Chapter II.Of the Causes which aggravate the Diseases of the People. General Considerations.Sect.14.The Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal.There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this—That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitateand untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is toothick, and thatit cannot circulate. On seeing it in the Bason after Bleeding, he finds itblack, dry, burnt; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out theSerum, the watery Part, of such a Blood by sweating, there is a Necessity to increase it?§ 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, andan Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure;in assuring themalso, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate.§ 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some15Faltranc, the greater Part of the Ingredientsof which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or ofFaltranc, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed hegenerallydoes, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood.§ 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simplyon stopt or abated Perspiration, to which such Pain instantly succeeds;where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such asFaltrancand Honey;which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable toFaltranc. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, byrepelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics.If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success.Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well;but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable.§ 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness.§ 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow.§ 20. They are also further injured by the Quality, as well as the Quantity, of their Food. They are forced to sup strong Gravey Soups,Eggs, Biscuits, and even Flesh, if they have but just Strength and Resolution to chew it. It seems absolutely impossible for them to survive all this Trash. Should a Man in perfect Health be compelled to eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as violent Symptoms, as if he had taken real Poison, which, in Effect, he has. He is seized with Vomiting, Anguish, a violent Purging, and a Fever, with Raving, and eruptive Spots, which we call the Purple Fever. Now when the very same Articles of Food, in their soundest State, are given to a Person in a Fever, the Heat, and the morbid Matter already in his Stomach, quickly putrify them; and after a few Hours produce all the abovementioned Effects. Let any Man judge then, if the least Service can be expected from them.§ 21. It is a Truth established by the first of Physicians, above two thousand Years past, and still further ratified by his Successors, that as long as a sick Person has a bad Humour or Ferment in his Stomach, his Weakness increases, in Proportion to the Food he receives. For this being corrupted by the infected Matter it meets there, proves incapable of nourishing, and becomes a conjunct or additional Cause of the Distemper.The most observing Persons constantly remark, that whenever a feverish Patient sups, what is commonly called some good Broth, the Fever gathers Strength and the Patient Weakness. The giving such a Soup or Broth, though of the freshestsoundest Meat, to a Man who has a high Fever, or putrid Humours in his Stomach, is to do him exactly the same service, as if you had given him, two or three Hours later, stale putrid Soup.§ 22. I must also affirm, that this fatal Prejudice, of keeping up the Patients' Strength by Food, is still too much propagated, even among those very Persons, whose Talents and whose Education might be expected to exempt them from any such gross Error. It were happy for Mankind, and the Duration of their Lives would generally be more extended, if they could be thoroughly persuaded of this medical, and so very demonstrable, Truth;—That the only things which can strengthen sick Persons are those, which are able to weaken their Disease; but their Obstinacy in this Respect is inconceivable: it is another Evil superadded to that of the Disease, and sometimes the more grievous one. Out of twenty sick Persons, who are lost in the Country, more than two Thirds might often have been cured, if being only lodged in a Place defended from the Injuries of the Air, they were supplied with Abundance of good Water. But that most mistaken Care and Regimen I have been treating of, scarcely suffers one of the twenty to survive them.