A Lecture on the Preservation of Health Part 1

A Lecture on the Preservation of Health.

by Thomas Garnett, M.D.

PREFACE.

_Most medical gentlemen will, it is supposed, agree that the greater part of the numerous train of diseases to which their patients are subject, have been brought on by improper conduct and imprudence.

That this conduct often proceeds from ignorance of its bad effects, may be presumed; for though it cannot be denied that some persons are perfectly regardless with respect to their health, yet the great ma.s.s of mankind are too sensible of the enjoyment and loss of this greatest of blessings, to run headlong into danger with their eyes open._

_It was with the hope of making the laws of life more generally known, and better understood, and from thence deducing such rules for the preservation of health, as would be evident to every capacity, that the author was induced to deliver this lecture. It has been honoured with the attention of numerous audiences, in some of the most populous towns in England, where it has generally been read for the benefit of charitable inst.i.tutions._

_The author flatters himself, that besides the benefit produced by his humble endeavours to serve these inst.i.tutions, those endeavours have not totally failed in the grand object of preserving health; and with the hope that the influence of the precepts here given, may be farther extended, he has concurred in the ideas of those who have advised the publication of this lecture._

_It is to be feared, that notwithstanding all which can be done, disease will continue to be a heavy tax, which civilized society must pay for its comforts; and the valetudinarian will often be tempted to envy the savage the strength and soundness of his const.i.tution. Much however may be done towards the prevention of a number of diseases. If this lecture should contribute to the attainment of so desirable an end, it will afford the highest gratification to the author._

_The first part of the lecture is the substance of an essay which was read by the author before the Royal Medical Society of Edinburgh, intended as a defence of the general principles of the system of Dr.

Brown, whose pupil he then was. It was, according to custom, transcribed into the books of the society, and the public have now an opportunity of judging how far Dr. Girtanner, in his first essay published in the Journal de Physique, about two years after, in which he gives the theory as his own, without the least acknowledgment to the much injured and unfortunate author of the_ Elementa Medicinae, _has borrowed from this essay._

_In public lectures, novelty is not to be expected, the princ.i.p.al object of the lecturer being to place in a proper point of view, what has been before discovered. The author has therefore freely availed himself of the labours of others, particularly of the popular publications of Dr. Beddoes, which he takes this opportunity of acknowledging._

_This lecture is published almost_ verbatim _as it was delivered. On this account the experiments mentioned are not minutely described, the reader being supposed to see them performed._

A LECTURE, &c.

THE greatest blessing we enjoy is health, without it, wealth, honors, and every other consideration, would be insipid, and even irksome; the preservation of this state therefore, naturally concerns us all. In this lecture, I shall not attempt to teach you to become your own physicians, for when the barriers of health are once broken down, and disease has established itself, it requires the deepest attention, and an accurate acquaintance with the extensive science of medicine, to combat it; to attain this knowledge demands the labour of years. But, a majority of the diseases to which we are subject, are the effects of our own ignorance or imprudence, and it is often very easy to prevent them; mere precepts however, have seldom much effect, unless the reasoning upon them be rendered evident; on this account, I shall first endeavour, in as plain and easy a manner as possible, to explain to you the laws by which life is governed; and when we see in what health consists, we shall be better enabled to take such methods as may preserve it. Health is the easy and pleasant exercise of all the functions of the body and mind; and disease consists in the uneasy and disproportioned exercise of all, or some of the functions.

When dead matter acts upon dead matter, the only effects we perceive are mechanical, or chemical; for though there may appear to be other kinds of attraction, or repulsion, such as electric and magnetic, yet these come under the head of mechanical attraction, as producing motion; we may therefore lay it down as a law, that when dead, or inanimate bodies act upon each other, no other than mechanical, or chemical effects are produced; that is, either motion, or the decomposition, and new combination of their parts. If one ball strike another, it communicates to it a certain quant.i.ty of motion, this is called mechanical action; and if a quant.i.ty of salt, or sugar, be put into water, the particles of the salt or sugar will separate from each other, and join themselves to the particles of the water; the salt and water in these instances, are said to act on each other chemically; and in all cases whatever, in which inanimate, or dead bodies act on each other, the effects produced are, motion, or chemical attraction.

