient does not
himself perceive it; the limbs grow numbed and torpid, the breathing
dull and slow, and the voice hollow; and usually the appetite in this
period declines, and comes almost to nothing: night sweats come on,
black swellings appear on the veins, the flesh wastes and the breast
becomes flat and hollow: the mouth is full of a thin spittle, the head
is dizzy and confus'd, and sometimes there is an unconquerable numbness
in the organs of speech.

I have known the temporary silence that follows upon this last symptom
become a jest to the common herd; and the unhappy patient, instead of
compassion and assistance, receive the reproof of sullenness, from those
who should have known and acted better.

About twenty years ago I met on a visit at Catthorpe in Leicestershire a
young gentleman of distinguished learning and abilities, who at certain
times was speechless. The vulgar thought it a pretence: and a jocose
lady, where he was at tea with company, putting him as she said to a
trial, poured out a dish very strong and without sugar. He drank it and
returned the cup with a bow of great reserve, and his eye bent on the
ground: she then filled the cup with sugar, and pouring weak tea on it,
sent it him: he drank that too, looked at her steadily, and blushed for
her. The lady declared the man was dumb; the rest thought him perverse,
and obstinate; but a constant and steady perseverance in an easy method
cured him.

All these are miseries which the disease, while it retains its natural
form, can bring upon the patient; and thus he will in time be worn out,
and led miserably, though slowly, to the grave. Let him not indulge his
inactivity so far as to give way to this, because it is represented as
far off; the disease may suddenly and frightfully change its nature; and
swifter evils follow.



SECT. IV.

The DANGER.


We have done with the obstruction considered in itself; but this, though
often unsurmountable by art, at least by the methods now in use, will be
sometimes broken through at once by nature, or by accidents; and bring
on fatal evils. These are strictly different diseases, and are no
otherway concerned here, than as the consequences of that of which we
are treating.

The thick and glutinous blood which has so long stagnated in the spleen,
will have in that time altered its nature, and acquired a very great
degree of acrimony: while it lies dormant, this does no more mischiefs,
than those named already; but when violent exercise, a fit of outrageous
anger, or any thing else that suddenly shocks and disturbs the frame,
puts it in motion, it melts at once into a kind of liquid putrefaction.
Being now thin, it mixes itself readily with the blood again, and brings
on putrid fevers; destroys the substance of the spleen itself, or being
thrown upon some other of the viscera, corrodes them, and leads on this
way a swift and miserable death. If it fall upon the liver, its tender
pulpy substance is soon destroyed, jaundices beyond the help of art
first follow, then dropsies and all their train of misery; if on lungs,
consumptions; if on the brain, convulsions, epilepsy, palsy, apoplexy;
if on the surface, leprosy.

The intention of cure is to melt this coagulation softly, not to break
it violently; and then to give it a very gentle passage through the
bowels. There is no safe way for it to take but that; and even that when
urged too far may bring on fatal dysenteries.

Let none wonder at the sudden devastation which sometimes arises from
this long stagnant matter, when liquified too hastily: how long, how
many years the impacted matter will continue quiet in a schirrous tumour
of the breast; but being once put in motion, whether from accident, or
in the course of nature, what can describe; or what can stop its
havock!

Instances of the other are too frequent. A nobleman the other day died
paralytick: dissection shewed a spleen consumed by an abscess, formed
from the dissolved matter of such an obstruction: and 'tis scarce longer
since, a learned gentleman, who had been several years lost to his
friends, by the extreams of a Hypochondriacal disorder, seem'd gradually
without assistance to recover: but the lungs suffered while the spleen
was freed; and he died very soon of what is called a galloping
consumption.

When the obstruction is great and of long continuance, if it be thus
hastily moved, the consequence is, equally, a sudden and a miserable
death, whether, like the matter of a cancer, it remains in its place; or
like that of a bad small pox, be thrown upon some other vital part.

Let not the patient be too much alarmed; this is laid down to caution,
not to terrify him: it is fit he should know his danger, and attend to
it; for the prevention is easy; and the cure, even of the most advanced
stages, when undertaken by gentle means, is not at all impracticable: to
assist the physician, let him look into himself, and recollect the
source of his complaint. This he may judge of from the following
notices.