§ 23. What furtherincreases our Horrorat this enormous Propensity to heat, dry up, and cram the sick is, that it is totally opposite to what Nature herself indicates in such Circumstances. The burning Heat of which they complain; theDryness of the Lips, Tongue and Throat; the flaming high Colour of their Urine; the great Longing they have for cooling things; the Pleasure and sensible Benefit they enjoy from fresh Air, are so many Signs, or rather Proofs, which cry out with a loud Voice, that we ought to attemperate and cool them moderately, by all means. Their foul Tongues, which shew the Stomach to be in the like Condition; their Loathing, their Propensity to vomit, their utter Aversion to all solid Food, and especially to Flesh; the disagreeable Stench of their Breath; their Discharge of fetid Wind upwards and downwards, and frequently the extraordinary Offensiveness of their Excrements, demonstrate, that their Bowels are full of putrid Contents, which must corrupt all the Aliments superadded to them; and that the only thing, which can prudently be done, is to dilute and attemper them by plentiful Draughts of refreshing cooling Drinks, which may promote an easy Discharge of them. I affirm it again, and I heartily wish it may be thoroughly attended to, that as long as there is any Taste of Bitterness, or of Putrescence; as long as there is aNauseaor Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs, and all kind of Food composed of them, or of any of them, and all Venice Treacle, Wine, and all heating things are so many absolute Poisons.§ 24. I may possibly be censured as extravagant and excessive on these Heads by thePublick, and even by some Physicians: but the true and enlightened Physicians, those who attend to the Effects of every Particular, will find on the contrary, that far from exceeding in this Respect, I have rather feebly expressed their own Judgment, in which they agree with that of all the good ones, who have existed within more than two thousand Years; that very Judgment which Reason approves, and continual Experience confirms. The Prejudices I have been contending against have costEuropesome Millions of Lives.§ 25. Neither should it be omitted, that even when a Patient has very fortunately escaped Death, notwithstanding all this Care to obtain it, the Mischief is not ended; the Consequences of the high Aliments and heating Medicines being, to leave behind the Seed, the Principle, of some low and chronical Disease; which increasing insensibly, bursts out at length, and finally procures him the Death he has even wished for, to put an End to his tedious Sufferings.§ 26. I must also take Notice of another dangerous common Practice; which is that of purging, or vomiting a Patient, at the very Beginning of a Distemper. Infinite Mischiefs are occasioned by it. There are some Cases indeed, in which evacuating Medicines, at the Beginning of a Disease, are convenient and even necessary. Such Cases shall be particularly mentioned in some other Chapters: but as long as we are unacquainted with them, it should be considered as a general Rule, that they arehurtfulat the Beginning; thisbeing true very often; and always, when the Diseases are strictly inflammatory.§ 27. It is hoped by their Assistance, at that Time, to remove the Load and Oppression of the Stomach, the Cause of a Disposition to vomit, of a dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven or Ferment of the Fever. But in this Hope they are very often deceived; since the Causes of these Symptoms are seldom of a Nature to yield to these Evacuations. By the extraordinary Viscidity or Thickness of the Humours, that foul the Tongue, we should form our Notions of those, which line the Stomach and the Bowels. It may be washed, gargled and even scraped to very little good Purpose. It does not happen, until the Patient has drank for many Days, and the Heat, the Fever and the great Siziness of the Humours are abated, that this Filth can he thoroughly removed, which by Degrees separates of itself. The State of the Stomach being conformable to that of the Tongue, no Method can effectually scour and clean it at the Beginning: but by giving refreshing and diluting Remedies plentifully, it gradually frees itself; and the Propensity to vomit, with its other Effects and Uneasinesses, go off naturally, and without Purges.§ 28. Neither are these Evacuations only negatively wrong, merely from doing no Good; for considerable Evil positively ensues from the Application of those acrid irritating Medicines, which increase the Pain and Inflammation; drawingthe Humours upon those Parts that were already overloaded with them; which by no means expel the Cause of the Disease, that not being at this time fitted for Expulsion, as not sufficiently concocted or ripe: and yet which, at the same Time, discharge the thinnest Part of the Blood, whence the Remainder becomes more thick; in short which carry off the useful, and leave the hurtful Humours behind.§ 29. The Vomit especially, being given in an inflammatory Disease, and even without any Distinction in all acute ones, before the Humours have been diminished by Bleeding, and diluted by plentiful small Drinks, is productive of the greatest Evils; of Inflammations of the Stomach, of the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes occasion a general Inflammation of the Guts, which16terminates in Death. Some Instances of each of these terribleConsequences have I seen, from blundering Temerity, Imprudence and Ignorance. The Effect of such Medicines, in these Circumstances, are much the same with those we might reasonably expect, from the Application of Salt and Pepper to a dry, inflamed and foul Tongue, in Order to moisten and clean it.