Hypochondriasis Part 2

The DANGER.

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

The thick and glutinous blood which has so long stagnated in the spleen, will have in that time altered its nature, and acquired a very great degree of acrimony: while it lies dormant, this does no more mischiefs, than those named already; but when violent exercise, a fit of outrageous anger, or any thing else that suddenly shocks and disturbs the frame, puts it in motion, it melts at once into a kind of liquid putrefaction.

Being now thin, it mixes itself readily with the blood again, and brings on putrid fevers; destroys the substance of the spleen itself, or being thrown upon some other of the viscera, corrodes them, and leads on this way a swift and miserable death. If it fall upon the liver, its tender pulpy substance is soon destroyed, jaundices beyond the help of art first follow, then dropsies and all their train of misery; if on lungs, consumptions; if on the brain, convulsions, epilepsy, palsy, apoplexy; if on the surface, leprosy.

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

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

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

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

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

SECT. V.

The Causes of the HYPOCHONDRIASIS.

The obstruction which forms this disease, may take its origin from different accidents: a fever ill cured has often caused it; or the piles, which had been used to discharge largely, ceasing; a marshy soil, poisoned with stagnant water, has given it to some persons; and altho'

indolence and inactivity are oftenest at the root, yet it has arisen from too great exercise.

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

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

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

SECT. VI.

The Cure of the HYPOCHONDRIASIS.

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

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

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

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

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

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

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

SECT. VI.

Rules of Life for Hypochondriac Persons.

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

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

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

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

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

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

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

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

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

'Twere endless to proceed; nor is it needful: one object will not fail to lead on to another, and every where the goodness of his G.o.d will s.h.i.+ne before him even in what are thought the vilest things; his greatness in the lead of them.

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

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

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

SECT. VII.

The proper DIET.