SECT. V.

The Causes of the HYPOCHONDRIASIS.


The obstruction which forms this disease, may take its origin from
different accidents: a fever ill cured has often caused it; or the
piles, which had been used to discharge largely, ceasing; a marshy soil,
poisoned with stagnant water, has given it to some persons; and altho'
indolence and inactivity are oftenest at the root, yet it has arisen
from too great exercise.

Real grief has often brought it on; and even love, for sometimes that is
real. Study and fixed attention of the mind have been accused before;
and add to these the stooping posture of the body, which most men use,
though none should use it, in writing and in reading. This has
contributed too much to it; but of all other things night studies are
the most destructive. The steady stillness, and dusky habit of all
nature in those hours, enforce, encourage, and support that settled
gloom, which rises from fixt thought; and sinks the body to the grave;
even while it carries up the mind to heaven. He who would have his lamp

        _At midnight hour
  Be seen in some high lonely tower,_[18]

will waste the flame of this unheeded life: and while he labours to
unsphere the spirit of Plato[18] will let loose his own.



SECT. VI.

The Cure of the HYPOCHONDRIASIS.


Let him who would escape the mischiefs of an obstructed spleen, avoid
the things here named: and let him who suffers from the malady,
endeavour to remember to which of them it has been owing; for half the
hope depends upon that knowledge.

Nature has sometimes made a cure herself, and we should watch her ways;
for art never is so right as when it imitates her: sometimes the
patient's own resolution has set him free. This is always in his power,
and at all times will do wonders.

The bleeding of the piles, from nature's single efforts, has at once
cured a miserable man; where their cessation was the cause of the
disorder. A leprosy has appeared upon the skin, and all the symptoms of
the former sickness vanished. This among the Jews happened often: both
diseases we know were common among them: and I have here seen something
very like it: Water-Dock has thrown out scorbutic eruptions, and all the
former symptoms of an Hypochondriacal disorder have disappeared:
returning indeed when these were unadvisedly struck in; but keeping off
entirely when they were better treated. A natural purging unsuppressed
has sometimes done the same good office: but this is hazardous.

It is easy to be directed from such instances; only let us take the
whole along with us. Bleeding would have answered nature's purpose, if
she could not have opened of herself the hæmorrhoidal vessels; but he
who should give medicines for that purpose, might destroy his patient by
too great disturbance. If a natural looseness may perform the cure, so
may an artificial; when the original source of the disorder points that
way. But these are helps that take place only in particular cases.

The general and universal method of cure must be by some mild and gently
resolving medicine, under the influence of which the obstructing matter
may be voided that, or some other way with safety. The best season to
undertake this is the autumn, but even here there must be caution.

In the first place, no strong evacuating remedy must be given; for that,
by carrying off the thinner parts of the juices, will tend to thicken
the remainder; and certainly encrease the distemper. No acrid medicine
must be directed, for that may act too hastily, dissolve the impacted
matter at once, and let it loose, to the destruction of the sufferer; no
antimonial, no mercurial, no martial preparation must be taken; in
short, no chymistry: nature is the shop that heaven has set before us,
and we must seek our medicine there. The venerable ancients, who knew
not this new art, will lead us in the search; and (faithful relators as
they are of truth) will tell us whence we may deduce our hope; and what
we are to fear.

But prior to the course of any medicine, and as an essential to any good
hope from it, the patient must prescribe himself a proper course of
life, and a well chosen diet: let us assist him in his choice; and speak
of this first, as it comes first in order.



SECT. VI.

Rules of Life for Hypochondriac Persons.


Air and exercise, as they are the best preservers of health, and
greatest assistants in the cure of all long continued diseases, will
have their full effect in this; but there requires some caution in the
choice, and management of them. It is common to think the air of high
grounds best; but experience near home shews otherwise: the
Hypochondriac patient is always worse at Highgate even than in London.

The air he breathes should be temperate; not exposed to the utmost
violences of heat and cold, and the swift changes from one to the
other; which are most felt on those high grounds. The side of a hill is
the best place for him: and though wet grounds are hurtful; yet let
there be the shade of trees, to tempt him often to a walk; and soften by
their exhalation the over dryness of the air.

