f 
 
THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
THE 
 
 INFLUENCE 
 
 OF 
 
 CIVIC LIFE, SEDENTARY HABITS, 
 
 jaro 
 INTELLECTUAL REFINEMENT, 
 
 ON 
 
 HUMAN HEALTH, AND HUMAN HAPPINESS; 
 
 IXCLUDING 
 
 AN ESTIMATE 
 
 OF THE 
 
 BALANCE OF ENJOYMENT AND SUFFERING 
 
 1ST THE 
 
 DIFFERENT GRADATIONS OF SOCIETY. 
 
 BY JAMES JOHNSON, ESQ. 
 
 Surgeon to His Royal Highness the Duke of CLARENCE; Author of the 
 " Influence of Tropical Climates on European Constitutions," of a 
 " Practical Treatise on Derangements of the Liver, Digestive Organs, 
 and Nervous System," and Editor of the " Medico-Chirurgical Journal.; 
 r Quarterly Register of Medical and Surgical Science." 
 
 Et mores Hominum multoram vidit et urbes. 
 
 He studied from the Life, 
 
 And in the Original perus'd Mankind. 
 
 AMERICAN FKOM THK LONDOX (OPT. 
 
 PHILADELPHIA: 
 PRINTED FOR THOMAS HOPE. 
 
 -HEP BY MATHEW CARET AlfD SON, THOMAS DOBSOV, AJTD MOSES THO.HAS. 
 1820. 
 
 T TOW.Y, PRIKTEB. 
 
 IB. , $ 
 

! 
 
 PREFACE. 
 
 THE practical inferences contained in the 
 following Essay form a part of the result of 
 twenty-one years' extensive observation of 
 Man, in all stages of civilization and refine- 
 ment, from the Savage of Nicobar to the 
 Philosopher of Europe. During the above 
 period, as Human Health was the Author's 
 primary object of study, so the Influences 
 of Climate and modes of life on that health, 
 were important subjects of investigation. 
 The first part of this interesting inquiry [In- 
 fluence of Climate] has already passed the 
 ordeal of public opinion and reception, in a 
 manner that can leave but little doubt in the 
 Author's mind respecting the fate of the pre- 
 sent Work. 
 
IV 
 
 As he took the pains to observe, so has 
 he claimed the privilege to think for himself; 
 and if he has made no allusion to any man's 
 writings on the subject of this Essay, it is 
 simply because he is not indebted to any man's 
 ideas or experience in its construction. 
 
 The mass of observations, on which his 
 positions are founded, were collected in ac- 
 tive scenes of life, during personal visitations 
 in many of the largest cities and societies 
 of the world; and a considerable proportion 
 of the morbid influences here delineated have 
 been severely felt, in person, by the Author. 
 They are not, therefore, the creatures of ima- 
 gination, or the theories of the closet. They 
 are promulgated under the sole patronage of 
 Nature and truth. The Author's immortal 
 namesake (Dr. Johnson) has indeed remarked, 
 that " truth is feeble when it stands alone." 
 The writer of this Essay has not hitherto found 
 it so. Truth is immutable, and consequently 
 cannot be feeble. Like a solid tower or pyra- 
 mid, it may be immersed and concealed, for 
 
a lime, in the mist of ignorance or prejudice; 
 but the light of reason ultimately dispels the 
 cloud, and the structure hursts upon our view, 
 unsullied and unshaken. 
 
 In this, as in the Author's other two Essays, 
 on " Tropical Climates," and " Derangements 
 of the Liver, Digestive Organs, and Nervous 
 System," he has endeavoured to render his 
 ideas and his language intelligible to all, with- 
 out, in any one instance, descending from the 
 dignity of a philosophical discussion. 
 
 Every individual, who has had the misfor- 
 tune to exchange a state of health for that of 
 sickness, will be able to appreciate the utility 
 of a work in which the preventive checks to 
 disease are clearly unfolded, and legitimately 
 deduced from actual and extensive observa- 
 tion. And as the Author is not aware that 
 any work has been expressly written on the 
 important subject of the following Essay, he 
 confidently trusts that he shall hereby render 
 some service to the community at large, but 
 
VI 
 
 more particularly to his fellow citizens in this 
 houndless and luxurious metropolis. That a 
 candid examination of the principles, and a 
 moderate adoption of the precepts here in- 
 culcated, would contribute greatly to the miti- 
 gation of human sufferings, and the preserva- 
 tion of human health, is the firm belief, and 
 the ardent hope of 
 
 THE AUTHOR, 
 
 Xo. 1, Albany Court Yard, Piccadilly, 
 October the 1st, 1818. 
 
TABLE OF CONTENTS. 
 
 INTRODUCTORY Observations on the impulse to Civic As- 
 sociation - - 
 
 CHAP. I. 
 
 Influence of Civic Life, sedentary Habits, and intellec- 
 tual Refinement, on the Organic System and its 
 Functions ... . 16 
 
 SECTION I. On the Digestive Organs. 
 
 SUBSECTION 1. Through the Medium of Food - 16 
 
 Balance of Enjoyment in Food 28 
 
 2. Influence of Civic Life, &c, on the Di- 
 gestive Organs, through the Me- 
 dium of Drink 31 
 Parallel of Enjoyment and Suffering in 
 
 Drink - 39 
 - 3. Influence of Civic Life, &c. on the Di- 
 gestive Organs, through the Me- 
 dium of Air - 40 
 Balance of Enjoyment in respect to Air 43 
 4. Influence of Civic Life, &c. on the Di- 
 gestive Organs, through the Me- 
 dium of sedentary Habits - 44 
 _ 5. Influence of Civic Life, &c. on the Di- 
 gestive Organs, through the Me- 
 dium of Mental Emotions 46 
 . 6. Influence of Civic Life, &c. on the Di- 
 gestive Organs, through the Me- 
 dium of late Hours - 50 
 7. Influence of Civic Life, &c. on the Di- 
 gestive Organs, through the Me- 
 dium of Medicine - - 51 
 Balance of Enjoyment and Suffering in 
 
 Medicine .... 57 
 
 
Vlii TABLE OF CONTENTS. 
 
 SECTION II. 
 Influence of Civic Life, sedentary Habits, and intellectual 
 
 Refinement, on the Heart and Circulating Vessels - 59 
 SUBSECTION 1. Influence of Civic Life, &c. on the 
 Heart, through the Medium of the 
 Digestive Organs - 61 
 
 2. Influence of Civic Life, &c. on the 
 
 Heart, through the Medium of the 
 
 Skin - 68 
 
 3. Influence of Civic Life, &c. on the 
 
 Heart, through the Medium of the 
 Passions - 71 
 
 SECTION III. 
 influence, of Civic Life, sedentary Habits , and intellectual 
 
 Refinement, on the Lungs and Glandular System - 75 
 
 CHAP. II. 
 Influence of Civic Life, sedentary Habits, and intellectual 
 
 Refinement, on the Animal or Muscular System - 78 
 
 CHAP. III. 
 Influence of Civic Life, sedentary Habits, and intellectual 
 
 Refinement, on the Brain and Nervous System - 85 
 
 SECTION I. 
 Influence of Civic Life, &TC. on the Brain and Nervous 
 
 System, through the Medium of the Digestive Organs 89 
 SUBSECTION 1. Influence of Civic Life, &c. on the 
 Brain and Nervous System, through 
 the Medium of the Liver in parti- 
 cular - 93 
 
 2. Influence of Civic Life, &c*. on the 
 
 Brain and Nervous System, through 
 
 the Medium of the Heart 96 
 
 SECTION II. 
 Influence of Civic Life, $c. on the Brain and Nervous 
 
 System, through the Medium of the Passions - 98 
 Prevention or Cure --..... 106 
 Balance of Enjoyment and Suffering in respect to the In- 
 tellectual System - - 109 
 
 
THE 
 
 INFLUENCE 
 
 OF 
 
 CIVIC LIFE, SEDENTARY HABITS, 
 
 AND 
 INTELLECTUAL REFINEMENT, 
 
 ON 
 HUMAN HEALTH AND HUMAN HAPPINESS. 
 
 IN all ages Man has evinced a gregarious im- 
 pulse. ' As most animals do the same, and as the 
 lower and weaker orders of these seem to associate 
 for the sake of mutual defence, a similar object has 
 been considered the reason of our species uniting 
 and congregating in cities and societies. It would 
 not appear, however, that fear is the principal 
 operating cause of this impulse, either in man or 
 animals. In the bosom of civilized society, and 
 in the security of peace, we see this powerful in- 
 clination to associate, unfolded in every stage of 
 B 
 
10 
 
 life, from the cradle to the grave. It must, there- 
 fore, be a dictate of Nature and Reason, for a 
 contrary disposition is one of the characteristics of 
 an insane mind. 
 
 Since Man is led to this, as well as to all other 
 objects, by his passions, it is necessary to trace 
 and distinguish these, in order to ascertain the 
 physical effects of civilization and refinement on 
 the corporeal fabric, in congregated masses of soci- 
 ety. This is an essential part of the investigation ; 
 for we shall find, that the same springs of action 
 which first draw men together, operate afterwards 
 with increased power, as the magnet attracts 
 stronger in proportion as it comes nearer its object, 
 or as the velocity of a falling body is accelerated 
 as it descends. 
 
 What, then, is the prime mover towards civic 
 association? The INTERCHANGE OF IDEAS, or THE 
 
 DESIRE OF INTELLECTUAL INTERCOURSE. This is 
 
 not only the strongest, but the earliest, the latest, 
 and the steadiest impulse or propensity implanted 
 in the mind of Man and of Woman too. Love, 
 ambition, avarice, has each its sera ; but the collo- 
 quial cacoethes begins with the infant's prattle,. 
 
11 
 
 and only ceases Avhen speech and hearing are ob- 
 literated by extreme age or infirmity. To be con- 
 vinced of this truth, we have but to look around 
 us in the book of Nature. We shall there see it 
 exemplified in every station of life, from the court 
 to the cottage from the crowd of the Exchange 
 to the study of the Philosopher, who converses 
 with the dead and the living through the medium 
 of books. Every where Man seeks opportunities 
 for collecting or transmitting ideas. The human 
 mind is a vast emporium, wherein the rude ma- 
 terials, conveyed by the external senses, are ma- 
 nufactured, and, as in the kaleidoscope, perpetu- 
 ally revolved into new forms and configurations. 
 
 In nova fert animus mutatas dicere formas, 
 Corpora. 
 
 The exchange of these manufactures secyns to 
 be the universal commerce of mankind with this 
 peculiarity, that we are generally more desirous to 
 bestow than to receive. 
 
 This parent impulse having drawn men together, 
 a host of new passions were, in consequence, de- 
 veloped, if not generated. Emulation, ambition, 
 envy, hatred, jealousy, &c. were the inevitable re- 
 
12 
 
 suits of the laws, regulations, and clashing inte- 
 rests, which arose out of this state of things ; and 
 which in proportion as civilization and refinement 
 advance, levy such severe contributions on our 
 health and happiness. This last investigation is 
 the great object of the present work, and is one 
 of high import and interest to every class of so- 
 ciety. 
 
 In Man we ran clearly distinguish three leading 
 systems or series of parts, with their appropriate 
 functions. The first is the organic system, compre- 
 hending the heart and vessels which circulate the 
 blood and other fluids the lungs the digestive or- 
 gans and the glands. These are not under the go- 
 vernance of the will, and perform their allotted 
 functions, whether we sleep or wake. The second 
 class comprehends all the voluntary muscles, by 
 means of which we transport ourselves from place 
 to place construct our edifices and manufactures 
 lay waste empires in war, or cultivate the fields in 
 peace ! This is termed the animal system. Last 
 of all comes the sentient and intellectual system, 
 yiz. the brain and nerves. The innumerable ram- 
 ifications of the nerves, spread over the surface of 
 the body, and crowded into the tissues composing 
 
the different organs of sense, convey to the brain, 
 like faithful videttes, intelligence of every thing 
 that passes in the world around us. From these 
 impressions, the mind forms its ideas, its judg- 
 ments, and its determinations. In the develop- 
 ment of this system Man excels all other animals, 
 as much as the sun excels, in size and splendour, 
 the meanest planet. 
 
 Now these three systems, although apparently 
 independent of each other, are yet linked in the 
 strictest bonds of sympathy and harmony, and are 
 perpetually influenced one by another. Thus, sup- 
 pose a few grains of emetic tartar are introduced 
 into the stomach, a part of the organic system. 
 As soon as nausea takes place, the animal powers,' 
 or voluntary muscles are enfeebled, and the intel- 
 lectual system, (or that through which the soul is 
 manifested) even of the proudest hero, feels the 
 shock, and lies prostrate with its suffering compa- 
 nions in the organic and animal life. Shakspeare, 
 that accurate observer of Nature, repeatedly ex- 
 emplifies this remark, and particularly in the cele- 
 brated dialogue between Brutus and Cassius, re- 
 lative to Caesar. 
 
14 
 
 He had a fever when he was in Spain , 
 And when the fit was on him I did mark 
 
 How he did shake 
 
 His coward lips did from their colour fly ; 
 Ay, and that tongue of his that bade the Romans 
 Mark him, and write his speeches in their books, 
 Alas ! it cried " Give me some drink Titinius," 
 As a sick girl. 
 
 Let a sudden gust of passion or sense of fear, on 
 the other hand, disturb the intellectual system ; 
 the heart palpitates, the function of digestion is 
 suspended and the voluntary muscles tremble 
 all through sympathy with the great sensorium or 
 seat of thought. In short, health and happiness 
 (for although we may have health without happi- 
 ness, it is impossible that we can have happiness 
 without health) depend on a just equilibrium and 
 harmony between the functions of these three sys- 
 tems; and whatever disturbs this harmony, by im- 
 pairing the functions of any one of these systems, 
 deranges directly or consecutively the whole fabric, 
 intellectual as well as corporeal. 
 
