_Means of Cure proposed by other Physicians._
There are some diseases against which the success of remedies is next
to sure. Those which are the consequences of venereal exhaustion, and,
_a fortiori_, of self-pollution, do not enter into this class; and the
prognostic which is to be made of them, when they shall have arrived at a
certain degree, has nothing in it but what is desperately terrible.
HIPPOCRATES has, in such case, denounced DEATH. “_It is a deplorable
disorder_, says BOERHAAVE; _I have often seen it, but could never cure
it._”[92]
M. VAN SWIETEN had, for three years, a patient whom he mentions for it,
under his hands, without success. I have seen some perish miserably
of this disorder. There were even others of those patients, to whom I
could not so much as give relief. Yet these examples should not intirely
discourage: there are not wanting instances of a happier issue. Some
may be found in the collection of the _Onania_, and in the Observations
of Physicians; my own practice has furnished me some. In the same place
where HIPPOCRATES gives a description of this disease, he points out
means of cure.
“When, (says he,) the patient is in this condition, let there be
fomentations made for him, over his whole body; then give him a medicine
that may provoke a puke; after that, another to purge his head, and then
a cathartic by stool. After the purgatives, give whey or asses milk;
after that, cows milk for forty days. While he drinks milk, he must
abstain from flesh meats, and in the evening he may have some boiled
wheat. After his milk diet is over, he should be nourished with the most
tender meats, beginning with a small quantity, and by this means he
will recover afresh. For a whole twelvemonth he must avoid all kind of
debauchery, all venereal indulgence, and all immoderate exercise; he must
confine himself to walks, in which he will do well to avoid the cold, or
the sun.”
It is remarkable here, that HIPPOCRATES begins the method of cure by an
emetic, and by purging. Now there is a danger of such an authority’s
obtaining the force of a law, and yet the observation of this law would,
in a number of cases, be pernicious. But it is easy to get rid of this
perplexity, by observing, that he only ordered purgatives in a view
to divert the fluxion which he supposed threw itself from the head on
the spine of the back; and that, in another place, he puts those who
are sick, after venereal excesses, in the catalogue of those to whom
no purgatives should be given, “_because not only they can do no good,
but, on the contrary, they may do a great deal of harm_[93].” So that
it is this last rule which must be considered as the general one: the
first constitutes an exception, and an exception which appears founded
on a theory, of which the error is now discovered, and which especially
therefore ought to have no force.
In HOFFMAN’s dissertation, which I have already often quoted, there are
to be found two observations, that should recommend great circumspection
as to the use of emetics. They are as follow:
A man of fifty years of age, having, for a long time, indulged himself
in excesses with women, fell into a state of languor, emaciation, and
consumptiveness. His sight grew dim, so that at length objects appeared
to him as if he saw them through a cloud. It was at this epoch that he
took an emetic by way of preventing a fever, which he apprehended, after
a long use of eating ham. This medicine made his head swell, and totally
deprived him of his eye-sight.
A common prostitute, who, every time that she had commerce with a man,
felt a dimness in her eyes come upon her, having taken an emetic, lost
her eye-sight intirely[94].
M. BOERHAAVE seems to have rather meant to establish the difficulties of
the cure, than to point out the means of obtaining it.
“There are (says he) little hopes of cure; the milk passes too easily;
the exercise of riding does no good to this kind of patients; they
complain that these remedies weaken them; and, in fact, exercise
encreases the waste of their seed, in the course of their nocturnal
pollutions by dreams, and at the same time diminishes their strength.
When the day re-appears, they quit their beds, all bathed in their
own sweat, and but the weaker for even their sleep; they cannot bear
aromatics, of which the effects are also dangerous. The only resource,
in these cases, is that of aliments, a moderate exercise of the body,
bathing the feet, and frictions used with precaution[95].”
Among the consultations of this great man, which M. DE HALLER has added
to the edition which he has procured to us of them, there is one for a
man, who had rendered himself totally impotent for the joys of love.