But, when dead matter acts on those bodies which we call living, the effects are much different; let us take for example a very simple instance.--Snakes, at least some species of them, pa.s.s the winter in a torpid state, which has all the appearance of death; now heat, if applied to dead matter, will only produce motion, or chemical combination; but if it be applied to the snake, let us see what will be the consequence; the reptile first begins to move, and opens its eyes and mouth; when the heat has been applied for some time, it crawls about in search of food, and performs all the functions of life. Here then, dead matter, when applied to a living body, produces living functions; for if the heat had not been applied, the snake would have continued senseless, and apparently lifeless. In more perfect animals, the effects produced by the action of dead matter on them, are more numerous, and are different in different living systems, but are in general the following--sense and motion in almost all animals, and in many the power of thinking, and other affections of the mind. The powers, or dead matters, which are applied, and which produce these functions, are chiefly, heat, food, and air. The proof that these powers do produce the living functions, is in my opinion a very convincing one, namely, that when their actions are suspended, the living functions cease; take away, for instance, heat, air, and food from animals, and they soon become dead matter, and it is not necessary that an animal should be deprived of all these to put a stop to the living functions; if any one of them be taken away, the body sooner or later becomes dead matter: it is found by experience, that if a man be deprived of air, he dies in about three or four minutes; for instance, if he be immersed under water; if he be deprived of heat, or in other words, exposed to a very severe degree of cold, he likewise soon dies; or if he be deprived of food, his death is equally certain, though more slow. It is sufficiently evident then, that the living functions are owing to the action of these external powers upon the body. What I have here said, is not confined to animals, but the living functions of vegetables are likewise caused by the action of dead matter upon them. The dead matters, which by their action produce these functions, are princ.i.p.ally heat, moisture, light, and air. It clearly follows therefore, from what I have said, that living bodies must have some property different from dead matter, which renders them capable of being acted upon by these external powers, so as to produce the living functions; for if they had not, the only effects which these powers could produce, would be mechanical, or chemical.

Though we know not exactly in what this property consists, or in what manner it is acted on, yet we see, that when bodies are possessed of it, they become capable of being acted upon by external powers, and thus the living functions are produced; we shall therefore call this property _excitability_, and in using this term it is necessary to mention, that I mean only to express a fact, without the least intention of pointing out the nature of that property which distinguishes living from dead matter, and in this we have the example of the great Newton, who called the property which causes bodies in certain situations to approach each other, _gravitation_, without in the least hinting at its nature; yet, though he knew not what gravitation was, he investigated the laws by which bodies were acted on by it, in the same manner, though we are ignorant of excitability, or the nature of that property which distinguishes living from dead matter, we can investigate the laws by which dead matter acts on living bodies through this medium. We know not what magnetic attraction is, and yet we can investigate its laws; the same holds good with regard to electricity; if we ever should attain a knowledge of the nature of this property, it would make no alteration in the laws which we had before discovered.

I shall now proceed to the investigation of the laws by which the excitability is acted on; but I must first define some terms which it will be necessary to use, to avoid circ.u.mlocution, and at the same time to give us more distinct ideas on the subject.

When the excitability is in such a state as to be very susceptible of the action of external powers, I shall call it _abundant_, or _acc.u.mulated_; but when it is found not very capable of receiving their action, I shall say, it is _deficient_, or _exhausted_. I would not wish however, to have it thought, that by these terms I mean in the least to hint at the _nature_ of excitability, nor that it is _really_ one while increased, and at another diminished in quant.i.ty, for the abstract question is in no shape considered; we know not whether the excitability, or the vital principle, depends on a particular arrangement of matter, or from whatever cause it may originate; by the terms here used, I mean only to say, that the excitability is easily acted on when I call it abundant, or acc.u.mulated; at other times the living body is with more difficulty excited, and then I say, the vital principle is deficient, or exhausted.