The exercise he takes should be frequent; but not violent. Motion
preserves the firmness of the parts, and elasticity of the vessels; it
prevents that aggregation of thick humours which he is most to fear. A
sedentary life always produces weakness, and that mischief always
follows: weak eyes are gummy, weak lungs are clogged with phlegm, and
weak bowels waste themselves in vapid diarrhoeas.

Let him invite himself abroad, and let his friends invite him by every
innocent inducement. For me, I should advise above all other things the
study of nature. Let him begin with plants: he will here find a
continual pleasure, and continual change; fertile of a thousand useful
things; even of the utility we are seeking here. This will induce him to
walk; and every hedge and hillock, every foot-path side, and thicket,
will afford him some new object. He will be tempted to be continually
in the air, and continually to change the nature and quality of the air,
by visiting in succession the high lands and the low, the lawn, the
heath, the forest. He will never want inducement to be abroad; and the
unceasing variety of the subjects of his observation, will prevent his
walking hastily: he will pursue his studies in the air; and that
contemplative turn of mind, which in his closet threatened his
destruction, will thus become the great means of his recovery.

If the mind tire upon this, from the repeated use, another of nature's
kingdoms opens itself at once upon him; the plant he is weary of
observing, feeds some insect he may examine; nor is there a stone that
lies before his foot, but may afford instruction and amusement.

Even what the vulgar call the most abject things will shew a wonderful
utility; and lead the mind, in pious contemplation higher than the
stars. The poorest moss that is trampled under foot, has its important
uses: is it at the bottom of a wood we find it? why there it shelters
the fallen seeds; hides them from birds, and covers them from frost;
and thus becomes the foster father of another forest! creeps it along
the surface of a rock? even there its good is infinite! its small roots
run into the stone, and the rains make their way after them; the moss
having lived its time dies; it rots and with the mouldered fragments of
the stone forms earth; wherein, after a few successions, useful plants
may grow, and feed more useful cattle![19]

Is there a weed more humble in its aspect, more trampled on, or more
despised than knot grass! no art can get the better of its growth, no
labour can destroy it; 'twere pity if they could, for the thing lives
where nothing would of use to us; and its large and most wonderfully
abundant seeds, feed in hard winters, half the birds of Heaven.

What the weak moss performs upon the rock the loathed toadstool brings
about in timber: is an oak dead where man's eye will not find it? this
fungus roots itself upon the bark, and rots the wood beneath it; hither
the beetle creeps for shelter, and for sustenance; him the woodpecker
follows as his prey; and while he tears the tree in search of him, he
scatters it about the ground; which it manures.

Nor is it the beetle alone that thus insinuates itself into the
substance of the vegetable tribe: the tender aphide[20], whom a touch
destroys, burrows between the two skins of a leaf, for shelter from his
winged enemies; tracing, with more than Dedalæan art, his various
meanders; and veining the green surface with these white lines more
beautifully than the best Ægyptian marble.

'Twere endless to proceed; nor is it needful: one object will not fail
to lead on to another, and every where the goodness of his God will
shine before him even in what are thought the vilest things; his
greatness in the lead of them.

Let him pursue these thoughts, and seek abroad the objects and the
instigations to them: but let him in these and all other excursions
avoid equally the dews of early morning, and of evening.

The more than usual exercise of this prescription will dispose him to
more than customary sleep, let him indulge it freely; so far from
hurting, it will help his cure.

Let him avoid all excesses: drink need scarce be named, for we are
writing to men of better and of nobler minds, than can be tempted to
that humiliating vice. Those who in this disorder have too great an
appetite, must not indulge it; much eaten was never well digested: but
of all excesses the most fatal in this case is that of venery. It is the
excess we speak of.



SECT. VII.

The proper DIET.


In the first place acids must be avoided carefully; and all things that
are in a state of fermentation, for they will breed acidity. Provisions
hardened by salting never should be tasted; much less those cured by
smoaking, and by salting. Bacon is indigestible in an Hypochondriac
stomach; and hams, impregnated as is now the custom, with acid fumes
from the wood fires over which they are hung, have that additional
mischief.