“A man (as the case is stated) has so much weakened the organs of
generation, that the seed comes away of itself, every time that he has
any beginning of erection, for that is never a complete one[96], and the
seed never spurts forth with any force, but dribbles away, drop by drop,
which renders him impotent; his memory, stomach, loins, legs, are totally
weakened.”
M. BOERHAAVE answered: “These disorders are always extremely hard to
cure: they hardly ever declare themselves, but when the body has lost
so much of its vital forces, that the remedies remain without efficacy.
However, it may not be amiss to try what the following ones will produce.
“_First_, A dry and temperate regimen, composed of fowls, of beef, of
mutton, of kid, all rather roasted than boiled, a small quantity of ale,
but excellent in its kind, of a very little wine, but then that wine
must be of a very generous restorative sort.
“_Secondly_, A great deal of exercise, augmented, by due degrees; it
should only border upon weariness, and always be taken fasting.
“_Thirdly_, Frictions, with a flannel perfumed with the smoke of incense,
to be used to the loins, the abdominal region, the _pubis_, the groin,
the scrotum, and regularly repeated night and morning.
“_Fourthly_, He should take, every two hours, half a drachm of the
following kind of electuary:
“℞. _Terr. Japon. dr._ iv. _Opoponac. dr._ v. _Cort. Peruv.
dr._ vi. _Conserv. rosar. rub. unc._ i. _Olib. dr._ ii. _Succ.
acac. unc._ ß. _Sir. Kerm. q. s. f. l. a. cond._
“Immediately after which he should drink half an ounce of the following
medicinal wine:
“℞. _Rad. cariophil. mont. Pœn. mar. ana unc._ i. _Cort. rad.
capp. tamarisc. ana unc._ iß. _Lign. agalloch. ver. unc._ i.
_Vin. Gall. alb. lib._ vi. _f. l. a. vin. med._
“I hope (added BOERHAAVE) that the patient will be cured, after having
employed this regimen for two months.”
But he would not make use of it, and died, in a few weeks, of a malignant
flux. What would have been the effect of this remedy? That can be only
conjectured.
M. ZIMMERMANN wrote to me, that he had made a patient try it for two
months, but without any success.
M. HOFFMAN sets forth the precautions which he conceived ought to be
taken, and the methods to be employed.
“We must (says he) avoid all the remedies which do not agree with
weak habits of body, or that may weaken still more those who are
already enervated: such are all astringents, all over-refrigerants,
all saturnines, nitrous, acid, and especially narcotic medicines: all
these are pernicious in cases of this kind, and unfortunately there is,
however, too much use made of them.
“The end to be proposed is to re-establish the vital forces, and to
restore to the fibres the tension they have lost. Heating remedies,
volatiles, aromatics, those that have an agreeable but strong odor, are
not proper here: nothing but the mildest aliments should be allowed,
such as are the fittest to repair that nutritious gelatinous substance,
which immoderate evacuations will have destroyed: such are strong broths
of beef, of veal, of capon, with a little of wine, of lemon-juice, of
salt, of nutmeg, and cloves. To the use of this diet may beneficially be
joined, those remedies which favor perspiration, and which reanimate the
languishing tone of the fibres.”
In another consultation for a self-pollutor, he ordered the taking,
every morning, a certain measure of asses milk mixed with a third of the
quantity of _Selter-water_.
It would be useless here to quote the precepts, or observations of other
authors. I shall content myself with relating here a very instructive
case, such as it stands in a thesis of M. WESPREMI, which thesis includes
fourteen observations, all interesting ones[97].
“W. CONYBEARE, about thirty-six years old, had had, for six years
past, his eyes so dimmed, without any apparent blemish in them, that
he saw all objects as it were through a thick cloud. He had been
successively in the three most celebrated hospitals in London, St.