 And here, to prevent misconception, I take oc- 
 casion to state what I mean by intellectual system. 
 1 protest against the doctrine of materialism from a 
 conviction of its erroneous foundation and pernici- 
 
15 
 
 ous influence on society. Mind I consider as dis- 
 tinct from matter. It is an invisible agent, mani- 
 festing itself solely through the medium of the cor- 
 poreal organs. When these last are deranged, the 
 mental manifestations must also be deranged ; but 
 the mind itself remains unchanged, unassailable, 
 imperishable. Even in insanity, it is not the mind 
 which is diseased. Some portion of the brain is 
 deranged, and then the mind can no more manifest 
 itself sanely, than a musician can bring forth har- 
 monious notes from an untuned instrument. The 
 mind, as it is not material, neither is it subject to 
 disease or death if we once admit that it is subject 
 to the one, we must inevitably come to the con- 
 clusion that it is liable to the other ! With the es- 
 sence or nature of mind we are, and ever will be 
 ignorant. It is with the corporeal organs, through 
 which it reveals its actions, that we have to do, 
 and which I designate by the term intellectual 
 system. 
 
CHAPTER I. 
 
 INFLUENCE OF CIVIC LIFE, SEDENTARY HABITS, AND IN- 
 TELLECTUAL REFINEMENT, ON THE ORGANIC SYSTEM 
 AND ITS FUNCTIONS. 
 
 SECTION I. 
 
 ON THE DIGESTIVE ORGANS. 
 
 SUBSECTION I. 
 Through the Medium of Food. 
 
 THE first law of Nature is, " Eat or be eaten." 
 Life can only subsist by death. Every organized 
 being, and particularly Man, slays thousands of 
 other organized beings, either in the vegetable or 
 animal kingdom, to build up or maintain his own 
 corporeal fabric. The doctrine of transmigration, 
 therefore, is not entirely visionary. 
 
17 
 
 With ceaseless change the restless atoms pass, 
 From li'e to life a transmigrating mass; 
 Hence the same org'ans which to day compose 
 The poisonous henbane or the fragrant rose 
 May, with to-morrow's sun, new forms compile, 
 Frown in the Hero in the Beauty smile ! 
 
 A single glance over the various nations of the 
 earth will convince us that Man is completely an 
 omnivorous animal. The human stomach will 
 draw nutriment from the ground we tread on, when 
 imbued with animal and vegetable exuviae; and 
 from every thing else between this ottomaque fare 
 and that of the most pampered London Epicure ! 
 This wonderful power of the digestive apparatus 
 to assimilate every thing which air, earth, or ocean 
 yields, to the support of Man, is a striking proof of 
 the wisdom as well as the beneficence of our Cre- 
 ator. But it is most erroneous in principle, and 
 pernicious in practice, to infer from this, that be- 
 cause we can eat all things, we therefore may eat 
 all things with impunity. And here one of the 
 evils of civilization becomes manifest. Not only 
 is every thing that can allure the sense, or stimu- 
 late the appetite, brought to view in congregated 
 society; but the " dishes tortured from their na- 
 tive taste" are indulged in by those who, of all 
 others, are least capable of digesting them. The 
 
 
18 
 
 ploughman, exposed at all seasons to the inclemen- 
 cies of the skies, and strenuously exercising his 
 voluntary muscles, might gormandize with safety 
 on alderman's fare. But not so the citizen, how- 
 ever well trained in the school of Epicurus. His 
 sedentary life, and a host of moral and physical 
 circumstances around him, render it a matter of 
 impossibility that repletion shall not succeed even 
 an apparently temperate regimen ; and in reality this 
 repletion, and the irregular states of plethora which 
 thence result, characterize nine-tenths of the dis- 
 eases of civilized life, though they assume the 
 garb of debility, and too often lead to the most er- 
 roneous and unsuccessful methods of treatment. 
 Every one, after a full meal, especially of animal 
 food, with all the etceteras of a civic table, must 
 have felt how incapacitated he was for either men- 
 tal or corporeal exertion. It is a law, indeed, in 
 the economy of the living machine, that where any 
 one of the three systems above mentioned is over- 
 exerted or over-excited, one or both of the other 
 two systems must fall into a state of irregular or 
 deficient action. The heavy meal of animal and 
 other food exemplifies this law. When the diges- 
 tive organs and circulating vessels are strongly en- 
 gaged, the muscular and the intellectual systems 
 
19 
 
 are indisposed towards the full exercise of their 
 functions, the greater portion of vital energy being 
 then apparently concentrated in the organic system, 
 the principal theatre of operations for the time. On 
 the other hand, let the animal system or voluntary 
 muscles he thrown into violent or unusual action 
 the digestive process is diminished or even sus- 
 pended, and the mind is incapable of dwelling in- 
 tently on any train of thought. Who could solve a 
 mathematical problem immediately after a furious 
 cricket match? Again; Let a man sit down to an 
 intricate calculation, or the investigation of an ab- 
 struse literary subject nay, even to the perusal of 
 an interesting poem or other effusion of genius, and 
 the appetite will be so withdrawn, that the hour of 
 dinner will be scarcely remembered. 
 
 This law of irregular or unequal excitement of 
 the system, hitherto so much overlooked, unfolds 
 the most important views both in health and dis- 
 ease ; and he who studies it deeply, will find there- 
 in a powerful engine in the healing art, and a 
 steady light on his researches, both physical and 
 philosophical. 
 
 But to return. The evil consequences of reple- 
 
tion, or luxurious living, far exceed belief, or even 
 the calculation of the physician; for they metamor- 
 phose themselves so artfully, and mask themselves 
 so successfully behind unsuspicious forms and plise- 
 nomena, that they are constantly undermining the 
 constitution, deceiving the patient, and misleading 
 the practitioner. 
 
 Observation has proved, that when a stimulating 
 substance is applied to any part of the body, inter- 
 nally or externally, a sensation or irritation is first 
 produced, and then an increased afflux of blood to 
 the vessels of the part. This law has long been 
 acknowledged; Ubi stimulus, ibi irritatio ubi 
 irritatio, ibi afflvxrus. The sensation or irritation 
 shows, that the nervous or sentient system of the 
 part is first acted on: the turgescence evinces, that 
 the vascular or blood-vessel system is next affected. 
 Now, in the present state of society, and particu- 
 larly of civic society, the whole internal surface of 
 the digestive organs is daily stimulated, in an in- 
 ordinate degree, not only by the poignant and com- 
 plicated qualities of our food, but also by the quan- 
 tity* If there be any one truth in nftfaical science 
 more firmly established than all others, it is this ! 
 Let us look around us, in this great and luxurious 
 
21 
 
 metropolis, for instance, and we shall not find one 
 in ten, whose digestive organs are in a natural 
 and healthy condition. The tint of the eye and 
 countenance, the feel of the skin, the state of the 
 tongue, the stomach, the bile, and the various eva- 
 cuations, offer to the experienced and discerning 
 physician the most incontestible proofs of the po- 
 sition here advanced. 
 
 The tissue or* membrane which lines the diges- 
 tive organs from the mouth downwards, is a secre- 
 ting surface, that is constantly pouring forth a 
 fluid which is necessary for the digestion of the 
 food in every stage of its progress. Now, when 
 any gland, or secreting surface, is over- excited, the 
 fluid secreted becomes unnatural in quantity and 
 quality. It is sometimes diminished, sometimes 
 increased; but always depraved. This is familiar- 
 ly exemplified when the mucous membrane, lining 
 the nose and air-tubes of the lungs, happens to be 
 acted on by atmospherical transitions, as in a com- 
 mon cold. At first, the membrane is dry and half 
 inflamed; afterwards a more copious secretion than 
 usual comes pouring forth, and of so acrid a quality 
 as to excoriate the nose and lips themselves. It is so 
 with the mucous membrane lining the stomach and 
 
22 
 
 bowels. When inordinately excited by the quality 
 or quantity of the food and drink, the secretions 
 are irregular and morbid, and therefore a constant 
 source of irritation is generated in this important 
 class of organs. This irritation is manifested by 
 some pain or uneasy sensation in the line of the 
 digestive organs ; irregularity of their functions, 
 particularly of the alvine evacuations ; and an un- 
 natural state of the tongue and urine. 
 
 
 
 But with these organs almost every part of the 
 human system sympathizes, and the discerning phy- 
 sician can plainly detect their derangement in the 
 state of the mind, the nerves, the muscles, and the 
 skin. Let it be remembered, that when any one part 
 of the system is inordinately excited, some other 
 part or parts are deprived of their due share of vi- 
 tal energy, as we see every day exemplified in what 
 is termed derivation. Now when so large a por- 
 tion of this vital energy is kept constantly concen- 
 trated round the digestive apparatus, it is easy to see 
 that the animal and intellectual systems must se- 
 verely feel the loss. The shattered state of the 
 nerves, the irritability of the temper, and the want 
 of tone in the muscles, which hourly present them- 
 selves in luxurious and civic society, afford the 
 
most convincing evidence of the truth of these po- 
 sitions. 
 
 This is one view of the affair ; but there are va- 
 rious others. It often happens, that such is the 
 strength of the constitution, and the efforts of Na- 
 ture to counteract the morbid effects of repletion. 
 that a degree of robustness or corpulency succeeds 
 these luxurious habits, and thus the evil conse- 
 quences are masked for a time. But the fact is, that 
 the superabundant supply of nutrition, which is 
 poured into the blood-vessel system, is deposited 
 in the shape of fat ; Nature being unable to throw 
 it off by other outlets. This deposition is only com- 
 paratively salutary ; and, in truth, the corpulent ha- 
 bit and ruddy complexion are too often but the in- 
 dex of a morbid excess of health, and the preludes 
 to most violent and dangerous diseases. 
 
 Another mode in which Nature frees herself, for 
 a time, from the effects of superabundant nutrition, 
 is by throwing out eruptions and other unsightly 
 blotches on the skin, by which means she often saves 
 internal organs from a dangerous irritation. This is 
 proved by the certainty and safety with which the 
 whole of these cutaneous affections maybe speedily 
 
24 
 
 removed by improving the state of the digestive or- 
 gans, lessening the quantity and simplifying the 
 quality of the food, and by the judicious use of the 
 warm bath. On the other hand, when Nature is 
 interrupted in her work, and these cutaneous ble- 
 mishes are incautiously repelled by external ap- 
 plications, the irritation is almost certain to fall 
 on some internal organ, and there cause a pain- 
 ful sensation or an inflammatory action, accor- 
 ding as the nervous or vascular structure of the 
 part be predisposed to disease. Thus, in one 
 constitution, on the repulsion of an eruption from 
 the skin, the irritation is transferred to the lungs, 
 and there excites pulmonary consumption. In 
 another, it is transferred to the mucous membrane 
 of the stomach, and heart-burn, or pain in the sto- 
 mach, or indigestion, or even chronic inflammation 
 of this organ may ensue. In a third, the liver be- 
 comes the seat of the translated irritation, and the 
 various phenomena of bilious or hepatic derange- 
 ments are developed. The intestines, the kidnies. 
 nay the coverings of the brain itself, may, and 
 often do, sufier in this way, with a host of corre- 
 sponding miseries. All these, however, may be 
 avoided by removing the cause or origin of the cu- 
 
25 
 
 taneous eruption, as seated in the digestive organs, 
 when the effect will soon cease. 
 
 But among the wonderful variety of means by 
 which Nature counteracts the repletion resulting 
 from too much and too rich food, stands GOUT. 
 This, though a severe disease in itself, is yet an 
 undoubted remedy or preventive of numerous other 
 and more fatal ones. After a course of luxurious 
 living, of longer or shorter duration, according to 
 peculiarity of constitution, the human machine can 
 no longer bear the rich tide of nutriment which dai- 
 ly flows through the interior organs, without dan- 
 ger of some of its channels giving way, and sud- 
 denly snapping the thread of life, as happens in 
 apoplexy, the bursting of blood-vessels, &c. Na- 
 ture, alarmed, now adopts a severe but a salutary 
 measure. She generally gives notice of the ap- 
 proach of her operation, by first deranging the 
 function of the stomach, for a few days, with oc- 
 casional premonitory sensations in other parts of 
 the body, as coldness of the feet, &c. Then the 
 storm bursts. A paroxysm of pain and irritation 
 is kindled up on some extreme part of the body, 
 and the whole constitution is kept, during a time, 
 in a feverish and restless condition, while a daily 
 D 
 
26 
 
 and critical discharge by the skin and kidneys re- 
 duces the system to a certain point compatible with 
 health, when a calm ensues the functions of the 
 stomach and other organs resume their accustomed 
 tone, and the luxurious advocate of civic society 
 returns to the pleasures of the table with renovated 
 vigour. 
 
 Woe to the man who rashly interferes with, or 
 suddenly checks this salutary process of Nature, 
 whether by internal or external means ! He who 
 does so, has little knowledge of the animal econo- 
 my, or little concern for the future welfare of the 
 patient. True it is, that the operations of Nature, 
 even when they are of a curative description, as 
 they almost always are, must frequently be re- 
 strained, regulated, or spurred on, and in this 
 consists the great art of the physician. But when 
 the pain and irritation of Gout are not suffered to 
 be moderately expended on some member at a dis- 
 tance from the vital centre ; when a violent com- 
 motion is raised in the system by internal remedies ; 
 or when the inflammation is suddenly arrested by 
 external cold, then, in all probability, will the ir- 
 ritation be transferred to some interior organ or tis- 
 sue, and there manifest itself, at some future day. 
 
27 
 
 in the shape of a chronic disease, which may bid 
 defiance to the powers of medicine. This consid- 
 eration should 
 
 make us rather bear those ills we have, 
 Than fly to others that we know not of. 
 
 These then are the prominent evils which, iu 
 civic society as now constituted, flow from redun- 
 dancy and richness of food combined with sedenta- 
 ry habits ; and a contemplation of them naturally 
 leads us to the institution of a comparison or paral- 
 lel of great moral and physical interest. But first 
 let us say a few words on the remedies. 
 
 In my work on {( the Influence of the Atmos- 
 phere," I have entered fully into the nature, cause, 
 and treatment of the disordered state of the diges- 
 tive organs. I may here only observe, that pre- 
 vention, of course, depends on temperance, and the 
 cure almost entirely on a well conducted course of 
 aperient medicine, with or without the decoction 
 of sarsaparilla. The kind of aperient must depend 
 on the particular organ whose function is most dis- 
 turbed, or whose structure may be in danger. This 
 discrimination requires an accurate examination of 
 all the phenomena, and of the state of the liver 
 
28 
 
 and other abdominal organs. Then the cure will 
 proceed with ease and certainty. 
 
 BALANCE OF ENJOYMENT IN FOOD. 
 
