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. 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 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, 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 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, 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 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 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 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. 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, 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 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 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 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 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. V.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 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 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 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 ob 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 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 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 custo 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. 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. 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 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 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 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 The antients 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 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 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 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, 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 FINIS. Footnotes: [18] Milton's Penseroso. [19] Biberg. [20] Reaumur. [21] asp?e??? [22] Silente Luna. [23] Pulvis Aureus. The Augustan Reprint SocietyWILLIAM ANDREWS CLARKMEMORIAL LIBRARYUNIVERSITY OF CALIFORNIA, LOS ANGELESPUBLICATIONS IN PRINT1948-194916. 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). 1949-195019. 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). 1951-195231. Thomas Gray, An Elegy Wrote in a Country Churchyard (1751), and The Eton College Manuscript. 1952-195341. Bernard Mandeville, A Letter to Dion (1732). 1963-1964104. Thomas D'Urfey, Wonders in the Sun; or, The Kingdom of the Birds (1706). 1964-1965110. 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William Andrews Clark Memorial Library: University of California, Los AngelesThe Augustan Reprint Society2520 CIMARRON STREET, LOS ANGELES, CALIFORNIA 90018General 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 Corresponding Secretary: Mrs. Edna C. Davis, William Andrews Clark Memorial Library The Society's purpose is to publish rare Restoration and eighteenth-century works (usually as facsimile reproductions). All income of the Society is devoted to defraying costs of publication and mailing. Correspondence concerning memberships in the United States and Canada should be addressed to the Corresponding Secretary at the William Andrews Clark Memorial Library, 2520 Cimarron Street, Los Angeles, California. Correspondence concerning editorial matters may be addressed to the General Editors at the same address. 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The original text contains two sections labeled "Sect. V." 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. ******* This and all associated files of various formats will be found in: Updated editions will replace the previous one--the old editions will be renamed. |