THE knowledge of diseases does not depend so much upon scientific principles as many imagine. It is chiefly the result of experience and observation. By attending the sick, and carefully observing the various occurrences in diseases, a great degree of accuracy may be acquired, both in distinguishing their symptoms, and in the application of medicines. Hence sensible nurses, and other persons who wait upon the sick, often discover a disease sooner than those who have been bred to physic. We do not however mean to insinuate that a medical education is of no use. It is doubtless of the greatest importance but it never can supply the place observation and experience
EVERY disease may be considered as an assemblage of symptoms, and must be distinguished by those which are most obvious and permanent. Instead therefore of giving a classical arrangement of diseases, according to the systematic method, it will be more suitable, in a performance of this nature, to give a full and accurate description of each particular disease as it occurs; and, where any of the symptoms of one disease have a near resemblance to those of another, to take notice of that circumstance, and at the same time to point out the peculiar or characteristic symptoms by which it may be distinguished. By a due attention to these, the investigation of diseases will be found to be a less difficult matter than most people would at first be ready to imagine.
A PROPER attention to the patient's age, sex, temper of mind, constitution, and manner of life, will, likewise greatly assist, both in the investigation and treatment of diseases.
IN childhood the fibres are lax and soft, the nerves extremely irritable,and the fluids thin, whereas in old age the fibres are rigid, the nerves become almost insensible, and many of the vessels imperviable. These and other peculiarities render the diseases of the young and aged very different, and of course they must require a different method of treatment.
FEMALES are liable to many diseases which do not afflict the other sex: Besides, the nervous system being more irritable in them than in men, their diseases require to be treated with greater caution. They are less able to bear large evacuations; and all stimulating medicines ought to be administered to them with a sparing hand.
PARTICULAR constitutions not only dispose persons to peculiar diseases, but likewise render it necessary to treat these diseases in a peculiar manner.
A DELICATE person, for example, with weak nerves, who lives mostly within doors, must not be treated, under any disease, precisely in the same manner as one who is hardy and robust, and who is much exposed to the open air.
THE temper of mind ought to be carefully attended to in diseases. Fear, anxiety, and a fretful temper, both occasion and aggravate diseases. In vain do we apply medicines to the body to remove maladies which proceed from the mind. When it is affected, the best medicine is to sooth the passions, to divert the mind from anxious thought, and to keep the patient as easy and cheerful as possible.
ATTENTION ought likewise to be paid to the climate, or place where the patient lives, the air he breathes, his diet, &c. Such as live in low marshy situations are subject to many diseases which are unknown to the inhabitants of high countries. Those who breathe the impure air of cities have many maladies to which the more happy rustics are entire strangers. Persons who feed grossly, and indulge in strong liquors, are liable to diseases which do not affect the temperate and abstemious, &c.
IT has already been observed, that the different occupations and situations in life dispose men to peculiar diseases. It is therefore necessary to inquire into the patient's occupation, manner of life, &c. This will not only assist us in finding out the disease, but will likewise direct us in the treatment of it. It would be very imprudent to treat the laborious and the sedentary precisely in the same manner, even supposing them to labour under the same disease.
IT will likewise be proper to enquire, whether the disease be constitutional or accidental; whether it has been of long or short duration; whether it proceeds from any great and sudden alteration in the diet, manner of life, &c. The state of the patient's body, and of the other evacuations, ought also to be enquired into; and likewise whether he can with ease perform all the vital and animal functions, as breathing, digestion, &c.
LASTLY, it will be proper to enquire what diseases the patient has formerly been liable to, and what medicines mere most beneficial to him; if he has a strong aversion to any particular drug, &c.
AS many of the indications of cure may be answered by diet alone, it is always the first thing to be attended to in the treatment of diseases. Those who know no better, imagine that every thing which goes by the name of a medicine possesses some wonderful power or secret charm, and think, if the patient swallows enough of drugs, that he must do well. This mistake has many ill consequences. It makes people trust to drugs, and neglect their own endeavours; besides, it discourages all attempts to relieve the sick, where medicines cannot be obtained.
MEDICINES are no doubt useful in their place, and, when administered with prudence, they may do much good; but when they are put in place of every thing else, or administered at random, which is not seldom the case, they must do mischief. We would therefore wish to call the attention of mankind from the pursuit of secret medicines, to such things as they are acquainted with. The proper regulation of these may often do much good, and there is little danger of their ever doing hurt.
EVERY disease weakens the digestive powers. The diet ought therefore, in all diseases, to be light and of easy digestion. It would be as prudent for a person with a broken leg to attempt to walk, as for one in a fever to eat the same kind of food, and in the same quantity, as when he was in perfect health. Even abstinence alone will often cure a fever, especially when it has been occasioned by excess in eating or drinking.
IN all fevers attended with inflammation, as pleurisies, peripneumonies, &c. thin gruels, wheys, watery infusions of mucilaginous plants, roots, &c. are not only proper for the patient's food, but they are likewise the best medicines which can be administered.
IN fevers of a slow, nervous, or putrid kind, where there are no symptoms of inflammation, and where the patient must be supported with cordials, that intention can always be more effectually answered by nourishing diet and generous wines, than by any medicines yet known.
NOR is a proper attention to diet of less importance in chronic than in acute diseases. Persons afflicted with low spirits, wind, weak nerves, and other hypochondriacal affections, generally find more benefit from the use of solid food and generous liquors, than from all the cordial and carminative medicines which can be administered to them.
THE scurvy, that most obstinate malady, will sooner yield to a proper vegetable diet, than to all the boasted antiscorbutic remedies of the shops.
IN consumptions, when the humours are vitiated, and the stomach so much weakened as to be unable to digest the solid fibres of animals, or even to assimiIate the juices of vegetables, a diet consisting chiefly of milk will not only support the patient, but will often cure the disease after every other medicine has failed.
NOR is an attention to other things of less importance than to diet. The strange infatuation which has long induced people to shut up the sick from all communication with the external air, has done great mischief. Not only in fevers, but in many other diseases, the patient will receive more benefit from having the fresh air prudently admitted into his chamber, than from all the medicines which can be given him.
EXERCISE may likewise, in many cases, be considered as a medicine. Sailing, or riding on horseback, for example, will be of more service in the cure of consumptions, glandular obstructions, &c. than any medicine yet known. In diseases which proceed from a relaxed state of the solids, the cold bath, and other parts of the gymnastic regimen, will be found equally beneficial.
FEW things are of greater importance, in the cure of diseases, than cleanliness. When a patient is suffered to lie in dirty clothes, whatever perspires from his body is again resorbed, or taken up into it; which serves to nourish the disease, and increase the danger. Many diseases may be cured by cleanliness alone; most of them may be mitigated by it, and in all of them it is highly necessary both for the patient and those who attend him.
MANY other observations, were it necessary, might be adduced to prove the importance of a proper regimen in diseases. Regimen will often cure diseases without medicine, but medicine will seldom succeed where a proper regimen is neglected. For this reason, in the treatment of diseases, we have always given the first place to regimen. Those who are ignorant of medicine may confine themselves to it only. For others, who have more knowledge, we have recommended some of the most simple, but approved, forms of medicine in every disease. These, however, are never to be administered but by people of better understanding; nor even by them without the greatest precaution.