Thomas’s, St. Bartholomew’s, and St. George’s; at length, about two
years ago, he came to ours. In all the others, after other remedies,
it had been tried whether a mercurial salivation might not cure this
kind of _gutta serena_. The physicians were tired out, and the patient
quite discouraged. On my interrogating him very particularly, and very
carefully, upon his illness, he told me, that, from time to time, he felt
a pain all along the spine of his back, especially when he stooped to
take up any thing; that his legs were so weak, that he could scarce stand
a minute upright, without leaning, which if he did not, his legs would
tremble, and he had then a vertigo and dizziness; that his memory was so
weakened, that he sometimes appeared stupid; and I could myself observe,
that he was greatly emaciated. All this made me suspect, that his _gutta
serena_ might be no other than the symptom of a more dreadful disorder,
and that the patient was attacked with a real _tabes dorsalis_.
“I pathetically urged him to own to me, whether he had not polluted
himself with the abominable crime of ONAN, which intirely destroys the
balsamic parts of the nervous fluid. After much hesitation, and blushing,
he confessed it. I ordered him to take, over night, two mercurial
pills, containing six grains each, of _mercurius dulcis_, and the next
day an ounce of purgative salts, and to repeat that four times in the
space of fifteen days. On the expiration of that term, I made him,
according to the prescription of HIPPOCRATES, live forty days intirely
upon a milk-diet, during which time he used to have himself, two or
three times a week, rubbed, as he went to bed. At the end of this method
of treatment, he returned from the country, in a much better condition
than he had gone thither. I advised him, afterwards the cold-bath for
three weeks. For two months together he took, twice a day, the mineral
electuary and volatile julep, to which he joined frictions, and the
bathing his feet. These remedies so far restored his health, that he
wanted to resume the exercise of his trade, which was that of a baker;
but I advised him to betake himself to some other business, being afraid
that his inhaling the flower, that rises in the kneading, might form in
his as yet weak stomach and breast, a paste, of which the effects might
be dangerous.”
M. STEHELIN gave some relief to the youth mentioned towards the end of
the second Section, by strengthening baths, by _Tinct. Mart. Ludovic._
and by aperitive broths.
The principal remedies mentioned in the _Onania_ consist of nostrums,
which the author reserved to himself. It may be observed on it,
in general, and the observation is important, that he employed no
_evacuants_, and that only corroboratives constituted the basis of them,
under the names of _The strengthening tincture_, and _The prolific
powder_. They act, without that action’s producing any sensible effect,
but, as the author says, they inrich, strengthen, and nourish the parts
of generation in both sexes. According then to him, they give them
new vigor; they favor the generation of seed, and powerfully restore
oppressed nature: in a word, like all nostrums, they do every thing that
is required of them. There is a third secret remedy mentioned, under the
name of _The restorative draught_, which operates very efficaciously,
and, in fact, if any faith may be given to the testimonies adduced in
favor of these remedies, they have doubtless great virtue. Besides these
three nostrums, he gives some formularies: One is a draught, composed of
amber, aromatics, and of some other remedies of that class: A second is
a liniment, composed of essential oils, of balsams, of acrid tinctures.
Both, these compositions appear to me too stimulative, and as they have
not any experience in their favor, I omit the particularising them. He
specifies two others, which seem more proper.
DECOCTION.
℞. _Flor. siccat. lamii_[98] _mpl._ vi. _Rad. cyper. et
galangal. ana unc._ ii. _Rad. bist. unc._ i. _Rad. osmund. reg.
unc._ ii. _Flor. ros. rub. mpl._ iv. _Icthiocoll unc._ iii.
_Scissa tus mixt. cum aquæ quart._ viii. _ad quartæ partis
evaporat. coquantur_.
Take a quart of this every day.
INJECTION.
℞. _Sacchari Saturn. Vitriol, alb. Alum. rup. ana drachm._
i. _Aq. chalyb. fabr._ ℔ i ß. _per dies decem igne arenæ
digerantur. Add. Spir. vin. camphorat. cochl._ iii.