Milk ought to be a great article in the diet: and even in this there
should be choice. The milk of grass-fed cows has its true quality: no
other. There are a multitude of ways in which this may be made a part
both of our foods and drinks, and they should all be used.

The great and general caution is that the diet be at all times of a kind
loosening and gently stimulating; light but not acrid. Veal, lamb,
fowls, lobsters, crabs, craw-fish, fresh water fish and mutton broth,
with plenty of boiled vegetables, are always right; and give enough
variety.

Raw vegetables are all bad: sour wines, old cheese, and bottled beer are
things never to be once tasted. Indeed much wine is wrong, be it of what
kind soever. It is the first of cordials; and as such I would have it
taken in this disease when it is wanted: plainly as a medicine, rather
than a part of diet. Malt liquor carefully chosen is certainly the best
drink. This must be neither new, nor tending to sourness; perfectly
clear, and of a moderate strength: it is the native liquor of our
country, and the most healthful.

Too much tea weakens; and even sugar is in this disorder hurtful: but
honey may supply its place in most things; and this is not only harmless
but medicinal; a very powerful dissolvent of impacted humours, and a
great deobstruent.

What wine is drank should be of some of the sweet kinds. Old Hock has
been found on enquiry to yield more than ten times the acid of the sweet
wines; and in red Port, at least in what we are content to call so,
there is an astringent quality, that is most mischievous in these cases:
it is said there is often alum in it: how pregnant with mischief that
must be to persons whose bowels require to be kept open, is most
evident. Summer fruits perfectly ripe are not only harmless but
medicinal; but if eaten unripe they will be very prejudicial. A light
supper, which will leave an appetite for a milk breakfast, is always
right; this will not let the stomach be ravenous for dinner, as it is
apt to be in those who make that their only meal.

One caution more must be given, and it may seem a strange one: it is
that the patient attend regularly to his hours of eating. We have to do
with men for the most part whose soul is the great object of their
regard; but let them not forget they have a body.

The late Dr. STUKELY has told me, that one day by appointment visiting
Sir ISAAC NEWTON, the servant told him, he was in his study. No one was
permitted to disturb him there; but as it was near dinner time, the
visitor sat down to wait for him. After a time dinner was brought in; a
boil'd chicken under a cover. An hour pass'd, and Sir ISAAC did not
appear. The doctor eat the fowl, and covering up the empty dish, bad
them dress their master another. Before that was ready, the great man
came down; he apologiz'd for his delay, and added, "give me but leave to
take my short dinner, and I shall be at your service; I am fatigued and
faint." Saying this, he lifted up the cover; and without any emotion,
turned about to STUKELY with a smile; "See says he, what we studious
people are, I forgot I had din'd."



SECT. VIII.

The MEDICINE.


'Tis the ill fate of this disease, more than of all others to be
misunderstood at first, and thence neglected; till the physician shakes
his head at a few first questions. None steals so fatally upon the
sufferer: its advances are by very slow degrees; but every day it grows
more difficult of cure.

That this obstruction in the spleen is the true malady, the cases
related by the antients, present observation, and the unerring
testimonies of dissections leave no room to doubt. Being understood, the
path is open where to seek a remedy: and our best guides in this, as in
the former instance, will be those venerable Greeks; who saw a thousand
of these cases, where we see one; and with less than half our theory,
cured twice as many patients.

One established doctrine holds place in all these writers; that whatever
by a hasty fermentation dissolves the impacted matter of the
obstruction, and sends it in that state into the blood, does incredible
mischief: but that whatever medicine softens it by slow degrees, and, as
it melts, delivers it to the bowels without disturbance; will cure with
equal certainty and safety.

For this good purpose, they knew and tried a multitude of herbs; but in
the end they fixed on one: and on their repeated trials of this, they
banished all the rest. This stood alone for the cure of the disease; and
from its virtue received the name of SPLEEN-WORT[21]. O wise and happy
Greeks! authors of knowledge and perpetuators of it! With them the very
name they gave a plant declared its virtues: with us, a writer calls a
plant from some friend; that the good gardener who receives the honour,
may call another by his name who gave it. We now add the term _smooth_
to this herb, to distinguish it from another, called by the same general
term, though not much resembling it.