 Walking one evening in the vicinity of Gros- 
 venor Square, I came opposite to an area, from 
 Whence issued the most profuse and savoury odours 
 of every thing which could at once stimulate and 
 gratify the human palate. An immense dinner 
 was in transitu from the kitchen to the banquet- 
 ing room ; and leaning over the iron railings was 
 a half starved and half naked wretch, apparently 
 inhaling the rich steam from below, and soliciting 
 charity from the passenger at the same time. A 
 tall and benevolent looking gentleman stopped at 
 this moment, and seemed to contemplate the scene. 
 Putting a small piece of money in the beggar's 
 hand, he lifted up his eyes to Heaven, and eja- 
 culated in a low voice " O how unequally are the 
 gifts and enjoyments of Nature distributed in this 
 world !" I could not undeceive this gentleman at 
 the time; but should these pages ever meet his 
 
29 
 
 eye, he will probably acknowledge that he took 
 but a partial view of the affair. 
 
 Whatever support the doctrine of a future state 
 of rewards and punishments may derive from the 
 triumpU of vice and the oppression of virtue here, 
 the belief in a future state of existence neither re- 
 quires nor derives support from the apparent ine- 
 quality among mankind, in respect to happiness or 
 enjoyment. Although I shall not attempt to prove 
 that all ranks are precisely on a par on this point, 
 yet I do maintain that they are very nearly so ; 
 and that Nature, indulgent but just to all her 
 children, preserves, by an admirable code of laws, 
 the most surprizing equilibrium in the balance of 
 enjoyment of her gifts. A slight sketch of the 
 extremes will enable every man of reflection and 
 observation to fill up the outline. 
 
 The Epicure sits down at seven or eight o'clock 
 in the evening to a sumptuous repast; but under 
 every cover lies some source of derangement to the 
 digestive organs, which more than counterbalances 
 the voluptuous sensations of the palate. The half 
 starved beggar, on the other hand, has little more 
 than the disagreeable cravings of hunger to contend 
 
with cravings which produce but few, and ward ofT 
 numerous diseases. True it is, that he may envy 
 the rich man's lot, and be discontented with his 
 own ; but the rich man lias little cause for exultation 
 here; for independent of the train of afflictions 
 that result from luxury, the latter itself " fades 
 upon the appetite," and, after a short time, either 
 ceases to afford pleasure, or destroys the capacity 
 of enjoying it ! 
 
 From these two extremes the shades blend im- 
 perceptibly, till they unite and form a picture of 
 that comparatively happy medium of rational and 
 philosophic temperance ia food which, while it re- 
 jects not the bounties and delicacies of nature, 
 keeps a steady check on the licentious appetite, 
 and suffers not the digestive organs to be goaded 
 to unnatural exertions by the compound qualities 
 and redundant quantities of the necessaries of life. 
 The memorable precept of the Roman poet, in fact, 
 is equally applicable to physiological comfort, as 
 to philosophical happiness. 
 
 Auream quisquis mediocritatem 
 Diliget tutus, caret obsoleti 
 Sordibus tecti, caret invidenda 
 Sobrws Aiila. 
 
31 
 
 SUBSECTION II. 
 
 Influence of Civic Life, 8fc. on the digestive Or- 
 gans, through the Medium of Drink. 
 
 NATURE has plentifully supplied the earth with 
 water, and animals drink nothing else to quench 
 their thirst ergo, says one party, water alone 
 should constitute the human beverage. But says 
 another sect, why did bounteous Nature weigh 
 down the mantling vine with the swelling grape, if 
 she did not design that man should drown his 
 cares occasionally in the goblet? It is doubtful, 
 however, if Nature destined the grape for fermen- 
 tation. Did this indulgent Parent ever mean that 
 barley and oats should be converted by the Scot 
 and Hibernian into whiskey ? It is certain, indeed, 
 that civic association, or the congregation of a peo- 
 ple any where, has a tendency towards Bacchanal- 
 ian indulgences. This, I conceive, has been the 
 case from the very infancy of the world. Homer's 
 heroes seldom meet together without getting drunk. 
 
especially when they are relating their own ex- 
 ploits. Let Ulysses himself confess it. 
 
 " Hear me, my friends ! who this good banquet grace, 
 
 'Tis sweet to play the fool in time and place ; 
 
 And wine can of their wits the wise beguile, 
 
 Make the sage frolic, and the serious smile ; 
 
 The grave in merry measures frisk about, 
 
 And many a long-repented word come out ! 
 
 Since to be talkative I now commence, 
 
 Let wit cast off the sullen yoke of sense." 
 
 ODTSSET, b. xvi. 
 
 The foregoing passage explains most correctly 
 the real source and universal cause of intempe- 
 rance in drink. When men assemble together, 
 they are anxious to please and be pleased. The 
 colloquial impulse predominates. Wine gives wit 
 to the dullest intellect ; crowds the brain with 
 ideas ; tips the tongue with eloquence, and illu- 
 mines the eye with the fire of expression. The 
 dull scenes and corroding cares of life are now 
 forgotten, or past dangers and difficulties are re- 
 membered and related with pleasure. The future 
 is clothed in romantic anticipations of success and 
 happiness in short, a sort of Elysium opens 
 round the soul ! Is it to be wondered at, that man 
 should wish to protract these' ecstatic moments; 
 or be too often carried insensibly along the stream, 
 
33 
 
 till he approached the brink, or even precipitated 
 himself into the gulph of excess ? 
 
 But let us examine the affair a little deeper. The 
 digestive organs, to which this inordinate stimula- 
 tion was applied, and through the medium of which 
 this intellectual excitement was raised, do not fall 
 back, after such a scene, to the healthy standard, 
 or to their usual integrity of function. No, indeed. 
 The power of digestion languishes ; the appetite is 
 impaired ; the biliary secretion is deranged. The 
 animal and intellectual systems participate in the 
 effects of this commotion. The muscles are en- 
 feebled and tremble. The nerves lose their tone. 
 The mind which, the evening before, was all prow- 
 ess, is in the morning over-run with timidity, or 
 clouded with horror. There is now a collapse of 
 the system. The arteries of the brain were tur- 
 gid and distended with blood during the excite- 
 ment of the wine ; they are now in an opposite 
 state. Is it to be wondered at, that these alter- 
 nate extremes should often lead to organic derange- 
 ment of the delicate texture of the brain, and end 
 in hypochondriasis or mania itself? 
 
 The liver and brain are the organs, in fact, 
 E 
 
34 
 
 which suffer most from intemperance in drink; and 
 it appears to me, that this occurs more from the 
 subsec|uent collapse, than from the previous excite- 
 ment. After a debauch, the power of the heart is 
 greatly weakened. It cannot keep the arterial 
 system proportionally distended, and hence the 
 blood accumulates in the venous system ; or, in 
 other words, congestion in the veins of the liver 
 and brain obtains, with great derangement of func- 
 tion, ending ultimately in lesion of structure in 
 these organs. 
 
 In the LIVER it manifests itself by flying or un- 
 easy sensations in the right side, or across the sto- 
 mach; flatulence; acidity; clay-coloured evacua- 
 tions; sallow complexion; mental despondency: 
 fickleness or irritability of temper; pink, or other 
 urinary sediment; disagreeable dreams; tender- 
 ness on deep pressure under the margin of the 
 right ribs; occasional palpitation or fluttering a- 
 bout the heart, or pit of the stomach, &c. When 
 this train of symptoms commences after irregulari- 
 ty of living, or indeed after any mode of life, the 
 functions of the liver and digestive organs are de- 
 rai ged, and there is but one step farther to organic 
 or incurable disease. This is the moment for a 
 
prompt administration of remedies, particularly 
 the blue pill, sarsaparilla, and antimonial aloetic 
 medicines. In these cases, I have derived the 
 most marked benefit from artificial Harrowgate 
 water } which is easily prepared from sulphate of 
 magnesia, super-tartrite of potash, and sulphuret 
 of potash. 
 
 In the brain, it manifests its baneful effects by 
 head- aches; flushings of the face; throbbings of 
 the temporal arteries while lying in bed; tremors 
 of the muscles, &c. These warn us that hypo- 
 choridriasis, apoplexy, palsy, or mental alienation 
 itself are to be apprehended, if not guarded against 
 by timely evacuations from the bowels, occasional 
 leeching or cupping in the temples or shoulders, 
 cold applications to the head itself, &c. 
 
 In tlit -heart and Mood-vessel system, the perni- 
 cious consequences of intemperance may be traced 
 by the discriminating physician, to irregularity of 
 action in the central organ of the circulation; oc- 
 casional palpitations or flutterings; strange and 
 undescribable sensations in the chest; unequal 
 distributions of the blood ; flushings in one part of 
 the body, and chilliness in another, but particular- 
 
ly an extreme dejection of spirits, which characte- 
 rizes deranged function and structure of the heart, 
 and I am convinced leads, in numerous instances, 
 to suicide! 
 
 To remedy these evils effectually, it is evident 
 that a gradual diminution, or total substraction of 
 the cause would be the surest method. But only a 
 few have resolution to reform entirely. The best 
 means of counteracting or retarding the deleteri- 
 ous effects of intemperance, are such agents as 
 keep all the secretions open ; particularly those of 
 the bowels and the skin. The blue pill, aloes, and 
 antimony, form a powerful combination for this 
 purpose, when judiciously proportioned; and, aid- 
 ed by carriage or horse exercise, and the oc- 
 casional use of the tepid or cold bath, (according 
 to the actual condition of the heart, liver, diges- 
 tive organs, and head) will ward off the punish- 
 ment of our indiscretions for a much longer period 
 than we deserve to enjoy! 
 
 The above observations apply to excesses in 
 drink every where ; but on the population of crowd- 
 ed cities, where sedentary habits and confined air 
 prevail, these excesses exert an infinitely more 
 
powerful influence than in towns, villages, or the, 
 open country. The citizen then, and particularly 
 the civic valetudinarian ought to be especially on- 
 guard against this source of ill health. 
 
 A few words on the salutary effects of drink. 
 There can he no question that water is the best, 
 and the only drink which Nature has designed for 
 man ; and there is as little doubt but that every per- 
 son might gradually, or even pretty quickly accus- 
 tom himself to this aqueous beverage. But this will 
 never be generally adopted. I believe a precept is 
 inculcated in the lectures of a deservedly eminent 
 physiologist of this metropolis, that no drink should 
 be taken at meals, nor for three hours afterwards, 
 lest the gastric juice should be diluted, and the 
 digestion thereby weakened. From an attentive 
 observation of man and animals in almost every 
 parallel of latitude and climate of the globe, and 
 among nations the nearest to a state of nature, I 
 am disposed to draw a very different conclusion. 
 Both men and animals, under these circumstances, 
 drink immediately after eating ; and this, I am 
 convinced, is the salutary habit. But even this 
 rule is not absolute. It must vary according to 
 the season of the year, and the exercise, &c. of 
 
38 
 
 the individual. In hot weather, when there is 
 great exudation from the pores of the skin, and 
 particularly where exercise is taken before dinner, 
 the food must be diluted by drink during the meal, 
 and vice versa. 
 
 Next to water, toast water, or soda water, is 
 Sherry or Madeira and water then very weak 
 brandy and water table beer. The next least in- 
 salutary species of drink, is undiluted Sherry, Ma- 
 deira, and other white wines; then Claret, and 
 least salubrious of all, Port wine and spirits. In 
 proportion as we adhere to the upper links of this 
 chain, so have we a chance of continued health. 
 As we descend in the series, so do we lay down a 
 substratum for disease. 
 
 It may here be remarked, that tea, independent 
 of its adulterations, has a peculiar effect on the ner- 
 vous system, and that the digestive organs suffer 
 through the influence of this system. The morbid 
 effects of ale or porter are more observable on the 
 circulating and absorbent system, and will be no- 
 ticed in the Section on that subject. Ardent spirits- 
 exert their deleterious influence chiefly on the sto- 
 mach, liver, brain, and nerves. 
 
PARALLEL OF ENJOYMENT AND SUFFERING IN DRINK. 
 
 The water- drinker glides tranquilly through 
 life, without much exhilaration or depression, and 
 escapes many diseases to which he would other- 
 wise be subject. The wine- drinker experiences 
 short, but vivid periods of rapture, and long inter- 
 vals of gloom ; he is also more subject to disease. 
 The balance of enjoyment, then, turns decidedly in 
 favour of the water-drinker, leaving out his tem- 
 poral prosperity and future anticipations ; and the 
 nearer we keep to his regime, the happier we shall 
 be. Here, however, as in all other things, there 
 is a certain latitude within the range of health and 
 happiness, which the wise man and the philoso- 
 pher will occasionally traverse ronnd, but not ex- 
 ceed. The native fountain is in the centre of this 
 circle, and from it our eccentric divergences should 
 be narrowly watched and carefully limited. 
 
40 
 
 SUBSECTION III. 
 
 Influence of Civic Life, i$c. on the digestive Or- 
 gans, through the Medium of Air. 
 
 THE exact effect of atmospheric air on our blood 
 through the medium of the lungs, is not yet clear- 
 ly ascertained; but we know that it is essential 
 to life. We know also, that the air is the great 
 agent in the production of disease, both by its vi- 
 cissitudes of temperature, and by its noxious im- 
 pregnations. If we examine the streets, the houses, 
 the manufactories, the dormitories, &c. of great 
 and crowded cities, we shall be, astonished that the 
 incalculable mass of exhalations of all kinds, which 
 is constantly floating in the lower strata of a civic 
 atmosphere, is not more detrimental to health than 
 it is ! Even the respiration of man and animals 
 must, in some degree, deteriorate the air of large 
 and populous cities. No man who has felt the ex- 
 hilaration of the country air, and the depression 
 of spirits which almost uniformly takes place on 
 
41 
 
 returning to town, can doubt that a heavy tax is 
 levied on the health of man in civic society ! 
 
 Its most visible effects are depicted in the com- 
 plexion, which is pale and eranguious ; and this 
 uniformly obtains wherever man is excluded from 
 the pure breath of heaven. Its influence then on 
 the digestive organs, through the medium of the 
 skin (between which and the stomach, liver, and 
 other internal organs, there is a most intimate sym- 
 pathy) must be great, and really is so. The whole 
 digestive apparatus is enfeebled in function, partly 
 through the medium of the skin, and partly through 
 the influence of that nervous depression which re- 
 sults from the inhalation of a civic atmosphere, and 
 exerts a most powerful effect on the digestive or- 
 gans. 
 
