Instead of rising from table after dinner, and availing themselves of the cooling and refreshing qualities of the air, even in the finest seasons, when every thing which pure and simple nature can offer, invites them abroad, they do every thing they can, as Dr. Beddoes observes, to add to the overstimulating operation of a full and hearty dinner. After taking strong wine with their food, they sit in rooms rendered progressively warmer, all the afternoon, by the presence of company, by the increase of fires, and for more than half the year, by the early closing of the shutters, and letting down of the window curtains. After a short interval, tea and coffee succeed; liquors stimulating both by their inherent qualities, and by virtue of the temperature at which they are often drank. And that nothing may be wanting to their pernicious effect, they are frequently taken in the very stew and squeeze of a fashionable mob. The season of sleep succeeds, and to crown the adventures of the evening, the bed room is fastened close, and made stifling by a fire: and though the robust may not quickly feel the effects of this mode of life, with the feeble it is quite otherwise. These, as they usually manage, rarely pass a few hours of sleep without feverishness and uneasy dreams; both of which contribute to their finding themselves by far more spent and spiritless in the morning, than after their evening fit of forced excitement, instead of having their spirits and strength recruited by the "chief nourisher in life's feast," Perhaps they drink tea before rising, and indulge in a morning nap; this weakens much more than the greatest muscular exertion they would be capable of supporting for an equal time. For the sleep at this time is almost invariably disturbed, and attended by a heat of the skin. The reason of this must be evident to every one who has attended these lectures.
The effect of sleep is to accumulate the excitability, or render it more sensible to the effects of any stimulants applied. This takes place in every constitution, and much more in the more delicate: hence the heat of the bed, and of the tea, acts so powerfully on the surface, as, in general, to produce great perspiration, or, at any rate, great languor and debility.
Let me ask, can any one, who lives in this manner, expect to enjoy good health? With as great probability might we expect, that when we plunged a thermometer into hot water, the mercury would not rise, or when we applied a lighted match to gunpowder, it would not explode. The laws of nature are constant and uniform, and the same, or similar causes, both in the animate and inanimate world, are always productive of the same, or similar effects.
The cure of these complaints is at least obvious, if not easy. It consists in deserting crowded and heated rooms, at least for part of the time they have been usually occupied; in abstaining from strong wines; in keeping the bed rooms moderately cool; and retiring to rest at a proper hour.
With respect to the effects of nutriment, in producing asthenic diseases, we may observe, that all watery vegetable food, too sparing a use of animal food, as also meat which is too salt, and deprived of its nutritious juices by keeping, when more nutritious matter is at the same time withheld, constantly weaken, and thereby tend to produce asthenic diseases. Hence would appear to arise that remarkable imbecility of body and mind which distinguishes the Gentoos. Hence arise the diseases with which the poor are every where afflicted; hence scrofula, epilepsy, and the whole band of asthenic diseases.
But intemperance in eating and drinking, or taking nutritious and highly stimulant substances too freely, will, infallibly, bring on asthenic disease, or a state of indirect debility, by exhausting the excitability; and it must be observed, that this species of debility is much worse to cure than the direct kind; for in the latter we have abundance of excitability, and a variety of stimuli, by which we can exhaust it to the proper degree, and thus bring about the healthy state; whereas, in indirect debility, the vital principle or excitability is deficient; and we have not the means of reproducing it, at pleasure, absolutely under our command. Besides, the subtraction of stimulants, which is one of the most certain means we have of accumulating excitability, if carried to a great extent, in diseases of indirect debility, would produce death, before the system had power to reproduce the lost or exhausted excitability. Hence the cure, in these two kinds of debility, must be very different: in cases of direct debility, as in epilepsy, we must begin with gentle stimulants, and increase them with the greatest caution, till the healthy state is established: we must, however, guard most carefully against over doing it; for, if we should once overstep the bounds of excitement, and convert the direct into indirect debility, we shall have a disease to combat, in which we have both a want of excitement and of exciting power.
In cases of violent indirect debility, as, for instance, in gout, when it affects the stomach: it would be wrong to withdraw the stimulus, for the excitability is in such an exhausted state as to produce no action, or very imperfect and diseased, from the effect of the common exciting powers; we must, therefore, here apply a stimulus greater than natural, to bring on a vigorous and healthy action, and this stimulus we should gradually diminish, in order to allow the excitability to accumulate, by which the healthy state will be gradually restored.
This method was very judiciously recommended, by a very eminent physician, in the case of a Highland chieftain, who had brought on dreadful symptoms of indigestion by the use of whisky, of which he drank a large silver cup full five or six times in the day. The doctor did not merely say, diminish the quantity of spirits gradually, for that simple advice would not have been followed; but he advised him to drink the cup the same number of times full, but each morning to melt into it as much wax as would receive the impression of the family seal. This direction, which had something magical in it in the mind of the chieftain, was punctually obeyed. In a few months the cup was filled with wax, and would hold no more spirits; but it had thus been gradually diminished, and the patient was cured.
This reminds me of a number of cases, which had been brought on by drinking porter, and other stimulant liquors, without knowing the taste of water. In many of these cases if a moderate quantity of water were drank every day they would be cured; but you would find few who would follow such plain and simple directions. How then must a physician proceed? Why, as is generally done by the most judicious: they direct their patients to Bath or Buxton, and there advise them to swallow a certain quantity of water every day, which they do most scrupulously, and, of course, return home cured.
As causes of asthenic disease, we must not omit the undue exercise of the intellectual functions. Thinking is a powerful exciting cause, and produces effects similar to those of intoxication. None of the exciting powers have more influence upon our activity, than the exercise of the intellectual powers, as well as passion and emotion. Homer, the great observer and copyist of nature, observes of the hero, whom he gives for a pattern of eloquence, that, upon his first address, before he had got into his train of thought, he was awkward in every motion, and in his whole attitude; he looked down upon the ground, and his hands hung straight along his sides, as if they had lost the power of motion; and his whole appearance was a picture of torpidity. But when he had once fairly entered upon his subject, his eyes were all on fire, his limbs all motion, grace, and energy.