Part 18 (2/2)
”Sleep, like the world, his ready visit pays, Where fortune smiles; the wretched he forsakes; Swift on his downy pinion flies from woe, And lights on lids unsullied with a tear.”
Hence the animal spirits will not be recruited, nor the worn out organs restored to vigour.
The minds of patients labouring under this division of nervous diseases, are likewise in general filled with over anxiety concerning their health; attentive to every feeling, they find, in trifles light as air, strong confirmations of their apprehensions.
It is evident, that in these cases, a state of direct debility prevails, attended with a morbidly acc.u.mulated excitability; hence, those remedies afford relief, which produce a quick exhaustion of this principle, and thus blunt the feelings, and lull the mind into some degree of forgetfulness of its woes. Hence opium, tobacco, and the fetid gums are often resorted to; and in the hands of a judicious pract.i.tioner, they will afford great relief, provided he carefully watch the patient, and prevent their abuse; for, if left to the discretion of the patient, he finds that kind of relief which he has long wished for; his moderation knows no bounds, and he is apt to take them in such a manner, as to add indirect debility, to direct, and thus bring on a state of exhausted excitability, while there is still a diminished state of mental stimulants. This will cause his spirits to be more depressed than ever; he will therefore increase the dose, whether it be of opium, tobacco, or spirituous liquors, and thus he will be hurried on, adding fuel to the flame, till his exhausted excitability becomes irrecoverable, and he ends his days in a miserable state of imbecility, if not by suicide. Hence, though some of these narcotic stimulants, which exhaust the excitability, and blunt the feelings, may be employed with advantage, in order to prepare the mind for those changes, which the physician wishes to produce, they should be used with the greatest caution, and never left in any degree to the discretion of the patient. The cure, however, depends chiefly on regulating the state of the mind, or interrupting the attention of the patient; and diverting it, if possible, to other objects than his own feeling.
Whatever aversion to application of any kind we may meet with in patients of this cla.s.s, we may be a.s.sured that nothing is more pernicious to them than absolute idleness, or a vacancy from all earnest pursuit.
The occupations of business suitable to their circ.u.mstances, and situations in life, if neither attended with emotion, anxiety, nor fatigue, are always to be advised to such patients; but occupations which are objects of anxiety, and more particularly such as are exposed to accidental interruptions, disappointments, and failures, are very improper for patients of this cla.s.s.
To such patients exercise in the open air is of the utmost consequence. Of all the various methods of preserving health and preventing diseases, which nature has suggested, there is none more efficacious than exercise. It puts the fluids all in motion, strengthens the solids, promotes digestion, and perspiration, and occasions the decomposition of a larger quant.i.ty of air in the lungs, and thus not only more heat, but more vital energy is supplied to the body; and of all the various modes of exercise, none conduces so much to the health of the body, as riding on horseback: it is not attended with the fatigue of walking, and the free air is more enjoyed in this way, than by any other mode of exercise. The system of the vena portarum, which collects the blood from the abdominal viscera, and circulates it through the liver, is likewise rendered more active, by this kind of exercise, than by any other, and thus a torpid state, not only of the bowels, but of this system of vessels, and the biliary system, is prevented.
When a patient of this cla.s.s, however, goes out for the sake of exercise only, it does not in general produce so good an effect, as might be expected; for he is continually brooding over the state of his health: there is no new object to arrest his attention, and he is constantly reminded of the cause of his riding. Exercise will therefore be most effectual when employed in the pursuit of a journey, where a succession of pleasant scenes are likely to present themselves, and new objects arise, which call forth his attention. A journey likewise withdraws the patient from many objects of uneasiness and care, which might present themselves at home.
With respect to medicines, costiveness, which often attends these diseases, ought to be carefully avoided, by some mild laxative.
Calcined magnesia, and lemonade, have always seemed to me to answer the purpose; but the most effectual method is to acquire a regular habit, which may be done by perseverance, and strict attention.
Chalybeate waters have been frequently tried, and may in general be recommended with success, particularly, as the amus.e.m.e.nt and exercise generally accompanying the use of these waters, aid the tonic powers of the iron. The bark may likewise be exhibited with advantage.
There is yet another cla.s.s of nervous diseases which we have to notice, which are by no means uncommon; yet they have, like the first cla.s.s, escaped the attention of writers on this subject, and of medical pract.i.tioners in general: I mean those where the system is in a state of torpor, or exhausted excitability.
This state of the system may be brought on by various causes, but princ.i.p.ally by the long continued use of opium, tobacco, or fermented liquors.
When these substances, which are powerful stimulants, have been taken for some time, they bring on a state of the system so torpid, that the usual exciting powers, and the usual occurrences, which in general produce pleasant sensations, do not occasion a sufficient degree of excitement, in those whose excitability is thus exhausted.
They therefore feel continual languor and listlessness, unless when under the influence of the stimulus which brought on the exhaustion.
Every scene, however beautiful, is beheld with indifference by such patients, and the degree of ennui they feel is insupportable: this makes them have recourse to the stimulus which has exhausted their excitability, which in some degree removes this languor for a time; but it returns with redoubled strength, and redoubled horror, when the stimulant effect is over: and as this repet.i.tion exhausts the excitability more and more, the stimulus is repeated in greater quant.i.ty, and thus the disease increases to a most alarming degree.