 It is a source of great satisfaction to the philan- 
 thropist to see that the construction of modern 
 streets, and of modern houses, is well calculated to 
 obviate the effects of contaminated air, and ensure a 
 free ventilation. Every citizen, and particularly every 
 valetudinarian, should endeavour, if possible, to em- 
 erge from the confines of the smoke once a day, were 
 it for ever so short a time, and enjoy the air and exer- 
 F 
 
42 
 
 else of the open country. The cold, or tepid bath, 
 will also be a powerful corrector of civic air. The 
 parks, in the vicinity of this capital, save thou- 
 sands of lives annually; and it is wonderful that 
 they are not still more crowded, considering the 
 countless hosts of sedentary invalids with which 
 this overgrown metropolis abounds. It is not 
 beneath the dignity, or even the prudence, of the 
 medical philosopher to saunter along the Mall, 
 or through the different parks, on Sundays, or 
 other days of relaxation, to study the civic phy- 
 siognomy, and contrast it with that of rural life. 
 He will read in almost every countenance the aspi- 
 ration of the Augustan poet : 
 
 O Rus, quando te aspiciam! 
 
 But it is through the medium of atmospherical 
 vicissitudes, that the digestive organs, in polished 
 life, suffer the worst effects. In civic society, the 
 human race is so little exposed, or at least inured 
 to the open inclemencies of the skies, that the sur- 
 face of the body becomes highly susceptible of 
 aerial transitions; and these impressions are quick- 
 ly transmitted by sympathy, or otherwise, to the 
 interior organs, particularly those concerned in di- 
 
43 
 
 gestion and biliary secretion, as 1 have shown, at 
 great length, in my work on " the Influence of the 
 Atmosphere/' to which I must refer for the details. 
 
 To counteract this enervated state of the surface, 
 the cold, or even the air bath is the most power- 
 ful remedy. 
 
 It will not be questioned that the balance of en- 
 joyment, in respect to air, points to the country ; 
 and that of suffering to the city. 
 
il 
 
 SUBSECTION IV. 
 
 Influence of Civic Life, 8{c. on the digestive Or- 
 gans, through the Medium of Sedentary Habits. 
 
 WHEN men began to congregate in cities, they 
 in a great measure, exchanged labour for art. 
 Now, it is well known that the muscles, when 
 briskly exerted, acquire tone and strength, and 
 this tonicity is extended to the organs of digestion. 
 But, on the other hand, by sedentary habits, the 
 muscles are relaxed and debilitated, and the diges- 
 tive apparatus participates in this debility. Be- 
 sides, a certain degree of exercise is necessary to 
 circulate the blood and other juices, and promote 
 the various secretions; without which, the liver, 
 stomach, and intestines cannot perform their pro- 
 per functions. This degree of exercise is rarely, 
 if ever, taken by the sedentary citizen, and its ef- 
 fects are seen in two different ways ; in morbid ac- 
 cumulations of fat, and in paleness, emaciation, 
 nervous debility, and hypochondriacal depression. 
 
 \ 
 
45 
 
 Another way, in which sedentary habits prove 
 prejudicial to the digestive organs is, by the me- 
 chanical pressure which the stomach and liver sus- 
 tain in numerous sedentary employments, where 
 there is much stooping or leaning forward. A great 
 deal of functional derangement is thus induced. 
 Indeed, every class of artizans or mechanics has 
 its peculiar train of prevailing diseases, which it 
 behoves the medical practitioner to study with 
 great care. The compositor who sets up the 
 types of this page, and the pressman who works 
 off the sheets, are affected with quite a distinct set 
 of complaints. It is the same with all other spe- 
 cies and subdivisions of labour. 
 
 The remedies are, exercise, passive or active, 
 the cold bath, where no organ is unsound, and al- 
 terative doses of the blue pill, with, or without sar- 
 saparilla. Tonics are more frequently hurtful than 
 beneficial. 
 
SUBSECTION V. 
 
 Influence of Civic Life, t$c. on the digestive Or- 
 gans, through the Medium of Mental Emotions. 
 
 THE nervous system and digestive organs act 
 and re-act upon each other with surprising force 
 and rapidity. The intelligence of a severe loss, or 
 the occurrence of an unexpected calamity will in- 
 stantaneously annihilate the appetite, suspend the 
 process of digestion, and allow the contents of the 
 stomach and bowels to run into all kinds of decom- 
 position and fermentation. A piece of agreeable 
 information, on the contrary, will recal the inclina- 
 tion for food, and qui( kly set all the digestive ma- 
 chine again in regular motion. Now it is quite evi- 
 dent, that in proportion as men accumulate in large 
 societies, those events and circumstances which 
 tend, in a thousand different ways, to disquiet the 
 mind, ruffle the temper, and excite the passions, 
 multiply in an increasing ratio. Compare the 
 whistling plough- boy with the calculating stock- 
 
47 
 
 broker; the shepherd on the mountains, with the 
 merchant in the city ; the village magistrate, with 
 the prime minister. Compare the state of their 
 minds, anil the state of their digestive organs, and 
 you will find a corresponding contrast in hoth! In- 
 deed, 1 firmly believe, that the mental perturba- 
 tions of a civic life cause, upon the whole, more 
 derangement of function? and ultimately of struc- 
 ture, in the stomach, liver, and alimentary canal, 
 than all the other agents which we have been hither- 
 to investigating. This is a subject deserving the 
 utmost attention of all classes in civic society, as 
 well as of the medical practitioner, whose prime 
 object should be to ascertain the real source of a 
 disease ; for this discovery gives him infinite advan- 
 tages in the mode of removing it. 
 
 Of all the digestive organs, the liver suffers most 
 in this way. This I know from long and painful 
 experience in my own person, as w r ell as observa- 
 tion on others, both in this country and in tropical 
 regions. Indeed, I have ascertained, that many 
 of the depressing passions will instantaneously 
 spasm the mouths of the biliary ducts, when a re- 
 gurgitation of bile takes place into the system at 
 large, tinging the eye yellow, and overcasting the 
 
 
 
48 
 
 mind with the most gloomy anticipations, and in- 
 describable despondency. 
 
 It is a curious but undoubted fact, that the dif- 
 ferent mental emotions, or passions, even of the 
 same class, produce different effects on the organs 
 of digestion, and especially on the biliary secre- 
 tion. This is so strikingly the case, that by exa- 
 mining the morbid conditions of these organs, I 
 have often guessed the real origin of them ; and, 
 on the other hand, by being told the malady of the 
 mind, I have stated, without inquiry, the corporeal 
 symptoms in the digestive viscera. The effects of 
 anger, for instance, are very different from those 
 of grief. The/0? 9 ?wer will often increase, and ren- 
 der acrid the biliary and gastric secretions, produ- 
 cing irritation all along the line of the bowels. 
 The latter, on the contrary, will diminish the same 
 secretions, and often leave the alimentary canal 
 completely torpid. Corresponding differences are 
 seen to result from love, fear, jealousy, inordinate 
 ambition, envy, &c. and the corporeal effects re- 
 quire an appropriate modification of treatment, a 
 circumstance that is too much overlooked. 
 
 Study and deep thought, not only among the li- 
 
49 
 
 terary, but among the professional, mechanical; 
 and manufacturing classes of society, exert a most 
 powerful and deleterious effect on the digestive 
 organs, by drawing the vital energy and circula- 
 tion to the brain and nervous system, and robbing 
 the lower viscera of their due share of these im- 
 portant principles. This subject I have already 
 touched on, in my work on i( Tropical Climates," 
 and also in that on the Influence of the British 
 Atmosphere." The subject will be again taken up 
 in the third Chapter on the Intellectual System. 
 
 The remedies here are partly moral, and partly 
 physical. The nature of the moral causes must be 
 explained to the patient ; though advice, in re- 
 spect to the passions, or mental emotions, has sel- 
 dom mueh effect. It is fortunate, however, that in 
 
 
 
 no instance is the efficacy of well directed remedies 
 more conspicuous than in derangements of the bili- 
 ary and digestive organs, resulting from mental 
 perturbations and anxieties. Indeed, it is astonish- 
 ing how easily, not only these derangements them- 
 selves, but even the causes that produced them, 
 may be relieved or removed, by a few simple re- 
 medies, when the real seat of the corporeal disor- 
 der is ascertained by accurate and careful examina- 
 tion of the symptoms and phenomena. 
 G 
 
50 
 
 SUBSECTION VI. 
 
 Influence of Civic Life, fc. on the digestive Or- 
 gans, through the Medium of late Hours. 
 
 SUCH is the harmonious balance, or sympathy,, 
 between the various organs and functions of the 
 .human frame, that no one can be disturbed, with- 
 out annoyance to several others. Thus the intel- 
 lectual and animal systems being greatly deranged 
 by the unnatural custom of turning night into day, 
 and day into night, which so universally prevails 
 in civic life, the digestive organs come in^for their 
 share of the mischief, through the sympathy, or 
 connexion in question; and that at a time too, when 
 the said organs are labouring under the evil conse- 
 quence of inordinate irritation from food and drink! 
 The united effects are such as we might expect, 
 and such as we actually meet with at every step. 
 They are in exact ratio to the cause, and follow the 
 commission of our crimes against Nature as closely 
 as the shadow follows the substance ! 
 
51 
 
 SUBSECTION VII. 
 
 Influence of Civic Life, V. on the digestive Or- 
 gans, through the Medium of Medicine. 
 
 " Medicines differ from poisons only in their doses." 
 
 THE multiplication of medicines and medical 
 men, with the progress of civilized society, is a 
 sufficient proof; if proof were wanting, of a corre- 
 sponding multiplication of human infirmities ! So 
 complicated is the living machine, in structure 
 and functions; so intricate its movements, and so 
 numerous the agents by which it is influenced, 
 from within and from without, that the science of 
 health and disease as much exceeds all other sci- 
 ences, in difficulty of attainment, as Algebra, or- 
 Astronomy, exceeds, in difficulty, the plainest rules 
 of arithmetic. Now, when we look around us, and 
 observe the host of old women, nurses, quacks, 
 and even patients themselves, (leaving aside the 
 
52 
 
 mass of ignorant, or unqualified, pretenders to re- 
 gular practice) all busily employed " in pouring 
 drugs, of which they know little, into bodies, of 
 which they know less/' we are irresistibly led to 
 the melancholy conclusion, that, all things consi- 
 dered, it were better for mankind if not a particle 
 of medicine existed on the face of the earth ! Nor is 
 this a stigma on the use, but on the abuse of the 
 science. It is still a "divine art," to which the 
 victim of pain must fly at last, however stoical or 
 sceptical his disposition. 
 
 It has been a just cause of reproach, to this coun- 
 try in particular, that we are fonder of studying re- 
 medies than indications : that is, that we hunt too 
 much after specifics, and do not sufficiently attend 
 to the minute features, phenomena,, and causes of 
 disease, by a knowledge of which we might more 
 effectually employ those remedies we already pos- 
 sess. Let us exemplify this observation. A lady 
 is seized with that painful affection, Tic doulou- 
 reux, or face-ache. One person recommends calo- 
 mel and opium, as an effectual remedy : a second, 
 proposes Fowler's solution : a third, asserts that 
 belladonna is a specific : a fourth, that cutting the 
 nerve is the surest remedy. Now 7 any one of these 
 
 
53 
 
 may happen to be the right remedy ; but they may 
 all be wrong, and the poor lady may run the gant- 
 let before she is cured. Thus, if the face-ache be 
 merely symptomatic of some derangement in the li- 
 ver, or digestive organs, the calomel and opium 
 will probably be successful: if the disease arise 
 from a translation of gouty, or rheumatic irritation 
 to the part, Fowler's solution may stop the parox- 
 ysms of pain : if it be, as it seems, a purely ner- 
 vous affection, belladonna may remove it ; and if 
 it consist in an inflamed state of the neurilema, or 
 covering of the nerve, the division of that covering 
 by the knife may so empty the vessels as to check 
 the disease : but if, as is often the case, the sen- 
 tient extremity of a nervous twig, be irritated by a 
 carious tooth, the whole of the foregoing means 
 will be useless, and the extraction of the cause 
 alone will destroy the effect. 
 
 What we have said of tic douloureux, applies 
 to every other disease. Each has not only numer- 
 ous causes, but numerous, and constantly varying 
 modes of action, which require incessant vigilance, 
 and the keenest penetration to trace and counteract. 
 Thus, suppose a person to be suffering under acute 
 rheumatism, or gout, in his foot or knee. We are 
 
 
54 
 
 treating it with cooling evaporating lotions, and 
 every thing appears to be going on well; hut we 
 hs x scarcely turned the corner of the street, when 
 the rheumatic, or gouty inflammation darts, like an 
 electric shock, to the heart or brain ; here then we 
 have to immediately undo all we have been doing. 
 To the part whpre we were applying refrigeration, 
 we must now apply mustard, blisters, or even 
 scalding water ; and, in short, totally reverse our 
 proceedings. What then must be the consequence 
 of employing specific remedies in diseases, that, 
 like Proteus, are constantly changing their forms? 
 Why misery, or death, to thousands every day !* 
 
 I have shown that, in civic life as now constitu- 
 ted, the digestive organs are very generally in a 
 state of irritation, from the quantity and quality of 
 our food, drink, &c. The situation of the nervous 
 system will hereafter be proved to be very similar. 
 To remove these evils, man will not avoid the 
 causes that produced them; the only alternative 
 then, is recourse to medicine. But almost all me- 
 dicines are in themselves, irritants; and more 
 than half the employment of the physician con- 
 
 * See my n Practical Researches on Gout," for examples. 
 