§ 30. Every Person of sound plain Sense is capable of perceiving the Truth of whatever I have advanced in this Chapter: and there would be some Degree of Prudence, even in those who do not perceive the real good Tendency of my Advice, not to defy nor oppose it too hardily. The Question relates to a very important Object; and in a Matter quite foreign to themselves, they undoubtedly owe some Deference to the Judgment of Persons, who have made it the Study and Business of their whole Lives. It is not to myself that I hope for their Attention, but to the greatest Physicians, whose feeble Instrument and Eccho I am. What Interest have any of us in forbidding sick People to eat, to be stifled, or to drink such heating things as heighten their Fever? What Advantage can accrue to us from opposing the fatal Torrent, which sweeps them off? What Arguments can persuade People, that some thousand Men of Genius, of Knowledge, and of Experience, who pass their Lives among a Croud and Succession of Patients; who are entirely employed to take Care of them, and to observe all that passes, have been only amusing and deceiving themselves, on the Effects of Food, ofRegimen and of Remedies? Can it enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or a Biscuit,deserves a Patient's Confidence, better than a Physician who forbids them? Nothing can be more disagreeable to the latter, than his being obliged to dispute continually in Behalf of the poor Patients; and to be in constant Terror, lest this mortally officious Attendance, by giving such Food as augments all the Causes of the Disease, should defeat the Efficacy of all the Remedies he administers to remove it; and should fester and aggravate the Wound, in Proportion to the Pains he takes to dress it. The more such absurd People love a Patient, the more they urge him to eat, which, in Effect, verifies the Proverb ofkilling one with Kindness.
Chapter II.Of the Causes which aggravate the Diseases of the People. General Considerations.Sect.14.The Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal.There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this—That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitateand untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is toothick, and thatit cannot circulate. On seeing it in the Bason after Bleeding, he finds itblack, dry, burnt; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out theSerum, the watery Part, of such a Blood by sweating, there is a Necessity to increase it?§ 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, andan Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure;in assuring themalso, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate.§ 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some15Faltranc, the greater Part of the Ingredientsof which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or ofFaltranc, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed hegenerallydoes, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood.§ 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simplyon stopt or abated Perspiration, to which such Pain instantly succeeds;where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such asFaltrancand Honey;which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable toFaltranc. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, byrepelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics.If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success.Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well;but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable.§ 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness.§ 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow.§ 20. They are also further injured by the Quality, as well as the Quantity, of their Food. They are forced to sup strong Gravey Soups,Eggs, Biscuits, and even Flesh, if they have but just Strength and Resolution to chew it. It seems absolutely impossible for them to survive all this Trash. Should a Man in perfect Health be compelled to eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as violent Symptoms, as if he had taken real Poison, which, in Effect, he has. He is seized with Vomiting, Anguish, a violent Purging, and a Fever, with Raving, and eruptive Spots, which we call the Purple Fever. Now when the very same Articles of Food, in their soundest State, are given to a Person in a Fever, the Heat, and the morbid Matter already in his Stomach, quickly putrify them; and after a few Hours produce all the abovementioned Effects. Let any Man judge then, if the least Service can be expected from them.§ 21. It is a Truth established by the first of Physicians, above two thousand Years past, and still further ratified by his Successors, that as long as a sick Person has a bad Humour or Ferment in his Stomach, his Weakness increases, in Proportion to the Food he receives. For this being corrupted by the infected Matter it meets there, proves incapable of nourishing, and becomes a conjunct or additional Cause of the Distemper.The most observing Persons constantly remark, that whenever a feverish Patient sups, what is commonly called some good Broth, the Fever gathers Strength and the Patient Weakness. The giving such a Soup or Broth, though of the freshestsoundest Meat, to a Man who has a high Fever, or putrid Humours in his Stomach, is to do him exactly the same service, as if you had given him, two or three Hours later, stale putrid Soup.