There is no way of curing this state of nervous torpor, but by leaving off the stimuli which caused the exhaustion; and if the patient have resolution to do this for a few weeks, though, at first, he will, no doubt, find his spirits a little depressed, he will ultimately overcome the habit, and will be rewarded by alacrity of spirits, such as he never experiences under the most powerful action of artificial stimulants.
I must not, however, forget to notice, that there is a nervous state, or ennui, originating from a wrong direction of mental exertion, which exhausts the excitability to a great degree, and brings on a state of depression scarcely to be born.
When a person has by habit made his mind constantly dependent on dissipation, on gaming, and on frivolous, but not inactive pursuits, in order to produce pleasurable sensations, and at the same time neglected that culture of the understanding which will enable him to retire into himself with pleasure, and receive more enjoyment from the exercise of this cultivated understanding than he does in the most noisy, or fas.h.i.+onable circle of dissipation: I say, when there is this vacancy of mind, whenever it is not engaged in such pursuits as I have mentioned, a languor and weariness is experienced, which is intolerable, and which prompts the person so circ.u.mstanced, to fly continually to the only scenes which interest his mind. Hence, the pa.s.sion for gaming, in which the anxiety attending it causes an interest in the mind, which takes off the dreadful languor experienced, when it is not thus employed.
It is owing to wealth, admitting of indolence, and yielding to the pursuit of transitory and unsatisfying amus.e.m.e.nts, or to that of exhausting pleasures only, that the present times exhibit to us so many instances of persons suffering under this state: it is a state totally unknown to the poor, who labour for their daily bread, and to those whose minds are actively employed in study or business. It can only be cured by cultivating the understanding, and applying to some art or science, which will engage and interest the attention. I have received the thanks of many for recommending the study of philosophy, and particularly of chemistry, to their attention. This affords a rational and interesting pursuit, which, if entered into with ardour, and if the person actually works, or makes experiments himself, he will soon experience an enjoyment and an interest, such as he never experienced at the gaming table, or at any other place of fas.h.i.+onable amus.e.m.e.nt. Nay, I will venture to say, that all elegant amus.e.m.e.nts will be enjoyed with much greater relish by one who employs himself in some rational pursuit, and only resorts to such amus.e.m.e.nts as a relaxation, than by one who makes these amus.e.m.e.nts a business.
From the view we have taken of these complaints, it is evident, that they are like other general diseases of the sthenic, or asthenic kind; they seem to const.i.tute a state of the body between predisposition and disease; and they differ from most diseases in this, that in most complaints the increase, or diminution of the excitement is unequal in different parts of the body, and this gives rise to the different forms of disease; but in nervous complaints the excitement seems much more equably affected in different parts. These complaints, as we have seen, may be divided into three cla.s.ses; sthenic; those of acc.u.mulated excitability; and those of exhausted excitability: but though they are evidently distinguishable in this manner, and require different modes of cure, I have never seen any account of more than one kind in any medical writer: the same remedies were prescribed for all, however different they might be.
Though medicines may relieve complaints of this kind, and particularly those of the second cla.s.s, yet from what has been said, it must be evident, that much more may be done by regulating the action of the common exciting powers. Indeed, this is the case in most chronic diseases. Exercise and temperance will do infinitely more than medicine. By their means, most diseases may be overcome; but without them we may administer drugs as long as we please.
Voltaire sets this advice, which I have frequently inculcated, in so strong a light, that it may perhaps carry more conviction than any thing I can say. Ogul was a voluptuary, ambitious of nothing but good living: he thought that G.o.d had sent him into the world for no other purpose than to eat and drink: his physician, who had but little credit with him, when he had a good digestion, governed him with despotic sway, when he had eaten too much.
On feeling himself much and seriously indisposed by indolence and intemperance, he requested to know what he was to do, and the doctor ordered him to eat a basilisk, stewed in rose water, which he a.s.serted would effect a complete cure. His slaves searched in vain for a basilisk; at last they met with Zadig, who was introduced to this mighty lord, and spoke to him in the following terms.
”May immortal health descend from Heaven to bless all thy days! I am a physician: at the report of thy indisposition, I flew to thy castle, and have now brought thee a basilisk, stewed in rose water.
But, my lord, the basilisk is not to be eaten; all its virtue must enter through thy pores. I have enclosed it in a little ball, blown up and covered with a fine skin. Thou must strike this ball, with all thy might, and I must strike it back for a considerable time: and by observing this regimen for a few days, thou wilt see the effects of my art.” The first day Ogul was out of breath, and thought he should have died with fatigue; the second he was less fatigued, and slept better. In eight days he recovered all the strength, all the health, all the agility and cheerfulness of his most agreeable years. Zadig then said unto him, ”there is no such thing in nature as a basilisk; but thou hast taken exercise, and been temperate, and hast recovered thy health.” In the same manner I say, that temperance and exercise are the two great preservers of health, and restorers of it when it is lost; and that the art of reconciling intemperance and health is as chimerical, as was.h.i.+ng the Ethiopian white.
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