Before I go on to the next Section, I think myself bound to mention, that
very sensible views, applicable to the disease of which I am treating,
may be found in a book lately published, intitled, _Precis de Medecine
pratique_, a work of M. LIEUTAUD, physician to the young royal family
of France, who, after having got to himself a distinguished name among
the Anatomists and Physiologists, has moreover secured to himself one
of the first ranks among the practitioners, by his excellent treatise on
intermittent and remittent fevers.
The chapters of his last work relative to the _tabes dorsalis_, are those
which have for their title _calor morbosus_, morbific heat, at disease,
be it here parenthetically remarked, very frequent, of which no one had
before treated, and which has been often subjected to improper methods of
cure, as I have elsewhere lamented, and of which M. LIEUTAUD has been the
first to unfold the symptoms, the nature, and curative indication. _Vires
exhaustæ_, and _anæmia, or deficiency of blood_, a very interesting
chapter, which is intirely and originally that author’s.
M. LEWIS, whose work I could not procure for myself before the impression
of the first edition of mine, is one who has the most of any enlarged
upon the method of cure. I had the pleasure of finding that we agreed
perfectly in our ideas, and that we employed the same remedies,
especially the bark, and the cold bath; a conformity which appears to me
a proof in favor of the practice we have, in this case, both followed. I
shall only quote here the two aphorisms that comprehend the substance of
his doctrine: I shall avail myself of some passages in the explanation
which he gives to them, to confirm, in the following Section, my own
practice.
“The cure of this disease (says that able physician) depends as much on
knowing what to avoid as what to do. Without a nice regularity of the
non-naturals, therefore, medicine will have little or no effect. Thus the
salubrity of the air is or great importance; the diet should be analeptic
and cooling; sleep little, and in due season; moderate exercise must be
used, especially riding on horseback. The secretions of the body are
to be regulated if out of order, and the patient should be entertained
with chearful company and mirthful diversions. All the remedies that
are necessary, are derived from the two classes of balsamics and
astringents[99].”
He recommends strongly, in the place of tea, which, he observes, is
always prejudicial to the nerves, the infusion of mint, or balm, in every
dish of which is to be put a tea-spoonful of the balsamic mixture of
cream and yolks of eggs beat together, with two or three drops of oil
of cinnamon, which he says give a very agreeable flavor, and is highly
grateful to the stomach[100]. This indeed I have had occasion to remark
myself, of its being both balsamic and strengthening; but I shall place
here a remark that may have its use: It is, that M. LEWIS specifies
among the corroboratives, medicines from lead, _Tinct. faturnia_[101];
and I think it my duty to give this caution, without offence to his
authority and to that of other respectable physicians, that the internal
use of all preparations of lead is a real poison, according to the almost
unanimous confession of all the faculty. I have seen the most tragical
effects from it; and the shameless rashness of quacks, furnishes but
too many occasions of observing such. But if the use of it is to be
preserved, like that of some other poisons, let the administration of it
at least be reserved for those who are able to discern its dangers and
its virtues, and not indicated without due precaution in works designed
for the public.
I shall conclude this Section with the method employed by M. STORCK in
the cure of these disorders: it is a very simple and a very efficacious
one. And by comparing all these methods, it will be seen, that they are
all founded on the same principles, all tend to the same end, and all
employ means nearly similar, a conformity which forms a recommendation of
the method, and inspires confidence.
“I begin (says M. STORCK) by trying to restore the patient with
nourishing broths. Rice, oatmeal, barley boiled with broth, or milk,
or milk itself, are all very serviceable; but it must be observed, to
let him eat but little at a time, and often. Should the stomach be so
weakened, which is sometimes the case when the disorder is far advanced,
that it cannot bear even these light aliments without great anguish, the
patient should be put to the female breast of milk, a recourse which has
retrieved many out of the most desperate condition. To restore strength
and activity to the relaxed fibres, I would recommend the use of wine
heated with a hot iron, bark, and cinnamon. As soon as the patient has
strength enough to walk, it will be of infinite service to him, his going
into the purest air of the country, or mountains[102].”