§ 22. I must also affirm, that this fatal Prejudice, of keeping up the Patients' Strength by Food, is still too much propagated, even among those very Persons, whose Talents and whose Education might be expected to exempt them from any such gross Error. It were happy for Mankind, and the Duration of their Lives would generally be more extended, if they could be thoroughly persuaded of this medical, and so very demonstrable, Truth;—That the only things which can strengthen sick Persons are those, which are able to weaken their Disease; but their Obstinacy in this Respect is inconceivable: it is another Evil superadded to that of the Disease, and sometimes the more grievous one. Out of twenty sick Persons, who are lost in the Country, more than two Thirds might often have been cured, if being only lodged in a Place defended from the Injuries of the Air, they were supplied with Abundance of good Water. But that most mistaken Care and Regimen I have been treating of, scarcely suffers one of the twenty to survive them.§ 23. What furtherincreases our Horrorat this enormous Propensity to heat, dry up, and cram the sick is, that it is totally opposite to what Nature herself indicates in such Circumstances. The burning Heat of which they complain; theDryness of the Lips, Tongue and Throat; the flaming high Colour of their Urine; the great Longing they have for cooling things; the Pleasure and sensible Benefit they enjoy from fresh Air, are so many Signs, or rather Proofs, which cry out with a loud Voice, that we ought to attemperate and cool them moderately, by all means. Their foul Tongues, which shew the Stomach to be in the like Condition; their Loathing, their Propensity to vomit, their utter Aversion to all solid Food, and especially to Flesh; the disagreeable Stench of their Breath; their Discharge of fetid Wind upwards and downwards, and frequently the extraordinary Offensiveness of their Excrements, demonstrate, that their Bowels are full of putrid Contents, which must corrupt all the Aliments superadded to them; and that the only thing, which can prudently be done, is to dilute and attemper them by plentiful Draughts of refreshing cooling Drinks, which may promote an easy Discharge of them. I affirm it again, and I heartily wish it may be thoroughly attended to, that as long as there is any Taste of Bitterness, or of Putrescence; as long as there is aNauseaor Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs, and all kind of Food composed of them, or of any of them, and all Venice Treacle, Wine, and all heating things are so many absolute Poisons.§ 24. I may possibly be censured as extravagant and excessive on these Heads by thePublick, and even by some Physicians: but the true and enlightened Physicians, those who attend to the Effects of every Particular, will find on the contrary, that far from exceeding in this Respect, I have rather feebly expressed their own Judgment, in which they agree with that of all the good ones, who have existed within more than two thousand Years; that very Judgment which Reason approves, and continual Experience confirms. The Prejudices I have been contending against have costEuropesome Millions of Lives.§ 25. Neither should it be omitted, that even when a Patient has very fortunately escaped Death, notwithstanding all this Care to obtain it, the Mischief is not ended; the Consequences of the high Aliments and heating Medicines being, to leave behind the Seed, the Principle, of some low and chronical Disease; which increasing insensibly, bursts out at length, and finally procures him the Death he has even wished for, to put an End to his tedious Sufferings.§ 26. I must also take Notice of another dangerous common Practice; which is that of purging, or vomiting a Patient, at the very Beginning of a Distemper. Infinite Mischiefs are occasioned by it. There are some Cases indeed, in which evacuating Medicines, at the Beginning of a Disease, are convenient and even necessary. Such Cases shall be particularly mentioned in some other Chapters: but as long as we are unacquainted with them, it should be considered as a general Rule, that they arehurtfulat the Beginning; thisbeing true very often; and always, when the Diseases are strictly inflammatory.§ 27. It is hoped by their Assistance, at that Time, to remove the Load and Oppression of the Stomach, the Cause of a Disposition to vomit, of a dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven or Ferment of the Fever. But in this Hope they are very often deceived; since the Causes of these Symptoms are seldom of a Nature to yield to these Evacuations. By the extraordinary Viscidity or Thickness of the Humours, that foul the Tongue, we should form our Notions of those, which line the Stomach and the Bowels. It may be washed, gargled and even scraped to very little good Purpose. It does not happen, until the Patient has drank for many Days, and the Heat, the Fever and the great Siziness of the Humours are abated, that this Filth can he thoroughly removed, which by Degrees separates of itself. The State of the Stomach being conformable to that of the Tongue, no Method can effectually scour and clean it at the Beginning: but by giving refreshing and diluting Remedies plentifully, it gradually frees itself; and the Propensity to vomit, with its other Effects and Uneasinesses, go off naturally, and without Purges.