The virtues of this smooth Spleen-wort have flood the test of ages; and
the plant every where retained its name and credit: and one of our good
herbalists, who had seen a wonderful case of a swoln spleen, so big, and
hard as to be felt with terror, brought back to a state of nature by it;
and all the miserable symptoms vanish; thought Spleen-wort not enough
expressive of its excellence; but stamp'd on it the name of MILT-WASTE.

In the Greek Islands now, the use of it is known to every one; and even
the lazy monks who take it, are no longer splenetic. In the west of
England, the rocks are stripped of it with diligence; and every old woman
tells you how charming that leaf is for bookish men: in Russia they use
a plant of this kind in their malt liquor: it came into fashion there
for the cure of this disease; which from its constant use is scarce
known any longer; and they suppose 'tis added to their liquor for a
flavour.

The ancients held it in a kind of veneration; and used what has been
called a superstition in the gathering it. It was to be taken up with a
sharp knife, without violence, and laid upon the clean linen: no time
but the still darkness of the night was proper, and even the moon was
not to shine upon it[22]. I know they have been ridiculed for this; for
nothing is so vain as learned ignorance: but let me be permitted once to
vindicate them.

The plant has leaves that can close in their sides; and their under part
is covered thick with a yellow powder, consisting of the seeds, and seed
vessels: in these they knew the virtue most resided: this was the golden
dust[23] they held so valuable; and this they knew they could not be too
cautious to preserve. They were not ignorant of the sleep of plants; a
matter lately spoken of by some, as if a new discovery; and being
sensible that light, a dry air, an expanded leaf, and a tempestuous
season, were the means of losing this fine dust; and knowing also that
darkness alone brought on that closing of the leaf which thence has
been called sleep; and which helped to defend and to secure it, they
therefore took such time, and used such means as could best preserve the
plant entire; and even save what might be scattered from it.--And now
where is their superstition?

From this plant thus collected they prepared a medicine, which in a
course of forty days scarce ever failed to make a perfect cure.

We have the plant wild with us; and till the fashion of rough chemical
preparations took off our attention from these gentler remedies, it was
in frequent use and great repute. I trust it will be so again: and many
thank me for restoring it to notice.

Spleen-wort gives out its virtues freely in a tincture; and a small dose
of this, mixing readily with the blood and juices, gradually dissolves
the obstruction; and by a little at a time delivers its contents to be
thrown off without pain, from the bowels. Let this be done while the
viscera are yet sound and the cure is perfect. More than the forty days
of the Greek method is scarce ever required; much oftener two thirds of
that time suffice; and every day, from the first dose of it, the patient
feels the happy change that is growing in his constitution. His food no
more turns putrid on his stomach, but yields its healthful nourishment.
The swelling after meals therefore vanishes; and with that goes the
lowness, and anxiety, the difficult breath, and the distracting cholick:
he can bear the approach of rainy weather without pain; he finds himself
more apt for motion, and ready to take that exercise which is to be
assistant in his cure; life seems no longer burthensome. His bowels get
into the natural condition of health, and perform their office once at
least a day; better if a little more: the dull and dead colour of his
skin goes off, his lips grow red again, and every sign of health
returns.

Let him who takes the medicine, say whether any thing here be
exaggerated. Let him, if he pleases to give himself the trouble, talk
over with me, or write to me, this gradual decrease of his complaints,
as he proceeds in his cure. My uncertain state of health does not
permit me to practise physic in the usual way, but I am very desirous to
do what good I can, and shall never refuse my advice, such as it may be,
to any person rich or poor, in whatever manner he may apply for it. I
shall refer him to no apothecary, whose bills require he should be
drenched with potions; but tell him, in this as in all other cases,
where to find some simple herb; which he may if he please prepare
himself; or if he had rather spare that trouble, may have it so prepared
from me.

With regard to Spleen-wort, no method of using it is more effectual than
simply taking it in powder; the only advantage of a tincture, is that a
proper dose may be given, and yet the stomach not be loaded with so
large a quantity: it is an easier and pleasanter method, and nothing
more.