55 
 
 sists in removing one irritation by inducing another. 
 Let us exemplify this remark. A man, after full 
 
 
 
 living, sedentary avocations, and irregular hours, 
 begins to feel loss of appetite, head-ache, drowsi- 
 ness, depression of spirits, fickleness of temper, 
 with sense of fulness, and uneasiness on pressure 
 in the right side, c. There is now engorgement 
 and irritation in the liver. What do we do ? We 
 give calomel, aloes> and colocynth, which irritate 
 the mucous membrane of the digestive organs, sti- 
 mulate the mouths of the biliary ducts, and cause 
 a flow of bile and various other secretions into the 
 intestines, which secretions are soon carried out of 
 the system entirely. The whole train of symptoms 
 now vanish like a fog before the sun beams. But 
 suppose (which indeed is every day done) we had 
 employed a different class of irritants, called tonics ; 
 as steel, bitters, &c. which the loss of appetite and 
 other symptoms would appear to indicate? Why 
 the result would be an aggravation, in the end, of 
 all the complaints. Hence then we perceive, that 
 nothing but the most careful and minute investiga- 
 tion of the natwre and seat of the morbid irrita- 
 tion can enable us to apply the artificial irritation 
 of medicine, with any prospect of ultimate success.. 
 This view of the subject might open the eyes of 
 
56 
 
 mankind to the devastation which is daily produ- 
 ced in the digestive organs by the careless and in- 
 discriminate administration of a farrago of medicines, 
 which, like food and drink, both by their quantities 
 and qualities, keep the whole line of the alimentary 
 canal, and, in fact, the whole system, in a state of 
 morbid irritability. 
 
 For this the patient has generally to thank him- 
 self. Instead of making a moderate remuneration 
 for the advice or opinion of the medical attendant, 
 he prefers paying him, like his wine merchant, at 
 per dozen, for what he can swallow ! In this way 
 the most efficacious remedies are often rendered 
 inert, by commixture or dilution, and perseverance 
 is prevented by satiety or disgust.* 
 
 * I could adduce numerous instances where the power of medicines 
 is affected by commixture ; but the following will suffice. In certain 
 urethral discharges, whether recent or chronic, the balsam capivi is 
 possessed of singular efficacy, when simply administered in a little 
 water, or on sugar. But I have seen it given in draughts and mix- 
 tures, for weeks together, without effect. When given in pretty 
 large doses, and watched till it produces its specific symptoms, it 
 rarely fails to stop the most inveterate gleet in three or four days. It 
 is a curious fact that it removes irritation, or even chronic inflamma- 
 tion from the prostate gland, or neck of the bladder, at the very 
 moment that it causes heat in making water. The manner and the 
 dose, however, in which it is generally given, render it abortive. 
 
57 
 
 But it may be said, that, as the specific action of 
 medicines on the human frame, was found out hy 
 accident and observation, and as their effects are 
 pretty uniform, so the knowledge of applying them 
 cannot be so very difficult or complicated. Why no. 
 A man of very common understanding may soon 
 learn the names, the doses, and the qualities of the 
 whole Materia Medica, and he may be able to tell 
 pretty nearly how each will act upon the living ma- 
 chine, in a state of health. But the great difficulty 
 is to discover the nature and seat of the disease, 
 and how to remove that disease by remedies, which 
 often produce diametrically opposite effects. It is 
 not by seeing a great deal of sickness only, that 
 this knowledge can be acquired 5 but by closely 
 studying what we do see. 
 
 Now, as in civic society, the health is constant- 
 ly wanting repairs ; as the human frame is there in 
 a state of morbid sensibility and irritability ; and 
 as patients, quacks, and illiterate practitioners are 
 constantly pouring a flood of physic, upon real or 
 imaginary diseases, it is no unreasonable inference, 
 that, upon the whole, a greater quantum of suffer- 
 ing and mortality is thus induced, than is prevent- 
 ed by the scientific and judicious administration of 
 medicine ! 
 
 H 
 
58 
 
 From the above considerations, it will be pretty 
 evident^ that the poor man is nearly on a par with 
 the rich. If he cannot afford medicine, or medical 
 advice, he runs no risk of injury from the delusive 
 promises of the quack, or the misapplication of do- 
 mestic prescription. The balance of happiness is 
 nearly in equilibria on this point. 
 
SECTION II. 
 
 INFLUENCE OF CIVIC LIFE, SEDENTARY HABITS, AND IN- 
 TELLECTUAL REFINEMENT, ON THE HEART AND CIR- 
 CULATING VESSELS. 
 
 OF all the internal organs, not immediately un- 
 der the control of the will, there is none so easily 
 and so commonly influenced and disturbed in its 
 functions by mental emotions and corporeal sensa- 
 tions, as the heart. A whitlow on the finger will 
 excite the action of the heart and arteries ; fear^ 
 shame, joy, anger, &c. will drive this organ from 
 its usual and healthy rhythm, into all kinds of ir- 
 regularity and excess. This susceptibility to wild 
 and tumultuous action, is in direct proportion to 
 the degree of intellectual refinement, nervous sen- 
 sibility, and delicacy of corporeal structure, which 
 we possess. As it is a well known law, that 
 disordered function will, in time, lead to diseased 
 substance ; and as in the progress of civilization and 
 refinement, a host of circumstances are engendered 
 and combined to disturb the tranquility of the heart, 
 both in a moral and physical sense, we have thus 
 
60 
 
 a clue to the overwhelming torrent of diseases of 
 this organ, which, of late years, have pressed upon 
 the observation of every intelligent practitioner. 
 Corvisart, who has long studied the disorders of 
 the heart, and who remarked their increased fre- 
 quency, during the agitations of the French Revo- 
 lution, declares it as his firm belief, that they are 
 more common and frequent than those of either the 
 liver or lungs. From the most unwearied attention 
 to this subject, during the last four or five years, 
 excited and kept up by personal feelings and suf- 
 ferings, I am strongly disposed to believe that Cor- 
 visart is correct. A multiplicity of anomalous 
 symptoms and feelings, usually clashed under the 
 sweeping term nervous," are, I know from ex- 
 perience, the result of functional or organic disor- 
 der of the heart ; and very many of those sudden, 
 awful, and mysterious deaths which we see and 
 hear of, are consequences of the same. As it is 
 only in the very earliest stages of these melancholy 
 affections that medicine can effectually avail, and 
 as prevention is still better than cure, I shall trace 
 slightly, but I hope correctly, the principal causes 
 which lead to the derangements of this vital organ, 
 and thereby enable the reader to guard against 
 suh a formidable class of human afflictions. 
 
61 
 
 SUBSECTION I. 
 
 Influence of Civic Life, %c. on 1he Heart, through 
 the Medium of the digestive Organs. 
 
 THE stomach, as it is the organ by which the 
 corporeal fabric is nurtured and maintained, so is 
 it the centre of sympathies. Between it and the 
 heart so intimate a sympathy or consent obtains, 
 that flatulence, indigestion and various other func- 
 tional disturbances in the stomach will often go so 
 far as to stop, for a moment, the action of the heart. 
 At the very moment that 1 am writing these lines, 
 my pulse intermits every fifth or sixth stroke, from 
 a little biliary derangement and indigestion, result- 
 ing from the intense heat of the weather, some 
 mental anxiety, and inordinate application to 
 study. About twelve months ago, from the same 
 causes^ the action of the heart was so deranged, 
 that I could not walk twenty yards without danger 
 of fainting, and such a degree of palpitation and 
 indescribable uneasiness in the chest, as threaten- 
 
62 
 
 eel instant death. To these were added frightful 
 dreams, starlings from sleep ; great mental despon- 
 dency ; irritability of temper; the most gloomy an- 
 ticipations and prognostications of all future events ; 
 in short, a very considerable number of those symp- 
 toms and phenomena, which attend organic, or in- 
 curable disease of the heart. My alarm was con- 
 siderable at first; but I soon discovered the func- 
 tional or sympathetic nature of the complaint, and, 
 by horse exercise, and improving the state of the 
 digestive organs, 1 at length conquered, in a great 
 measure, the disease. But the same causes still 
 continue, occasionally, to reproduce it; and will 
 do so, while I am subjected to their influence. I 
 forsee that these functional disturbances will, in 
 time, lead to organic changes in the heart ; and 
 though I know the causes I cannot avoid them ! 
 
 video, meliora proboque, 
 
 Deteriora sequor ! * 
 
 Although I had studied both functional and 
 organic diseases of the heart, with peculiar care, 
 for fifteen years past, yet the phenomena which; 
 
 * In my work on the Influence of the Atmosphere ( Second Edition J 
 page 194, I have stated this case more in detail. 
 
63 
 
 during the last twelve months, I observed and felt 
 in my own person, have enabled me to ascertain 
 certain minute, but distinctive features in the two 
 classes of disease, on which 1 can rest with con- 
 siderable confidence, my diagnostic decisions, in 
 regard to their nature and treatment. 
 
 One most curious and interesting phenomenon 
 is this $ 1 can perceive when certain gases distend 
 the stomach, the diaphragm, on which the heart 
 rests, is either pushed up mechanically, or sympa- 
 thetically affected, so as to disturb the action of the 
 heart, and prevent it from unloading itself of its 
 blood. At that moment, there is an unusual throb, 
 or struggle of the heart, accompanied by a most dis- 
 tressing and sickening sensation, and a cessation 
 of the pulse in all tangible arteries. For many 
 months together this used to occur twenty, thirty, 
 or one hundred times in the course of an hour. 
 Another peculiar circumstance is this : a glass of 
 spirits and water, or two or three glasses of wine, 
 would, at any time, put an end to this phenomenon, 
 for four or five, or six hours, to return again with 
 increased violence. Walking, but particularly go- 
 ing up a flight of stairs, always aggravated the 
 complaint ; whereas I could trot or gallop on horse- 
 
back, with a sure diminution of the irregularity of 
 action in the heart. By repeated examination of 
 numerous cases, where organic disease was sus- 
 pected during life, and found on dissection, I as- 
 certained that the above phenomena were diamet- 
 rically opposite to those attendant on disordered 
 structure of the heart. But an important mean of 
 distinguishing sympathetic, from substantial dis- 
 ease of this organ, is percussion of the chest, and 
 pressure of the stomach and abdomen, as first re- 
 commended by that experienced physician, M. 
 Corvisart, of Paris. During the last six years, I 
 have employed this measure in a great variety of 
 instances; and the more I have seen, the morel am 
 convinced, that, in conjunction with a minute ex- 
 amination of the symptoms of the disease, it affords 
 a most invaluable criterion, whereby to estimate 
 the nature and danger of disordered action, or de- 
 ranged structure of the heart. But it is not by ask- 
 ing half a dozen questions, and then simply patting 
 the chest, and squeezing the abdomen, that any ac- 
 curate knowledge of an internal disease can be gain- 
 ed. The whole of the symptoms and phenomena, 
 together with a rigid inquiry into the history and 
 causes of the illness, should first be weighed, and 
 then the chest and abdomen should be accurately 
 
65 
 
 examined, while the patient is placed in various 
 positions. Were this process always instituted 
 (and no man can say that he has conscientiously 
 investigated the nature and seat of a serious inter- 
 nal disease without it), we should not hear such 
 conflicting opinions proceeding from eminent phy- 
 . sicians relative to individual cases, nor patients 
 complaining of the vacillating and contradictory 
 modes of treatment, to which they have been sub- 
 jected.* ' 
 
 But to return. The action of the heart being 
 thus shewn to be greatly influenced by derange- 
 ments of the stomach ; and as a civic life perpetu- 
 ally tends to produce disorders of the latter organ, 
 we need no longer wonder at the rapid increase of 
 this new and destructive form of disease. 
 
 Independently of this sympathy between the 
 heart and stomach, there are various ways in 
 which the organ of the circulation becomes dis- 
 turbed, through the medium of the digestive appa- 
 
 * In a course of lectures on functional and structural derangements 
 of internal organs which the author is preparing- to deliver, in this me- 
 tropolis, the mode of conducting thoracic percussion and abdominal 
 compression will be particularly delineated. 
 I 
 
66 
 
 ratus. The stimulating and intoxicating drinks 
 \vhich we use accelerate the action of the heart in 
 an unnatural manner. The richness and the quan- 
 tity of our food, induce a too great fulness of the 
 blood-vessels, and then the heart is called upon 
 for exertions in circulating the blood, to which it 
 Is often unequal. These extraordinary exertions 
 ultimately injure the texture, or mechanism of the 
 heart itself, and hence a prolific source of terrible 
 diseases. 
 
 Another, and very common way in which the 
 heart suffers, is from derangements of the liver. 
 Whenever the circulation of the blood in the liver 
 is obstructed, the heart feels the bad effects; and 
 that the liver, in this country, is frequently in a state 
 of congestion, from a variety of causes, need not 
 here be insisted on.* The very enlargement of the 
 liver itself, by mechanically encroaching on the ca- 
 pacity of the chest, disturbs the free action of the 
 heart, and ultimately injures its structure. 
 
 It requires not to be stated, that to prevent or 
 
 * See the Section on biliary derangements, in my wor, on " Atmos- 
 pheric Influence," (Second Edition, J from page 56 to page 96. 
 
67 
 
 eure these affections of the heart, the original cau- 
 ses must be removed, as a sine qua non. 
 
 On this point the balance of suffering is clearly 
 against the pampered citizen, and in favour of the 
 frugal peasant. 
 
68 
 
 
 SUBSECTION II. 
 
 Influence of Civic Life, &c. on the Heart, through 
 the Medium of the Skin. 
 
 OUR habits of life in civic society render us 
 extremely susceptible to atmospherical transitions; 
 and, as in this climate, these transitions are pro- 
 verbially common, so we are all obnoxious to 
 rheumatism. In my work on Atmospheric Influ- 
 ence, I have shewn, at great length, that rheuma- 
 tism of the heart (from translation of the disease 
 to that organ, from the muscles or joints) is re- 
 markably frequent in this country. 1 have there 
 stated numerous cases and disections of this dan- 
 gerous disease, that happened in my own practice, 
 and in that of others. I beg leave to refer, there- 
 fore, to the second edition of that work, from 
 page 115 to page 130, for the fullest history of 
 the complaint that has yet been published. 
 
 I may here state that gout is frequently trans- 
 lated to the heart, especially since the new modes 
 
69 
 
 of curing that disease by the eau medicinale, col- 
 chicum, and cold applications, have come into 
 vogue. I have lately seen a decided and melan- 
 choly instance of this kind. 
 
 Independently of these translations of specific ir- 
 ritation, as of gout and rheumatism, to the heart, this 
 organ suffers much from sudden changes of tempe- 
 rature in the air, whereby the volume of blood is 
 often abruptly driven from the surface to the inte- 
 rior, embarrassing the action of the heart. These 
 effects are, of course, increased, if not principally 
 occasioned, by our fashionable attire, which leaves 
 not only the skin, but the great vital organs of the 
 body at the mercy of inclement', and ever varying 
 skies ! 
 