The laws by which external powers act on living bodies, will, on a careful examination, be found to be the following--

First, when the powerful action of the exciting powers ceases for some time, the excitability acc.u.mulates, or becomes more capable of receiving their action, and is more powerfully affected by them.

If we examine separately the different exciting powers, which act on the body, we shall find abundant confirmation of this law. Let us first consider Light; if a person be kept in darkness for some time, and be then brought into a room in which there is only an ordinary degree of light, it will be almost too oppressive for him, and appear excessively bright; and if he have been kept for a considerable time in a very dark place, the sensation will be very painful. In this case, while the retina, or optic nerve, was deprived of light, its excitability acc.u.mulated, or became more easily affected by light; for if a person goes out of one room, into another which has an equal degree of light, he will feel no effect. You may convince yourselves of this law by a very simple experiment--shut your eyes, and cover them for a minute or two with your hand, and endeavour not to think of the light, or of what you are doing; then open them, and the day-light will for a short time appear brighter. If you look attentively at a window, for about two minutes, and then cast your eyes upon a sheet of white paper, the shape of the window-frames will be perfectly visible upon the paper; those parts which express the wood-work, appearing brighter than the other parts. The parts of the optic nerve on which the image of the frame falls, are covered by the wood-work from the action of the light; the excitability of these portions of the nerve will therefore acc.u.mulate, and the parts of the paper which fall upon them, must of course appear brighter.

If a person be brought out of a dark room where he has been confined, into a field covered with snow, when the sun shines, it has been known to affect him so much, as to deprive him of sight altogether.

Let us next consider what happens with respect to heat; if heat be for some time abstracted, the excitability acc.u.mulates; or in other words, if the body be for some time exposed to cold, it is more liable to be affected by heat, afterwards applied; of this also you may be convinced by an easy experiment--put one of your hands into cold water, and then put both into water which is considerably warm; the hand which has been in cold water, will feel much warmer than the other. If you handle some snow with one hand, while you keep the other in your bosom, that it may be of the same heat as the body, and then bring both within the same distance of the fire, the heat will affect the cold hand infinitely more than the warm one. This is a circ.u.mstance of the utmost importance, and ought always to be carefully attended to. When a person has been exposed to a severe degree of cold for some time, he ought to be cautious how he comes near a fire, for his excitability will be so much acc.u.mulated, that the heat will act violently; often producing a great degree of inflammation, and even sometimes mortification. We may by the way observe, that this is a very common cause of chilblains, and other inflammations. When the hands, or any other parts of the body have been exposed to violent cold, they ought first to be put into cold water, or even rubbed with the snow, and exposed to warmth in the gentlest manner possible.

Exactly the same takes place with respect to food, if a person have for some time been deprived of food, or have taken it in small quant.i.ty, whether it be meat or drink; or if he have taken it of a less stimulating quality, he will find, that when he returns to his ordinary mode of living, it will have more effect upon him than before he lived abstemiously.

Persons who have been shut up in a coal-work from the falling in of the pit, and have had nothing to eat for two or three days, have been as much intoxicated by a bason of broth, as a person in common circ.u.mstances with two or three bottles of wine; and we all know that spirituous, or vinous liquors affect the head more in the morning, than after dinner.

This circ.u.mstance was particularly evident among the poor sailors who were in the boat with Captain Bligh after the mutiny. The captain was sent by government to convey some plants of the bread-fruit tree from Otaheite, to the West-Indies; soon after he left Otaheite, the crew mutinied, and put the captain and most of the officers, with some of the men, on board the ship's boat, with a very short allowance of provisions, and particularly of liquors, for they had only six quarts of rum, and six bottles of wine, for nineteen people, who were driven by storms about the south-sea, exposed to wet and cold all the time, for nearly a month; each man was allowed only a tea-spoon full of rum a-day, but this tea-spoon full refreshed the poor men, benumbed as they were with cold, and faint with hunger, more than twenty times the quant.i.ty would have done those who were warm, and well fed; and had it not been for the spirit having such power to act upon men, in their condition, they never could have outlived the hardships they experienced. All these facts, and many others which might be brought, establish beyond a doubt the truth of the law I have mentioned, namely, that when the powerful action of the exciting powers ceases for some time, the excitability acc.u.mulates, or becomes more capable of receiving their actions.