§ 28. Neither are these Evacuations only negatively wrong, merely from doing no Good; for considerable Evil positively ensues from the Application of those acrid irritating Medicines, which increase the Pain and Inflammation; drawingthe Humours upon those Parts that were already overloaded with them; which by no means expel the Cause of the Disease, that not being at this time fitted for Expulsion, as not sufficiently concocted or ripe: and yet which, at the same Time, discharge the thinnest Part of the Blood, whence the Remainder becomes more thick; in short which carry off the useful, and leave the hurtful Humours behind.§ 29. The Vomit especially, being given in an inflammatory Disease, and even without any Distinction in all acute ones, before the Humours have been diminished by Bleeding, and diluted by plentiful small Drinks, is productive of the greatest Evils; of Inflammations of the Stomach, of the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes occasion a general Inflammation of the Guts, which16terminates in Death. Some Instances of each of these terribleConsequences have I seen, from blundering Temerity, Imprudence and Ignorance. The Effect of such Medicines, in these Circumstances, are much the same with those we might reasonably expect, from the Application of Salt and Pepper to a dry, inflamed and foul Tongue, in Order to moisten and clean it.§ 30. Every Person of sound plain Sense is capable of perceiving the Truth of whatever I have advanced in this Chapter: and there would be some Degree of Prudence, even in those who do not perceive the real good Tendency of my Advice, not to defy nor oppose it too hardily. The Question relates to a very important Object; and in a Matter quite foreign to themselves, they undoubtedly owe some Deference to the Judgment of Persons, who have made it the Study and Business of their whole Lives. It is not to myself that I hope for their Attention, but to the greatest Physicians, whose feeble Instrument and Eccho I am. What Interest have any of us in forbidding sick People to eat, to be stifled, or to drink such heating things as heighten their Fever? What Advantage can accrue to us from opposing the fatal Torrent, which sweeps them off? What Arguments can persuade People, that some thousand Men of Genius, of Knowledge, and of Experience, who pass their Lives among a Croud and Succession of Patients; who are entirely employed to take Care of them, and to observe all that passes, have been only amusing and deceiving themselves, on the Effects of Food, ofRegimen and of Remedies? Can it enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or a Biscuit,deserves a Patient's Confidence, better than a Physician who forbids them? Nothing can be more disagreeable to the latter, than his being obliged to dispute continually in Behalf of the poor Patients; and to be in constant Terror, lest this mortally officious Attendance, by giving such Food as augments all the Causes of the Disease, should defeat the Efficacy of all the Remedies he administers to remove it; and should fester and aggravate the Wound, in Proportion to the Pains he takes to dress it. The more such absurd People love a Patient, the more they urge him to eat, which, in Effect, verifies the Proverb ofkilling one with Kindness.
Of the Causes which aggravate the Diseases of the People. General Considerations.
Sect.14.
Sect.14.
The Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal.
There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this—That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitateand untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is toothick, and thatit cannot circulate. On seeing it in the Bason after Bleeding, he finds itblack, dry, burnt; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out theSerum, the watery Part, of such a Blood by sweating, there is a Necessity to increase it?
§ 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, andan Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure;in assuring themalso, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate.
§ 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some15Faltranc, the greater Part of the Ingredientsof which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or ofFaltranc, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed hegenerallydoes, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood.
§ 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simplyon stopt or abated Perspiration, to which such Pain instantly succeeds;where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such asFaltrancand Honey;which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable toFaltranc. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, byrepelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics.