 To obviate the serious ills which result in this 
 way, more attention should be paid to clothing, and 
 to those circumstances which I have pointed out, 
 under this head, in my other work. In treating 
 rheumatism we should equally avoid the extremes 
 of a warm and a cold regimen, both of which tend to 
 give the disease a disposition to shift its seat from 
 external to internal parts, and thus endanger the 
 heart. Oa this subject I have treated fully in my 
 
70 
 
 other work before alluded to. The same observa 
 tions apply to the treatment of gout, especially, in 
 valetudinary constitutions, and where the disease 
 has existed some time. Those heroic medicines, as 
 our French brethren call them, which drive gout 
 out of the system, as it were by surprize, only 
 enable it to re-enter, with greater force, and in- 
 stead of lodging on the outworks, to take posses- 
 sion at once of the citadel ! 
 
 The balance of suffering here preponderates, on 
 the whole, against the luxurious citizen and se- 
 dentary artizan. For although the soldier, the sai- 
 lor, and the rustic labourer, are more exposed to 
 the vicissitudes of the skies, and are, perhaps, more 
 generally affected with rheumatic complaints; yet, 
 they are exempt from that delicate organization, 
 morbid irritability, and keen susceptibility, which 
 tend to produce translations of this painful malady 
 from the exterior to the interior of the body. 
 
71 
 
 SUBSECTION 
 
 Influence of Civic Life, "c. on the Heart, through 
 the Medium of the Passions. 
 
 THE influence of mental emotions on the func- 
 tions of the heart is still greater than on the diges- 
 tive organs. No one who has felt the palpitation, 
 anxiety about the chest, and galloping pulse, which 
 accompany perturbation of mind, can doubt the truth 
 of this position. The detection of Antiochus ? s pas- 
 sion for Stratonica by the pulse, is a proof of how 
 early the influence of the mind on the heart and 
 arteries was remarked. And, in fact, the innume- 
 rable instances on record of sudden and slow 
 death, from mental causes, can only be accounted 
 for in this way. Every body knows that Philip 
 the Fifth, of Spain, died suddenly on learning the 
 disastrous defeat of his army near Plaisance. Zim- 
 merman states that, on opening his body, the heart 
 was found burst. And thus it is that the vulgar 
 and metaphorical expression of a broken heart," 
 is sometimes pathologically correct. 
 
72 
 
 But it is not the heart alone that feels the im- 
 pulse of mental perturbation. The minutest capil- 
 laries are under its influence. Shame, for exam- 
 ple, will instantaneously gorge the capillaries of 
 the cheek, and render the skin like crimson. Let 
 the emotion he changed to fear, the lily usurps the 
 of the rose, and the face is blanched and 
 less ! Auger can rouse the organs of the cir- 
 i'jii into such preternatural action as to over- 
 fur a time, habitual decrepitude. Thus Mu- 
 ly Moloc, though lying on the bed of death, worn 
 out by an incurable disease, and not expected to 
 live an hour, started from his litter, during the im- 
 portant crisis of a battle between his troops and 
 the Portuguese rallied his army led them to 
 victory and immediately expired ! 
 
 The heart then being so particularly under the 
 influence of the mind, we may form some idea of the 
 wide range of effects resulting from the various, 
 and almost unlimited play of the passions among 
 so thinking, so reading, and so political a people 
 as the English. With the progress of civilization, 
 refinement, and intellectual cultivation, a host of 
 what may be termed predispositions to disease 
 have arisen, that lay us at the mercy of almost 
 
73 
 
 every breath of heaven. Our feelings are render- 
 ed so acute, that we are all soul within, and all 
 nerve without. We thus, like the spider, " live 
 along the line," and every event that happens on 
 any point of the globe's surface is regularly trans- 
 mitted, like an electric shock, to this sympathetic 
 island ! The consequence is that a morbid sensibi- 
 lity is generated throughout the whole population, 
 but particularly among those in the upper walks of 
 life, where exposure to the vicissitudes of the at- 
 mosphere, temperance, and daily labour, blunt not 
 the senses, and fortify not the corporeal fabric. 
 Thus constituted, it may easily be conceived what 
 havoc those great and predominant passions, love, 
 ambition, jealousy, emulation, &c. produce on the 
 enervated frame, when carried beyond their natu- 
 ral and healthy boundaries. 
 
 The effects of the mind on the body, in a salutary 
 point of view, cannot be accounted for, in any other 
 way, than through the medium of the heart and 
 blood vessels. 
 
 In fine, after a long and attentive study and ob- 
 servation of this subject, I am led to conclude, 
 that of all causes, which conspire to disturb the 
 function, and ultimately to injure the structure of 
 K 
 
74 
 
 this important organ, mental agitation holds the 
 first rank. 
 
 It need hardly he remarked that mental sensibi- 
 lity is in proportion to civilization and refinement ; 
 and hence that if the upper classes of society taste 
 more exquisite pleasure, they also suffer more ex- 
 quisite pain than those in lower gradations of rank. 
 Enjoyment and suffering then are probably in equi- 
 libria here. 
 
 P. S. Before closing this section, I may be 
 permitted to state, that on examining my notes, re- 
 lative to diseases of the heart, I find more cases 
 have presented themselves from the class of tailors, 
 than any other description of tradesmen. May not 
 this be owing to the bent position in which they sit, 
 obstructing the free circulation of blood from the 
 heart, and ultimately disturbing its function or in- 
 juring its structure ? 
 
 It would appear that, in sedentary occupations, 
 where much stooping or leaning over a desk is 
 used, the heart suffers more than the lungs, though 
 the attention of patients and physicians has been 
 principally directed to the latter, without suspect- 
 ing the injury which the former was sustaining. 
 
75 
 
 SECTION III. 
 
 INFLUENCE OF CIVIC LIFE, ETC. ON THE LUNGS AND 
 GLANDULAR SYSTEM. 
 
 THERE is every reason to believe that scrofula 
 first originated, and still continues to be produced 
 by the confined air, sedentary habits, irregularity 
 of clothing, and derangement of the digestive or- 
 gans, so prevalent in civic life. The surface of 
 the body is rendered peculiarly susceptible of at- 
 mospheric impressions; and as aerial transitions are 
 remarkably frequent and abrupt, in this climate, 
 so the glands and absorbent vessels are constantly 
 disturbed in thvir functions, and their structure ul- 
 timately suffers. Thus are produced the external 
 or visible forms of scrofula, which are but too fa- 
 miliar to every eye. Yet these are trifling, when 
 compared with the internal ravages of the disease. 
 The external forms having been induced by the 
 causes enumerated above, an hereditary disposition 
 
76 
 
 to the complaint is afterwards transmitted from pa- 
 rent to progeny. It now manifests itself in the 
 lungs. Children, under these circumstances, will 
 be born with the organ of respiration studded with 
 scrofulous tubercles, smaller than the finest grains 
 of sand ; and these may lie dormant and harmless 
 during the longest life, if they aro not excited into 
 action by the various causes alluded to, and parti- 
 cularly by the impressions of the atmosphere on 
 the surface of the body. When we become ener- 
 vated by a civic life, these impressions act with 
 redoubled force, and then pulmonary consumption 
 is developed with all its slow but fatal ravages on 
 the human constitution ! 
 
 To obviate these melancholy consequences, the 
 children of citizens should be early accustomed to 
 bear the vicissitudes of our climate, by taking eve- 
 ry opportunity of bringing them into the open air 
 of the country, or the vicinity of town. They should 
 be clothed uniformly, but not too warmly ; for by 
 this ill judged advice more injury than good is 
 done. The cold, or shower bath, should be early 
 commenced, and long persevered in, as it is the 
 grand agent in fortifying the constitution against 
 the changes of the climate ; while the digestive or- 
 
 
77 
 
 gans should be particularly attended to, so that no 
 irritation may be propagated from thence to the 
 lungs or glandular system. 
 
 It is but justice to observe that the soldier, the 
 sailor, and the peasant, have not greatly the ad- 
 vantage of the citizen, in respect to immunity from 
 pulmonary consumption ; for the great and frequent 
 exposures of the three former classes to the rude in- 
 clemencies of the skies, make serious depredations 
 on the lungs, and probably occasion as wide a 
 range of mortality among them, as the luxurious 
 and refined habits produce in civic society. Here 
 then the balance of enjoyment and suffering hangs 
 pretty nearly in equilibria ; but it might be made 
 to preponderate in favour of the citizen, were he 
 to adopt the suggestions contained in various parts 
 of this essay. 
 
 
CHAPTER II. 
 
 INFLUENCE OF CIVIC LIFE, SEDENTARY HABITS, AND IN- 
 TELLECTUAL REFINEMENT, ON THE ANIMAL OR MUS- 
 CULAR SYSTEM. 
 
 WE now come to that division of the human 
 frame which consists of the muscles that are entire- 
 ly under the subjection of the will. It is a certain 
 and well ascertained fact, that the more a volunta- 
 ry muscle is exercised, within the bounds of mo- 
 deration, the stronger and larger it will become. 
 This is exemplified in the arms of blacksmiths, or 
 goldbeaters, and in the legs of chairmen, or port- 
 ers ; which members are more developed in growth 
 and strength than the other parts of the body. The 
 converse of this position is equally true ; inaction 
 will render a muscle pale, flabby, weak, and cause 
 it to shrink. The author of this essay lately am- 
 putated a boy's thigh, who had been confined two 
 
79 
 
 or three years to one position, by a dreadful state 
 of disease in the knee and leg. Not a single mus- 
 cular fibre was to be seen, and the surface of the 
 stump presented one uniform appearance, like the 
 brawn of pork ! The poor little fellow perfectly re- 
 covered.* 
 
 From these facts we may form some idea of the 
 debility and relaxation, which must be induced 
 throughout the muscular systems of people congre- 
 gated in large cities, cooped up in confined apart- 
 ments, and employed in sedentary occupations, 
 without adequate air or exercise. The physical 
 effects resulting from these causes are so glaring 
 and conspicuous in every street through which we 
 pass ; in every house, or manufactory, which we 
 enter ; in almost every individual whom we con- 
 template, that the medical philosopher is struck 
 with the enormity of the evil ! How would the pale, 
 the puny, and the sedentary artizan of this metro- 
 polis look, if robed in the armour of Bruce, w r ith 
 the bow of Ulysses in his hand ? How would he 
 groan beneath the pressure of the one, and tug, in 
 vain, to bend the other ! 
 
 * See the 5th vol. Medico-Chirurgical Journal and Review, whe^e 
 this curious case is related. 
 
80 
 
 Was it the sires of such as these, 
 
 Who dared the elements and pathless seas, 
 
 Who made proud Asian monarchs feel, 
 
 Ho'vv weak their gold was against Europe's steel, 
 
 Or being's of another mould ? 
 
 Hough, hardy, vigorous, manly, bold. 11 
 
 This debility of muscle is a very prominent trait 
 in the physical character of civic life, and operates 
 with great, and decisively injurious influence, not 
 only on various functions of the body, but, through 
 the medium of the nervous system, on the mind 
 itself! Corporeal inertion is at once a cause and a 
 consequence of this muscular weakness ; and as a 
 due action of the voluntary muscles lends infinite 
 assistance to the heart and arteries, in circulating 
 the blood ; to the absorbent vessels, in taking up 
 the various fluids ; and to the different glandular 
 organs in secreting what is necessary or unne- 
 cessary to the system, so a deficiency of exer- 
 cise cramps and confines all those functions, and 
 mainly contributes to that paleness or sallowness 
 of the countenance, languor of mind and body, ti- 
 midity, nervousness, accumulations of fat in the 
 abdomen, or dropsical swellings in the limbs, pal- 
 pitations of the heart, head-aches, in short, to that 
 tout ensemble, which distinguishes the sedentary 
 citizen from the laborious peasant. 
 
81 
 
 What is the remedy ? " there is no remedy," 
 says the inhabitant of the city. " I have neither 
 time nor place for exercise and fresh air ; my busi- 
 ness confines me, and there is no alternative/' Yet 
 I have observed through life, that if a man have 
 but the willy he may soon have the power to do al- 
 most any thing. There is hardly a merchant, 
 tradesman, or mechanic, within the sound of Bow 
 bells, who may not take sufficient air and exercise 
 for the preservation of health, provided he has a 
 proper degree of determination so to do. Few 
 there are who cannot spare an hour, either early in 
 the morning, late at night, or at some period of the 
 day, to emerge from the midst of noise and smoke 
 into the nearest point of open space, there to stretch 
 his muscles by active exercise, and fill his lungs 
 with wholesome air. Where this cannot be done, 
 exercise may be taken within doors, by going up 
 and down stairs, using the dumb bells, &c. Where 
 the valetudinarian is unable to take pedestrian ex- 
 ercise, and cannot afford a horse or carriage, the 
 swing offers a tolerable substitute. In short, any 
 man who will have a little energy of mind, may 
 contrive to exercise the body, to a considerable ex- 
 tent, even were he within the walls of a prison. To 
 the affluent I would recommend more horse and 
 L 
 
82 
 
 carriage exercise than they now take. It would 
 counteract a host of those maladies, which their 
 other deviations from a state of nature induce. In 
 my work on Atmospheric Influence, I have dedi- 
 cated a w r hole section to the subject of passive ex- 
 ercise, in which the invalid will find important in- 
 formation, and to whose serious perusal 1 beg leave 
 to recommend it. The cold bath supplies, in a 
 very considerable degree, the want of regular ex- 
 ercise. Where there is no organ deranged in struc- 
 ture, this substitute may be resorted to at almost 
 any period of life. 
 
 The balance of enjoyment and suffering, in the 
 muscular system, is, upon the whole, I think, in 
 favour of labour, and against indolence. Fatigue 
 is at all times preferable to ennui. To the former, 
 sleep, " tir'd nature's kind restorer/' offers her 
 oblivious opiate of repose. To the latter, night 
 brings only a scene of feverish restlessness, or 
 frightful dreams ! 
 
 Labor ipse voluptas. 
 
 
83 
 
 
 CHAPTER III. 
 
 INFLUENCE OF CIVIC LIFE, SEDENTARY HABITS, AND IN- 
 TELLECTUAL REFINEMENT, ON THE BRAIN, AND NER- 
 VOUS SYSTEM. 
 