If any person choose to take it in the other way, I should still wish
him once at least to apply to me; that he may be assured what he is
about to take is the right plant. Abuses in medicines are at this time
very great, and in no instance worse than what relates to herbs. The
best of our physicians have complained upon this head with warmth, but
without redress: they know the virtues and the value of many of our
native plants, but dread to prescribe them; lest some wrong thing should
be administered in their place; perhaps inefficacious, perhaps
mischievous, nay it may be fatal. The few simple things I direct are
always before me; and it will at all times be a pleasure to me, in this
and any other instance, to see whether what any person is about to take
be right. I have great obligations to the public, and this is the best
return that I know how to make.

To see the need of such a caution, hear a transaction but of yesterday!
An intelligent person was directed to go to the medicinal herb shops in
the several markets, and buy some of this Spleen-wort; the name was
written, and shewn to every one; every shop received his money, and
almost every one sold a different plant, under the name of this: but
what is very striking, not one of them the right. Such is the chance of
health in those hands through which the best means of it usually pass;
even in the most regular course of application.

I would not be understood to limit the little services I may this way be
able to render the afflicted, to this single instance; much less to
propose to myself any advantages from it. Whoever pleases will be
welcome to me, upon any such occasion; and whatever be the herb on which
he places a dependance, he shall be shewn it growing. I once recommended
a garden to be established for this use, at the public expence: one
great person has put it in my power to answer all its purposes.


                        F  I  N  I  S.



THE AUGUSTAN REPRINT SOCIETY


WILLIAM ANDREWS CLARK MEMORIAL LIBRARY

UNIVERSITY OF CALIFORNIA, LOS ANGELES

PUBLICATIONS IN PRINT


1948-1949

16. Henry Nevil Payne, _The Fatal Jealousie_ (1673).

18. Anonymous, "Of Genius," in _The Occasional Paper_, Vol. III, No. 10
(1719), and Aaron Hill, Preface to _The Creation_ (1720).


1949-1950

19. Susanna Centlivre, _The Busie Body_ (1709).

20. Lewis Theobald, _Preface to the Works of Shakespeare_ (1734).

22. Samuel Johnson, _The Vanity of Human Wishes_ (1749), and two
_Rambler_ papers (1750).

23. John Dryden, _His Majesties Declaration Defended_ (1681).


1951-1952

31. Thomas Gray, _An Elegy Wrote in a Country Churchyard_ (1751), and
_The Eton College Manuscript_.


1952-1953

41. Bernard Mandeville, _A Letter to Dion_ (1732).


1963-1964

104. Thomas D'Urfey, _Wonders in the Sun; or, The Kingdom of the Birds_
(1706).


1964-1965

110. John Tutchin, _Selected Poems_ (1685-1700).

111. Anonymous, _Political Justice_ (1736).

112. Robert Dodsley, _An Essay on Fable_ (1764).

113. T. R., _An Essay Concerning Critical and Curious Learning_ (1698).

114. _Two Poems Against Pope_: Leonard Welsted, _One Epistle to Mr. A.
Pope_ (1730), and Anonymous, _The Blatant Beast_ (1742).


1965-1966

115. Daniel Defoe and others, _Accounts of the Apparition of Mrs. Veal_.

116. Charles Macklin, _The Covent Garden Theatre_ (1752).

117. Sir George L'Estrange, _Citt and Bumpkin_ (1680).

118. Henry More, _Enthusiasmus Triumphatus_ (1662).

119. Thomas Traherne, _Meditations on the Six Days of the Creation_
(1717).

120. Bernard Mandeville, _Aesop Dress'd or a Collection of Fables_
(1704).


1966-1967

123. Edmond Malone, _Cursory Observations on the Poems Attributed to Mr.
Thomas Rowley_ (1782).

124. Anonymous, _The Female Wits_ (1704).

125. Anonymous, _The Scribleriad_ (1742). Lord Hervey, _The Difference
Between Verbal and Practical Virtue_ (1742).

126. _Le Lutrin: an Heroick Poem, Written Originally in French by
Monsieur Boileau: Made English by N. O._ (1682).