If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success.
Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well;but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable.
§ 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness.
§ 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow.
§ 20. They are also further injured by the Quality, as well as the Quantity, of their Food. They are forced to sup strong Gravey Soups,Eggs, Biscuits, and even Flesh, if they have but just Strength and Resolution to chew it. It seems absolutely impossible for them to survive all this Trash. Should a Man in perfect Health be compelled to eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as violent Symptoms, as if he had taken real Poison, which, in Effect, he has. He is seized with Vomiting, Anguish, a violent Purging, and a Fever, with Raving, and eruptive Spots, which we call the Purple Fever. Now when the very same Articles of Food, in their soundest State, are given to a Person in a Fever, the Heat, and the morbid Matter already in his Stomach, quickly putrify them; and after a few Hours produce all the abovementioned Effects. Let any Man judge then, if the least Service can be expected from them.
§ 21. It is a Truth established by the first of Physicians, above two thousand Years past, and still further ratified by his Successors, that as long as a sick Person has a bad Humour or Ferment in his Stomach, his Weakness increases, in Proportion to the Food he receives. For this being corrupted by the infected Matter it meets there, proves incapable of nourishing, and becomes a conjunct or additional Cause of the Distemper.
The most observing Persons constantly remark, that whenever a feverish Patient sups, what is commonly called some good Broth, the Fever gathers Strength and the Patient Weakness. The giving such a Soup or Broth, though of the freshestsoundest Meat, to a Man who has a high Fever, or putrid Humours in his Stomach, is to do him exactly the same service, as if you had given him, two or three Hours later, stale putrid Soup.
§ 22. I must also affirm, that this fatal Prejudice, of keeping up the Patients' Strength by Food, is still too much propagated, even among those very Persons, whose Talents and whose Education might be expected to exempt them from any such gross Error. It were happy for Mankind, and the Duration of their Lives would generally be more extended, if they could be thoroughly persuaded of this medical, and so very demonstrable, Truth;—That the only things which can strengthen sick Persons are those, which are able to weaken their Disease; but their Obstinacy in this Respect is inconceivable: it is another Evil superadded to that of the Disease, and sometimes the more grievous one. Out of twenty sick Persons, who are lost in the Country, more than two Thirds might often have been cured, if being only lodged in a Place defended from the Injuries of the Air, they were supplied with Abundance of good Water. But that most mistaken Care and Regimen I have been treating of, scarcely suffers one of the twenty to survive them.
§ 23. What furtherincreases our Horrorat this enormous Propensity to heat, dry up, and cram the sick is, that it is totally opposite to what Nature herself indicates in such Circumstances. The burning Heat of which they complain; theDryness of the Lips, Tongue and Throat; the flaming high Colour of their Urine; the great Longing they have for cooling things; the Pleasure and sensible Benefit they enjoy from fresh Air, are so many Signs, or rather Proofs, which cry out with a loud Voice, that we ought to attemperate and cool them moderately, by all means. Their foul Tongues, which shew the Stomach to be in the like Condition; their Loathing, their Propensity to vomit, their utter Aversion to all solid Food, and especially to Flesh; the disagreeable Stench of their Breath; their Discharge of fetid Wind upwards and downwards, and frequently the extraordinary Offensiveness of their Excrements, demonstrate, that their Bowels are full of putrid Contents, which must corrupt all the Aliments superadded to them; and that the only thing, which can prudently be done, is to dilute and attemper them by plentiful Draughts of refreshing cooling Drinks, which may promote an easy Discharge of them. I affirm it again, and I heartily wish it may be thoroughly attended to, that as long as there is any Taste of Bitterness, or of Putrescence; as long as there is aNauseaor Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs, and all kind of Food composed of them, or of any of them, and all Venice Treacle, Wine, and all heating things are so many absolute Poisons.