 IT is by the brain, or organ of thought, that man 
 is distinguished and raised above all other animals. 
 The nerves of sense, by which impressions are con- 
 veyed to this organ, are not so acute in the lord of 
 the creation, as in many of the inferior orders of 
 animated beings. He is surpassed by the eagle in 
 sight, by the dog in smelling, by the hare in hearing, 
 and by almost all animals in taste; strange and in- 
 credible as this may seem to some of our epicurean 
 connoisseurs ! Yet there is a spark, I trust an in- 
 extinguishable spark, in the sensorium of man, 
 which radiates the light of reason in every direc- 
 tion, and proclaims its superiority over instinct, by 
 tokens which none but the marble-hearted materi- 
 alist can fail to recognize. True it is, and melan- 
 
84 
 
 choly is this truth, that man, as a free and respon- 
 sible agent, often breaks through the admonitory 
 barriers of reason, and plunges in the ocean of 
 folly, or vice, or crime, till " the divinity that stirs 
 within him," can no longer manifest itself! But 
 for this he suffers ; even in this world he is punish- 
 ed for every imprudence ; and, probably, expiates 
 here every iota of his guilt 
 
 But to return. When the human species began 
 to congregate in cities, it was soon perceived that 
 in this class of society, the exertion of the intellect 
 must predominate over that of the body. As civi- 
 lization advanced, intellectual labour became more 
 necessary, and the labourers multiplied in propor- 
 tion. At the present period, the employment of a 
 very large class of human beings, especially in 
 civic life, consists almost exclusively in mental ex- 
 ertion. Look at the rulers of countries ; the legis- 
 lators, with their innumerable hosts of agents and 
 sub-agents ; the members of the pulpit; the bar ; the 
 medical world ; the literary world ; the superior 
 orders of the mercantile world. In all these men- 
 tal labour is the regular duty, and corporeal ex- 
 ertion only the occasional relaxation. Nay, in 
 the vast body of mechanics and artists them- 
 
85 
 
 selves, thought predominates over action. Even the 
 semi-feminine man- milliner, who measures out our 
 ribbon or lace, depends more on his talents, that 
 is, on the volubility of his tongue, than on the agi- 
 lity of his muscles, for success in business. To 
 such an extent is intellectual labour now arri- 
 ved, that a very large and important class of soci- 
 ety, live entirely by " teaching the young ideas 
 how to shoot ;" and a still larger class, who have 
 no actual occupation, rack their minds with inven- 
 tions, schemes, and projects that fade away as fast 
 as they are engendered. 
 
 Now 1 have before shewn that the more a volun- 
 tary muscle is exercised, within a reasonable limit, 
 the stronger and more capable of exertion it be- 
 comes: it is so with the brain and nervous system; 
 the more their faculties are brought into play, with- 
 in a certain bound of moderation, the more exten- 
 sive becomes the sphere of their power. The sense 
 of touch, the sense of smell, and the sense of hear- 
 ing, all become more acute, in proportion as they 
 are exercised. But this extra developement and 
 sensibility of the brain and nervous system, cannot 
 take place but at the expense of some function, or 
 structure, in the animal or organic system 5 for na 
 
 
86 
 
 ture, though sufficiently liberal, is, upon the whole, 
 very economical of her gifts, and extremely impar- 
 tial in the distribution of her favours. When, there- 
 fore, an undue share of the vital energy of any in- 
 dividual is directed to a particular organ or system, 
 a proportionate subduction is made from some other 
 organ or system, and this is a most undoubted, and 
 a most important truth, which is little understood, 
 and less attended to by the world in general. Ex- 
 amples meet the eye at every step ; one or two may 
 suffice. A man devotes his whole soul to study, or 
 mental exertion, in any way, whether literary, po- 
 litical, military, commercial, or mechanical. Ex- 
 amine that man minutely ; you will find him thin 
 and sallow, with weak digestive organs, and quick- 
 ness or irritability of nerve. This is the man for 
 deeds of "bold emprize !" He is such a man as 
 tyrants like not near their thrones. What said 
 Csesar to a man of this description? 
 
 " Would he were fatter.' 
 
 For, if my name were liable to fear, 
 
 I do not know the man I should avoid, 
 
 So SOOH as that spare Gassius. He reads much, 
 
 He is a great observer, and he looks 
 
 Quite through the deeds of men." 
 
 Bonaparte was thin and sallow, till the " work- 
 ings of his mind," so deranged the functions of the 
 
87 
 
 liver and digestive organs, that he became bloated. 
 He will soon die dropsical. Wellington is thin and 
 sallow ; but his frame of mind is happy; his career 
 of glory unclouded. He mingles active exercise 
 with intellectual labour; and he will live long his 
 country's pride. 
 
 Let us look, on the other hand, to those who 
 cultivate, with assiduity, the noble art of eating. 
 In these the stomach and neighbouring organs be- 
 come the great foci of the vital energy of the sys- 
 tem. Here the organic life predominates over the 
 animal and intellectual lives. The digestive or- 
 
 o 
 
 gaiis, in fact, among such people, form the " seat 
 of the soul/' instead of the Pineal gland of De- 
 scartes, and consequently the brain, the nerves, 
 and the muscles, are deprived of their due propor- 
 tion of vitality. This did not escape the Poet of 
 Nature, though he knew not in what way it was 
 produced. 
 
 " Fat paunches have lean pates, and dainty bits 
 Make rich the sides, but banker out the wits." 
 
 The above preliminary view of the subject shews 
 us, at once, the necessity and the importance of pre- 
 serving a harmonious balance between the three 
 
 
88 
 
 great systems which compose the human fabric 
 the intellectual, the organic, and the animal sys- 
 tems. Health and happiness depend on a just 
 equilibrium between the functions of these three 
 systems ; and whenever one is too much exercised, 
 or too much pampered, it must inevitably be at the 
 expense of another) and disease and disquiet are 
 the certain results ! 
 
 When we reflect on the complicated and minute 
 machinery of which the human fabric is composed ; 
 when we consider its various ties and " nice depen- 
 dencies," we shall be constrained to acknowledge, 
 that no trifling discrimination is necessary in adjust- 
 ing its erratic movements! What mischief then 
 must every day be done by the rude hand of the 
 ignorant pretender to so difficult a science! Could 
 the tomb open its " marble jaws," and disclose the 
 secrets which are there locked in impenetrable 
 night, it would doubtless 
 
 a tale unfold 
 
 Whose lightest word would harrow up the soul ! 
 But this eternal blazon must not be 
 
 
89 
 
 SECTION I. 
 
 INFLUENCE OF CIVIC LIFE, ETC. ON THE BRAIN AND NER- 
 VOUS SYSTEM, THROUGH THE MEDIUM OF THE DIGES- 
 TIVE ORGANS. 
 
 THE intimate sympathy which subsists between 
 the stomach and the head, has been observed hi 
 all ages ; and, in fact, is well known to every in- 
 dividual, by that common complaint a sick head- 
 ache. Whether this sympathy takes place through 
 the medium of the blood-vessels, or nerves, or 
 both (which is more probable), we cannot tell; but 
 it is sufficient that we are assured of the fact. A 
 similar sympathy obtains between the brain and 
 liver, as is exemplified by blows on the head pro- 
 ducing abscess in the biliary organ ; and obstruc- 
 tions of the liver causing the most tormenting head- 
 aches. Now, when we reflect on the numerous 
 causes, already traced, of derangement in the sto- 
 mach, liver, and other digestive organs, arising out 
 M 
 
90 
 
 of civic life, and all its consequences/ can we won- 
 der at their effects on the' brain and nervous sys- 
 tem, as evinced in the long catalogue of nervous 
 and hypochondriacal complaint?, and even of insa- 
 nity itself^ now so prevalent in civic life ? 
 
 We thus see how the digestive organs repay, in 
 kiim ; the morbid influence and effects which they 
 sustain from the brain and nervous system, through 
 the medium of- the passions, and intellectual refine- 
 ment. In fact, these two systems, like two friends 
 in harmonious co-operation, mutually support each 
 oilier, in health ; but, in disease, like sworn ene- 
 mies, they act and re- act upon one another, with 
 the most destructive malignity. 
 
 When the brain and nervous system suffer from 
 faults in the digestive organs, we generally find 
 among the more obtrusive symptoms head- aches ; 
 either watchfulness at night, or too great a disposi- 
 tion to sleep, especially after dinner (a symptom that 
 peculiarly denotes a regurghation of bile into the 
 blood, and a deficiency of this fluid in the bowels); 
 fickleness or irritability of temper ; unsteadiness in 
 any pursuit or application ; occasional dimness or 
 other affection of the eyes; disturbed sleep; dc- 
 
91 
 
 spondency; gloomy anticipations; distrust of, or 
 want of conii deuce in, our best friends : restlessness 
 of disposition ; and great nervous susceptibility 
 on the occurrence of any untoward accident, or un- 
 expected event : these and very many other phe- 
 nomena indicate a disordered state of the circula- 
 tion, and excitability in the brain and nerves, ari- 
 sing from derangement of function in the digestive 
 
 organs. 
 
 To superficial observers these appear to be moral 
 affections, whereas they are, in reality, physical 
 evils, which are only to be remedied or removed 
 by physical means. By improving the state of the 
 digestive organs, we remove a load from the brain 
 and nerves ; and a total revolution in the frame of 
 mind is thus produced, in a few weeks, by agents 
 whose operations ^.re supposed to be exclusively 
 confined to the corporeal fabric. 
 
 And it must ever be borne in mind, that, when 
 the above-mentioned disordered state of the brain 
 and nervous system has been originally induced by 
 moral causes, as grief, disappointment, &c. the de- 
 rangement which thence ensues to the digestive or- 
 gans, keeps up, or perpetuates, the evil, long after 
 
92 
 
 the moral causes are themselves removed : for un- 
 fortunately, in diseases, efficts do not always dis- 
 * appear with their causes. There is another impor- 
 tant consideration connected with the present sub- 
 ject : we all know how little control we possess 
 over moral or mental impressions. The loss of a 
 husband or wife, of a parent or child, cannot be 
 erased from the memory by the most powerful elo- 
 quence, or soothing friendship. But the effects of 
 these depressing passions on the digestive organs, 
 and the reaction on the intellectual system which 
 ensues, may be greatly counteracted by physical 
 means, and the melancholy mental emotions there- 
 by surprisingly lessened in intensity, and shortened 
 in duration. This is a fact which is little under- 
 stood, and almost totally overlooked by Philoso- 
 pher, Physician, and Patient ; yet it is one of high 
 import, and of direct application to the purposes of 
 life, 
 
 
93 
 
 SUBSECTION I. 
 
 Influence of Civic Life, tgc. on the Brain and 
 Nervous System, through the Medium of the 
 Liver in particular. 
 
 DURING the last fifteen years, I have traced, with 
 great care, the influence of a deranged state of the 
 liver and biliary secretion on the brain and nervous 
 system, both in my own person and those of others ; 
 and the result is, a conviction that the extent of 
 this influence is infinitely greater than the world is 
 aware of. The idea of the ancients, respecting the 
 origin of melancholy and insanity in black bile 
 was not entirely chimerical ; and, in modern times, 
 Pinel and a few others have brought forward facts 
 that strongly countenance the supposition. That a 
 disordered state of the biliary organ produces an 
 irregular distribution of the blood and nervous en- 
 ergy in the brain, I am as well convinced as of my 
 own existence ; for so certainly does the mental in- 
 dex point to the corporeal derangement, that 1 am 
 
94 
 
 warned of the latter by my waking trains of (ho 
 nay, even by the tenour of my dreams. When the 
 biliary derangement arises to any height, the spring 
 of .my mental energy is lost, and every where dif- 
 fii -<l f "^-, like "hills over hills and Alps on Alps," 
 arise to embarrass my pursuits and defeat my ob- 
 ! 1 am quite satisfied that many important 
 events in a man's life, which are usually attributed 
 to moral causes, have hinged on material ones ; 
 and that not a day passes in which we do not see 
 
 -enterprizes of vast pith and moment, 
 
 In this respect their currents turn awry, 
 And lose the name of action. 
 
 In civilized society thousands moulder away 
 their lives in mental torpor and apathy, who, by a 
 proper attention to the functions of the liver and di- 
 gestive organs, would soon evince an energy of 
 mind and activity of body that might render them 
 useful, if not distinguished members of the commu- 
 nity. 
 
 But this is not all. Conjugal and domestic hap- 
 piness is every day blighted and turned into misery 
 by irritability of temper, resulting, unequivocally, 
 from derangement of the biliary and digestive or- 
 
95 
 
 gans, while the cause is supposed to be of a moral 
 nature, ami consequently the proper remedies to- 
 tally neglected. There is indeed another unsus- 
 pected source of this evil, of which I may take 
 some notice on a future occasion. Meantime I may 
 state, that, whenever a change in the temper or mind 
 of a man or woman takes place, without a plain 
 and manifest moral cause, the condition of the liver 
 and digestive organs should be minutely examined 
 and accurately ascertained; for there the origin of 
 the mischief will, three times out of four, be disco- 
 vered : nay, where the mental disturbance has evi- 
 dently arisen out of circumstances quite foreign to 
 corporfal ailments, it will be found that the latter 
 have quickly supervened, and are perpetuating, if 
 not aggravating the evil. 
 
 The remedies are aperient medicines ; particu- 
 larly the aloetic, mercurial, and antimonial kind, 
 with decoction of sarsaparilla, Harrowgate water, 
 and the nitro- muriatic acid bath, varied and appor- 
 tioned according to the peculiarity of the constitu- 
 tion, and the nature and degree of the biliary de- 
 rangement. 
 
SUBSECTION II. 
 
 Influence of Civic Life, Sedentary Habits, $'c. 
 on the Brain and Nervous by stem, through the 
 Medium of the Heart. 
 
 I HAVE already shewn the powerful influence 
 which mental emotions exert on the action of the 
 heart. When the functions, and particularly when 
 the structure of this organ become deranged, they 
 exercise a reciprocal influence on the organ of the 
 mind ; that is, on the brain and nervous system. 
 The character of this influence assimilates very 
 much with that resulting from derangement of the 
 liver and digestive organs, particularly in respect 
 to mental despondency. Among the numerous ca- 
 ses of disease of the heart which have fallen un- 
 der my observation, I never knew one unaccompa- 
 nied by mental despondency. Indeed, there is a 
 cast of countenance attending this melancholy class 
 of human afflictions, which speaks more than words 
 to the discriminating and experienced eye ; and 
 
97 
 
 leads the intelligent physician, at once to the true 
 seat of the disorder. The depression of spirits re- 
 sulting from affections of the heart, is often of the 
 deepest hue; and I have known two instances where 
 it led to suicide. I am strongly disposed to believe 
 that this unnatural crime, is frequently the conse- 
 quence of the disease under consideration. 
 