The second law is, that when the exciting powers have acted with violence, or for a considerable time, the excitability becomes exhausted, or less fit to be acted on, and this we shall be able to prove by a similar induction. Let us take the effects of light upon the eye; when it has acted violently for some time upon the optic nerve, it diminishes the excitability of that nerve, and renders it incapable of being affected by a quant.i.ty of light that would at other times affect it. When you have been walking out in the snow, if you come into your room, you will scarcely be able to see any thing for some minutes. Look stedfastly at a candle for a minute or two, and you will with difficulty discern the letters of a book, which you were before reading distinctly; and if you happen to cast your eyes upon the sun, you will not see any thing distinctly for some time afterwards.

Let us next consider the matter of heat: suppose water to be heated lukewarm, if you put one hand into it, it will feel warm; if you now put the other hand into water, heated for instance to 120 degrees or 130 degrees, and keep it there some time, we will say, two minutes; if then you take it out, and put it into the lukewarm water, that water will feel cold, though still it will seem warm to the other hand; for, the hand which had been in the heated water, has had its excitability exhausted by the application of heat. Before you go into a warm bath, the temperature of the air may seem warm and agreeable to you, but after you have remained for some time in a bath that is rather hot, when you come out, you feel the air uncommonly cool and chilling.

Let us now examine the effects of substances taken into the stomach; and as the effects of spirituous, and vinous liquors, are a little more remarkable than food, we shall make our observations upon them.

A person who is unaccustomed to drink these liquors, will be intoxicated by a quant.i.ty that will produce no effect upon one who has been for some time accustomed to take them; and when a person has used himself to these stimulants for some time, the ordinary powers which in common support life, will not have their proper effects upon him, because his excitability has been in some measure exhausted by the stimulants.

The same holds good with respect to tobacco and opium; a person accustomed to take opium will not be affected by a quant.i.ty that would completely intoxicate one not used to it; because the excitability has been so far exhausted by the use of that drug, that it cannot be acted on by a small quant.i.ty.

These facts, with innumerable others, which will easily suggest themselves to you, prove the truth of our second proposition, namely, that when the exciting powers have acted violently, or for a considerable time, the excitability is exhausted, or less fit to be acted on.

This exhaustion of the excitability, may, however, be either finite, or temporary; we see animals, while the exciting powers continue to act, at first appear in their greatest vigour, then gradually decay, and at last come into that state, in which, from the long continued action of the exciting powers, the excitability is entirely exhausted, and death takes place.

We likewise see plants in the spring, while the exciting powers have acted on them, moderately, and for a short time, arrayed in their verdant robes, and adorned with flowers of "many mingling hues;"

but, as the exciting powers which support the life of the plant, continue to be applied, and some of them, for instance heat, as the summer advances become increased, they first lose their verdure, then grow brown, and at the end of summer cease to live; because their excitability is exhausted by the long continued action of the exciting powers; and this does not happen merely in consequence of the heat of summer decreasing, for they grow brown and die, even in a greater degree of heat than that which in spring made them grow luxuriantly.

These are examples of the finite, or irreparable exhaustion of the excitability, but we find also, that it may be exhausted for a time, and acc.u.mulated again. Though the eye has been so dazzled by the splendour of light, that it cannot see an object moderately illuminated, yet, if it be shut for some time, the excitability of the optic nerve acc.u.mulates again, and we are again capable of seeing with an ordinary light.

We find, that we are not always equally capable of performing the functions of life. When we have been engaged in any exertion, either mental or corporeal, for some hours only, we find ourselves fatigued, and unfit to pursue our labours much longer; if in this state, several of the exciting powers, particularly light and noise, be withdrawn; and if we are laid in a posture which does not require much muscular exertion, we soon fall into that state which nature intended for the acc.u.mulation of the excitability, and which we call Sleep. In this state, many of the exciting powers cannot act upon us, unless applied with some violence, for we are insensible to their moderate action. A moderate light, or a moderate noise, does not affect us, and the power of thinking, which exhausts the excitability very much, is in a great measure suspended. When the action of these powers has been suspended for six or eight hours, the excitability is again capable of being acted on, and we rise fresh, and vigorous, and fit to engage in our occupations.