1967-1968

127-

128. Charles Macklin, _A Will and No Will, or a Bone for the Lawyers_
(1746). _The New Play Criticiz'd, or The Plague of Envy_ (1747).

129. Lawrence Echard, Prefaces to _Terence's Comedies_ (1694) and
_Plautus's Comedies_ (1694).

130. Henry More, _Democritus Platonissans_ (1646).

131. John Evelyn, _The History of Sabatai Sevi, The Suppos'd Messiah of
the Jews_ (1669).

132. Walter Harte, _An Essay on Satire, Particularly on the Dunciad_
(1730).

Publications of the first fifteen years of the Society (numbers 1-90)
are available in paperbound units of six issues at $16.00 per unit, from
the Kraus Reprint Company, 16 East 46th Street, New York, N.Y. 10017.

Publications in print are available at the regular membership rate of
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Memorial Library

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REGULAR PUBLICATIONS FOR 1968-1969

133. John Courtenay, _A Poetical Review of the Literary and Moral
Character of the Late Samuel Johnson_ (1786). Introduction by Robert E.
Kelley.

134. John Downes, _Roscius Anglicanus_ (1708). Introduction by John
Loftis.

135. Sir John Hill, _Hypochondriasis, a Practical Treatise on the Nature
and Cure of that Disorder Call'd the Hyp or Hypo_ (1766). Introduction
by G. S. Rousseau.

136. Thomas Sheridan, _Discourse ... Being Introductory to His Course of
Lectures on Elocution and the English Language_ (1759). Introduction by
G. P. Mohrman.

137. Arthur Murphy, _The Englishman From Paris_ (1756). Introduction by
Simon Trefman. Previously unpublished manuscript.

138. [Catherine Trotter], _Olinda's Adventures_ (1718). Introduction by
Robert Adams Day.


SPECIAL PUBLICATION FOR 1968-1969

_After THE TEMPEST_. Introduction by George Robert Guffey.

Next in the continuing series of special publications by the Society
will be _After THE TEMPEST_, a volume including the Dryden-Davenant
version of _The Tempest_ (1670); the "operatic" _Tempest_ (1674); Thomas
Duffet's _Mock-Tempest_ (1675); and the "Garrick" _Tempest_ (1756), with
an Introduction by George Robert Guffey.

Already published in this series are:

1. John Ogilby, _The Fables of Aesop Paraphras'd in Verse_ (1668), with
an Introduction by Earl Miner.

2. John Gay, _Fables_ (1727, 1738), with an Introduction by Vinton A.
Dearing.

3. Elkanah Settle, _The Empress of Morocco_ (1673) with five plates;
_Notes and Observations on the Empress of Morocco_ (1674) by John
Dryden, John Crowne and Thomas Shadwell; _Notes and Observations on the
Empress of Morocco Revised_ (1674) by Elkanah Settle; and _The Empress
of Morocco. A Farce_ (1674) by Thomas Duffet; with an Introduction by
Maximillian E. Novak.

Price to members of the Society, $2.50 for the first copy of each title,
and $3.25 for additional copies. Price to non-members, $4.00. Standing
orders for this continuing series of Special Publications will be
accepted. British and European orders should be addressed to B. H.
Blackwell, Broad Street, Oxford, England.



Footnotes:

[18] Milton's Penseroso.

[19] Biberg.

[20] Reaumur.

[21] asplenon

[22] Silente Luna.

[23] Pulvis Aureus.



      *      *      *      *      *



Transcriber's Notes:

  Long "s" has been modernized.

  Page 21 contains two markers referring to the same footnote.

  The original text contains two sections labeled "Sect. V."

  Passages in italics are indicated by _underscore_.

  Additional spacing after some of the quotes is intentional to indicate
  both the end of a quotation and the beginning of a new paragraph as
  presented in the original text.

  The original text includes Greek characters. For this text version these
  letters have been replaced with transliterations.

  The following misprints have been corrected:
    "the the" corrected to "the" (page v)
    "sympton" corrected to "symptom" (page 14)
    "symptons" corrected to "symptoms" (page 23)

  Other than the corrections listed above, printer's inconsistencies in
  spelling, punctuation, hyphenation, and ligature usage have been
  retained.





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