 It is of the utmost importance to distinguish de- 
 rangements of the heart from derangements of the 
 liver, or digestive organs, since the treatment is 
 very different. A minute investigation of all the 
 phenomena, aided by thoracic percussion and ab- 
 dominal compression, will generally unveil the 
 true nature of the complaint. 
 
 N 
 
SECTION II. 
 
 INFLUENCE OP CIVIC LIFE, ETC. ON THE BRAIN AND NER- 
 VOUS SYSTEM, THROUGH THE MEDIUM OF THE PAS- 
 SIONS. 
 
 Civic life, by rendering the senses more acute, 
 makes the passions more ungovernable than in ru- 
 ral retirement. In congregated masses of society, 
 every kind of food for the passions is not only su- 
 perabundant in quantity, but of the most stimula- 
 ting quality. Hence, among a very considerable 
 class in the upper walks of life, we find an unna- 
 tural and insalutary degree of excitement, kept up 
 in the brain and nervous system from this prolific 
 source. The extent of injury, which our health 
 sustains in this way is beyond all calculation ! 
 Plato believed, that " omnia corporis mala ab an- 
 ima procedere;" "all diseases of the body proceed- 
 ed from the mind, or soul," and certainly a great 
 proportion of them do ! Here we cannot fail to per- 
 ceive the great analogy which obtains between the 
 
99 
 
 state of the digestive organs and that of the nervous 
 system, in civic and luxurious life. The one is 
 over-excited by too much and too stimulating^/botZ/ 
 the other, by excess in the passions. The derange- 
 ments resulting from each set of causes act and re- 
 act, directly or indirectly, on both systems; and 
 thus it is that we never see a morbid condition of 
 the nervous system unconnected with a similar con- 
 dition of the digestive organs, and vice versa. 
 
 The over-action of the principal passions on 
 brain and nerves, closely resembles the over-ac- 
 tion of food and drink on the stomach and other 
 digestive organs, in many minute particulars, and 
 especially by attracting an undue proportion of 
 blood to the over-excited parts. The whole of the 
 phenomena attending the Proteian host of nervous 
 diseases, and all the most successful methods of 
 treatment, attest that their immediate seat, or 
 source, is, an unequal distribution of the blood, 
 and of the sensibility. The brain and nerves, be- 
 coming more irritable, from over-excitement by the 
 passions, their vessels swell with blood, and this 
 local turgidity causes a constant pressure on, and 
 keeps up a perpetual irritation in, the whole ner- 
 vous system. This is a doctrine which, though 
 
100 
 
 deduced from actual observation and experience, is 
 far wide of the popular belief, and but little diffused 
 in the medical world itself. It is such importance, 
 however, ami opens out so much better a practice 
 than is generally pursued, that I shall go some- 
 what into detail, in order to elucidate it. 
 
 Let us single out a few of the more prominent 
 forms of diseases, affecting the brain and nervous 
 system, in order to investigate their nature and treat- 
 ment. Excepting mania, (to which indeed it oft- 
 en leads,) there is no affliction, in this class, more 
 terrible to the sight, or more disastrous to the hu- 
 man intellect in its consequences, than epilipsy. 
 Now the original seat of this disease may be, and 
 usually is, in some organ, or part, at a distance 
 from the head ; for nine patients out of ten, feel a 
 premonitory sensation (called the Aura Epileptica) 
 creeping, or darting from the remote part to the 
 brain, where, when it arrives, it produces the con- 
 vulsive attack. The seat of this irritation is general- 
 ly in the liver, digestive organs, or genital system ; 
 but sometimes in other parts. While this irritation 
 remains in its common domicile, the brain and ner- 
 vous system have an immunity from disturbance ; 
 but unfortunately it has a character of mobility, 
 
101 
 
 like the irritation of gout, (with which it is often row- 
 plicated,) and when from any cause the brain and 
 nervous system become predisposed ; that is, weak- 
 ened, or impaired, in their functions, the epileptic 
 irritation is transferred, from time to time, to the 
 head and spine, when an instantaneous rush of 
 blood to these parts succeeds, and epileptic. strug- 
 gle follows. Even when an organic disease of 
 the brain, or spinal marrow, determines epilepsy, 
 it is only when an excess of irritation and blood 
 accumulates in these organs, that the convulsions 
 take place. The organic disease must be con- 
 stantly present; yet the epileptic paroxysm only 
 occurs occasionally ; a convincing proof that the di- 
 cease depends on a temporary super-excitement of 
 the nervous, and turgidity of the blood-vessel sys- 
 tem. 
 
 When the original seat of the epileptic irritation 
 is at a distance from the head, as in the liver, or 
 digestive organs, yet repetitions of this determina- 
 tion to the brain and spine, mast sooner or later in- 
 duce organic disease there. Dissection has always 
 proved this ; and I may refer to a remarkable case. 
 which fell under my own observation, and is pub- 
 lished in the October (1818) Number of the Mecli- 
 
102 
 
 co-Chirurgical Journal, for a memorable illustra- 
 tion. 
 
 This view of the subject leads to most important 
 indications in the treatment and prevention of this 
 afflicting malady. What would naturally present 
 itself as the first ? Why to search out the seat of 
 the distant irritation, which radiates on the brain 
 at intervals, and endeavour to remove it. If this 
 cannot be done, the next object is to jix the irrita- 
 tion there, or in some other unimportant part. The 
 third indication is to strengthen the nervous and 
 intellectual system, by avoiding an undue exercise 
 of the passions, or strong mental emotions. The 
 fourth, or preventive indication, is, to lower the ful- 
 ness of the blood vessels, by spare diet and various 
 evacuations. These are tho means by which I have 
 often succeeded, and by which we may often suc- 
 ceed, in lengthening the intervals of epileptic at- 
 tacks, if not of 'entirely checking their progress.* 
 
 The same reasoning will apply to hysteria. There 
 is here some local irritation, or some local torpor 
 
 * See the sf ction on epilepsy, in my work on "the Influence of the 
 Atmosphere," where I have pointed out a new remedy for this disease, 
 from the use of which I have seen the greatest benefit derived. 
 
 
103 
 
 (for opposite extremes often] produce the same ef- 
 fect) in an organ remote from, the head, generally 
 in the uterine system ; and when, at any time, the 
 irritation shifts its seat to the Irain, a congestion of 
 blood in the vessels of this orsran is the immediate 
 
 o 
 
 consequence, and the hysterical paroxysm ensues. 
 The whole farrago of antispasmodic medicines, ex- 
 hibited in this complaint, produce no other effect, 
 than occasionally to irritate the stomach, bowels, 
 or uterine system, and thus recall the blood and ir- 
 ritability from the head. These effects might be 
 induced by much more simple and much more per- 
 manently beneficial means. 
 
 MANIA is another modification of corporeal de- 
 rangement (for it is strictly and essentially a bodily 
 disease) originally induced by repeated irritations 
 and congestions of blood in the head, resulting 
 from undue exercise of the passions ; stimulating 
 food and drink, and all those various causes which 
 lead to derangement in the digestive organs, to gout, 
 &c. The changes that precede this worst of human 
 afflictions are always slow, and often imperceptible 
 to any but the experienced eye of the medical ob- 
 server. How frequently does this cruel enemy ad- 
 vance, at first, under the guise of a little qtiick- 
 
104 
 
 ness or irascibility of temper ; shewing the increas- 
 ing morbid sensibility of the brain and nerves. 
 Next we see higher gusts of passion, upon trifling 
 occasions than the individual was accustomed to 
 evince ; always attended with a rush of blood to 
 the head, which is visible in the face and eyes. 
 Every rush of this kind leaves the irritability of 
 the brain more acute than before, and consequently 
 predisposes to a repetition of the occurrence. 
 
 In this state the patient may go on for years, un- 
 suspicious of the growing evil. At length these re- 
 peated disturbances of function in the intellectual 
 organ, begin to produce slight derangements of 
 structure in a part of such delicate texture. Then 
 the judgment, which was hitherto unimpaired, 
 loses its balance, as is evinced by whims, antipa- 
 thies, capricious attachments, peculiarity of opini- 
 ons, religious enthusiasm, and a thousand other 
 slight alterations from previous strength of mind. 
 The corporeal derangement advances another step ; 
 and now a window of the soul is shut ! a dark spot 
 is but too plainly perceptible in the manifestation 
 of the mind ; an erroneous idea is formed on some 
 particular subject, and to this the patient clings 
 with invincible obstinacy, although perhaps, on all 
 
165 
 
 other points, the judgment is correct. From this 
 stage, the corporeal disease and the mental hallu- 
 cination advance, with equal steps, till the " soul's 
 dark cottage" admits not a single ray of light from 
 without, nor emits a gleam of intelligence from 
 within ! 
 
 Alack, 'tis he ! why he was met even now 
 As mad as the vex'd sea ; sing-ing uloud ; 
 Crown'd with rank fumiter, and furrow weeds, 
 With harlocs, hemlock, nettles, cuckoo-flowers, 
 Darnel, and all the idle weeds that grow ! LEAR . 
 
 In the various stages, from the lowest grade of 
 nervous irritability up to raging wild insanity, thou- 
 sands are every day to be seen. By far the greater 
 number, however, pass through a < 4 feverish ex<- 
 istence," without entering the pale of what is term- 
 ed " mental alienation ;" while many are cut off by 
 other and more violent forms of the disease, as ap- 
 oplexy, palsy, &c. 
 
 What is apoplexy or paralysis but a rush of 
 blood to the head, either bursting its channels there, 
 or swelling them to such an extent as to compress 
 the brain, and abolish sense or voluntary motion ? 
 What are the causes that lead to this event ? The 
 O 
 
106 
 
 same which produce the whole catalogue of ner- 
 vous affections. Too much food and drink, with 
 too little exercise ; too much scope to the passions, 
 with too little restraint from reason or religion ; too 
 many sedentary hahits of body, with too many 
 anxieties of mind ! 
 
 PREVENTION OR CURE. 
 
 Having pointed out the causes of this formidable 
 host of enemies to civic life, the prevention must, 
 of necessity, depend on the patient himself. There 
 is a considerable proportion of my readers, who 
 will benefit by the elucidations here given, and by 
 the rules which 1 have laid down. But a great 
 majority will pursue their course till they are over- 
 taken by the consequences. Then the physician 
 is called in ; for strange as it may appear, man will 
 rather take physic which costs much, than advice 
 which costs nothing. It is fortunate, however, that 
 medicine has greater power over the class of ner- 
 vou* diseases than is commonly supposed. They 
 have been too long attributed to a " distempered 
 
107 
 
 imagination," and treated as *" airy nothings/" 
 without a " local habitation or a name." But I 
 have shewn, that they are real corporeal ailments, 
 and of the most painful kind too, inasmuch as they 
 more heavily press down the springs and energies 
 of the mind than any other class of human afflic- 
 tions. % 
 
 Let it he remembered, that when the circulation 
 of the blood and the sensibility of the system expe- 
 rience any irregularity of distribution, the whole 
 frame seems to languish under debility : for the parts 
 to which too much blood or irritability is directed 
 are not strengthened ; while those parts which are 
 deprived of their due share must be weakened. 
 Here lies the ignis fatuus, which so often leads 
 astray both physician and patient. All the tonics, 
 stimulants, or cordials in the world, will not restore 
 the energy of the system, till the equilibrium of 
 the circulation and excitement is effected ; and this 
 must be done either by relieving the oppressed parts 
 of their overplus, by evacuations, local or general, 
 as may be necessary ; or by determining the blood 
 and irritation to another or other parts of the sys- 
 tem. In these two operations lies the grand se- 
 cret of treating nervous diseases with success ; and 
 
108 
 
 any man who studies carefully the laws of the ani- 
 mal economy, and observes with accuracy the na- 
 tural efforts of the constitution, may apply a very 
 few simple but energetic means, with the greatest 
 ease and advantage. 
 
 The brain and nerves must be relieved by occa- 
 sional leeches to the temples, or cupping glasses to 
 the shoulders. The diet must be lessened and re- 
 gulated; the bowels must be kept free; the biliary 
 secretion improved; and the circulation and excita- 
 bility kept even and balanced, by the warm or cold 
 bath, according to circumstances by horse, car- 
 riage, or pedestrian exercise by regular hours 
 and by governance of the passions. 
 
 This will be considered a bold innovation by 
 those whose minds are clouded with the inert phan- 
 tasies of Hoffmanic spasm, or the delusive dogmas 
 of Brimoriian debility. But it is not a doctrine of 
 the cabinet ; it is the offspring of extensive obser- 
 vation, and clinical experience. 
 
169 
 
 BALANCE OF ENJOYMENT AND SUFFERING IN RE- 
 SPECT TO THE INTELLECTUAL SYSTEM. 
 
 IT is extremely difficult to draw a parallel of en- 
 joyment and suffering, in the intellectual system 
 between the upper and lower ranks of life. If, to 
 undergo much pain for the sake of a little pleasure, 
 be a proof that the balance is in favour of the lat- 
 ter, then the lean monde has it. But if, on the 
 other hand, the Hindoo precept, that rest is pre- 
 ferable to action, sleep to waking, and death to all," 
 have any foundation in reason, then a question may 
 arise, whether the lower classes of society, who 
 have little susceptibility towards intellectual plea- 
 sures or pains, may not, upon the whole, claim the 
 balance of enjoyment, in their journey through the 
 present state of existence. But, at all events, Na- 
 ture has here, as in most other instances, charita- 
 bly ordained a surprising equilibrium. Sbe has 
 strewed the paths of rank, riches, and luxury, 
 with a corresponding proportion of painful diseas- 
 
110 
 
 eSj particularly of the nervous or intellectual sys- 
 tem ; while the uncultivated boor glides along, un- 
 conscious of the pleasures and unacquainted with 
 the sufferings which necessarily grow out of civic 
 society and intellectual refinement.* 
 
 JAMES JOHNSON. 
 
 * See the Section on " Diseases of Literary Characters," in my work 
 on " the Influence df the Atmosphere on Health," second edition, p. 217, 
 
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