The observations concerning Diet, Air, Exercise, &c. are of a more general nature, and have not escaped the attention of physicians in any age. They are subjects of too great importance, however, to be passed over in an attempt of this kind, and can never be sufficiently recommended. The man who pays a proper attention to these, will seldom need the physician; and he who does not, will seldom enjoy health, let him employ as many physicians as he pleases.
Though we have endeavoured to point out the causes of diseases, and to put people upon their guard against them, yet it must be acknowledged that they are often of such a nature as to admit of being removed only by the diligence and activity of the public magistrate. We are sorry, indeed, to observe, that the power of the magistrate is seldom exerted in this country for the preservation of health. The importance of a proper medical police is either not understood, or little regarded. Many things highly injurious to the public health are daily practiced with impunity, while others, absolutely necessary for its preservation, are entirely neglected.
Some of the public means of preserving health are mentioned in the general prophylaxis, as the inspection of provisions, widening the streets of great towns, keeping them clean, supplying the inhabitants with wholesome water, &c.; but they are passed over in a very cursory manner. A proper attention to these would have swelled this volume to too large a size; I have therefore reserved them for the subject of a future publication.
In the treatment of diseases, I have been peculiarly attentive to regimen. The generality of people lay too much stress upon Medicine, and trust too little to their own endeavours. It is always in the power of the patient, or of those about him, to do as much towards his recovery as can be effected by the physician. By not attending to this, the designs of Medicine are often frustrated; and the patient, by pursuing a wrong plan of regimen, not only defeats the Doctor’s endeavours, but renders them dangerous. I have often known patients killed by an error in regimen, when they were using very proper medicines. It will be said, the physician always orders the regimen when he prescribes a medicine. I wish it were so, both for the honour of the Faculty and the safety of their patients: but physicians, as well as other people, are too little attentive to this matter.
Though many reckon it doubtful whether physic is more beneficial or hurtful to mankind, yet all allow the necessity and importance of a proper regimen in diseases. Indeed the very appetites of the sick prove its propriety. No man in his senses ever imagined that a person in a fever, for example, could eat, drink, or conduct himself in the same manner as one in perfect health. This part of medicine, therefore, is evidently founded in Nature, and is every way consistent with reason and common sense. Had men been more attentive to it, and less solicitous in hunting after secret remedies, Medicine had never become an object of ridicule.
This seems to have been the first idea of Medicine. The ancient physicians acted chiefly in the capacity of nurses. They went very little beyond aliment in their prescriptions; and even this they generally administered themselves, attending the sick for that purpose through the whole course of the disease; which gave them an opportunity not only of marking the changes of diseases with great accuracy, but likewise of observing the effects of their different applications, and adapting them to the symptoms.
The learned Dr. Arbuthnot asserts, that by a proper attention to those things which are almost within the reach of every body, more good and less mischief will be done in acute diseases, than by medicines improperly and unseasonably administered; and that great cures may be effected in chronical distempers, by a proper regimen of the diet only. So entirely do the Doctor’s sentiments and mine agree, that I would advise every person, ignorant of physic, to confine his practice solely to diet, and the other parts of regimen; by which means he may often do much good, and can seldom do any hurt.
This seems also to have been the opinion of the ingenious Dr. Huxham, who observes, that we often seek from Art what all-bountiful Nature most readily, and as effectually, offers us, had we diligence and sagacity enough to observe and make use of them; that the dietetic part of Medicine is not so much studied as it ought to be; and that, though less pompous, yet it is the most natural method of curing diseases.
To render the book more generally useful, however, as well as more acceptable to the intelligent part of mankind, I have in most diseases, besides regimen, recommended some of the most simple and approved forms of medicine, and added such cautions and directions as seemed necessary for their safe administration, it would no doubt have been more acceptable to many, had it abounded with pompous prescriptions, and promised great cures in consequence of their use; but this was not my plan: I think the administration of medicines always doubtful, and often dangerous, and would much rather teach men how to avoid the necessity of using them, than how they should be used.
Several medicines, and those of considerable efficacy, may be administered with great freedom and safety. Physicians generally trifle a long time with medicines before they learn their proper use. Many peasants at present know better how to use some of the most important articles in the materia medica, than physicians did a century ago; and doubtless the same observation will hold with regard to others some time hence. Wherever I was convinced that medicine might be used with safety, or where the cure depended chiefly upon it, I have taken care to recommend it; but where it was either highly dangerous, or not very necessary, it is omitted.