Sleep then, is the method which nature has provided to repair the exhausted const.i.tution, and restore the vital energy; without its refreshing aid, our worn-out habits would scarcely be able to drag on a few days, or at most a few weeks, before the vital spring was quite run down; how properly therefore has the great poet of nature called sleep the chief nourisher in life's feast.--

'Sleep, that knits up the ravell'd sleeve of care, 'the death of each day's life, sore labour's bath, 'balm of hurt minds, great Nature's second course, 'chief nourisher in life's feast.'

From the internal sensations often excited, it is natural to conclude that the nerves of sense are not torpid during sleep; but that they are only precluded from the perception of external objects, by the external organs being rendered unfit to transmit to them the impulses of bodies, during the suspension of the power of volition; thus, the eye-lids are closed in sleep, to prevent the impulse of the light from acting on the optic nerve; and it is very probable that the drum of the ear is not stretched; it is likewise probable that something similar happens to the external apparatus of all our organs of sense, which may make them unfit for their office of perception during sleep.

The more violently the exciting powers have acted, the sooner is sleep brought on; because the excitability is sooner exhausted, and therefore, sooner requires the means of renewing it; and on the contrary, the more weakly the exciting powers have acted, the less is a person inclined to sleep. Instances of the first are, excess of exercise, strong liquors, or study, and of the latter, an under proportion of these.

A person who has been daily accustomed to much exercise, whether mental or corporeal, if he omit it, will find little or no inclination to sleep; he may however be made to sleep by taking a little diffusible stimulus; for instance, a little warm punch, or opium: these act entirely by exhausting the excitability to that degree which is compatible with sleep; and when their stimulant effect is over, the person soon falls into that state.

But though the excitability may have been sufficiently exhausted, and the action of the external powers considerably moderated, yet there are some things within ourselves, which stimulate violently, and prevent sleep; such as pain, thirst, and strong pa.s.sions and emotions of the mind. These all tend to drive away sleep, but it may be induced, by withdrawing the mind from these impressions; particularly from uneasy emotions, and employing it on something which makes a less impression; sleep, in such cases, is frequently brought on by listening to the humming of bees, [1] or the murmuring of a rivulet; by employing the mind on subjects which do not require much exertion, nor produce too much commotion; such as counting to a thousand, or counting drops of water which fall slowly.

It sometimes happens, as has been well observed by Dr. Franklin, that an uneasy heat of the skin, from a want of perspiration, occasioned by the heat of the bed-cloaths, will prevent sleep; in this case, he recommends a method, which I believe will often succeed--namely, to get up and walk about the room till you are considerably cooled; when you get into bed again, the heat of the skin will be diminished, and perspiration become more free, and you will probably sleep in a very few minutes. [2]

By induction we have discovered two of the princ.i.p.al laws by which living bodies are governed; the first is, that when the ordinary powers which support life have been suspended, or their action lessened for a time, the excitability, or vital principle acc.u.mulates, or becomes more fit to receive their actions; and secondly, when these powers have been acted upon violently, or for a considerable time, the excitability is exhausted, or becomes less fit to receive their actions. There are therefore three states in which living bodies exist.--

First, a state of acc.u.mulated excitability.

Second, a state of exhausted excitability.

Third, when it is in such a state as to produce the strongest and most healthy actions, when acted upon by the external powers.

From what I have said, it must appear, that life is a forced state, depending on the action of external powers upon the excitability; and that, by their continued action, if they are properly regulated, the excitability will be gradually and insensibly exhausted; and life will be resigned into the hands of him who gave it, without a struggle, and without a groan.

We see then, that nature operates in supporting the living part of the creation, by laws as simple and beautiful as those by which the inanimate world is governed. In the latter we see the order and harmony which is observed by the planets, and their satellites, in their revolution round the great source of heat and light.