§ 24. I may possibly be censured as extravagant and excessive on these Heads by thePublick, and even by some Physicians: but the true and enlightened Physicians, those who attend to the Effects of every Particular, will find on the contrary, that far from exceeding in this Respect, I have rather feebly expressed their own Judgment, in which they agree with that of all the good ones, who have existed within more than two thousand Years; that very Judgment which Reason approves, and continual Experience confirms. The Prejudices I have been contending against have costEuropesome Millions of Lives.
§ 25. Neither should it be omitted, that even when a Patient has very fortunately escaped Death, notwithstanding all this Care to obtain it, the Mischief is not ended; the Consequences of the high Aliments and heating Medicines being, to leave behind the Seed, the Principle, of some low and chronical Disease; which increasing insensibly, bursts out at length, and finally procures him the Death he has even wished for, to put an End to his tedious Sufferings.
§ 26. I must also take Notice of another dangerous common Practice; which is that of purging, or vomiting a Patient, at the very Beginning of a Distemper. Infinite Mischiefs are occasioned by it. There are some Cases indeed, in which evacuating Medicines, at the Beginning of a Disease, are convenient and even necessary. Such Cases shall be particularly mentioned in some other Chapters: but as long as we are unacquainted with them, it should be considered as a general Rule, that they arehurtfulat the Beginning; thisbeing true very often; and always, when the Diseases are strictly inflammatory.
§ 27. It is hoped by their Assistance, at that Time, to remove the Load and Oppression of the Stomach, the Cause of a Disposition to vomit, of a dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven or Ferment of the Fever. But in this Hope they are very often deceived; since the Causes of these Symptoms are seldom of a Nature to yield to these Evacuations. By the extraordinary Viscidity or Thickness of the Humours, that foul the Tongue, we should form our Notions of those, which line the Stomach and the Bowels. It may be washed, gargled and even scraped to very little good Purpose. It does not happen, until the Patient has drank for many Days, and the Heat, the Fever and the great Siziness of the Humours are abated, that this Filth can he thoroughly removed, which by Degrees separates of itself. The State of the Stomach being conformable to that of the Tongue, no Method can effectually scour and clean it at the Beginning: but by giving refreshing and diluting Remedies plentifully, it gradually frees itself; and the Propensity to vomit, with its other Effects and Uneasinesses, go off naturally, and without Purges.
§ 28. Neither are these Evacuations only negatively wrong, merely from doing no Good; for considerable Evil positively ensues from the Application of those acrid irritating Medicines, which increase the Pain and Inflammation; drawingthe Humours upon those Parts that were already overloaded with them; which by no means expel the Cause of the Disease, that not being at this time fitted for Expulsion, as not sufficiently concocted or ripe: and yet which, at the same Time, discharge the thinnest Part of the Blood, whence the Remainder becomes more thick; in short which carry off the useful, and leave the hurtful Humours behind.
§ 29. The Vomit especially, being given in an inflammatory Disease, and even without any Distinction in all acute ones, before the Humours have been diminished by Bleeding, and diluted by plentiful small Drinks, is productive of the greatest Evils; of Inflammations of the Stomach, of the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes occasion a general Inflammation of the Guts, which16terminates in Death. Some Instances of each of these terribleConsequences have I seen, from blundering Temerity, Imprudence and Ignorance. The Effect of such Medicines, in these Circumstances, are much the same with those we might reasonably expect, from the Application of Salt and Pepper to a dry, inflamed and foul Tongue, in Order to moisten and clean it.
§ 30. Every Person of sound plain Sense is capable of perceiving the Truth of whatever I have advanced in this Chapter: and there would be some Degree of Prudence, even in those who do not perceive the real good Tendency of my Advice, not to defy nor oppose it too hardily. The Question relates to a very important Object; and in a Matter quite foreign to themselves, they undoubtedly owe some Deference to the Judgment of Persons, who have made it the Study and Business of their whole Lives. It is not to myself that I hope for their Attention, but to the greatest Physicians, whose feeble Instrument and Eccho I am. What Interest have any of us in forbidding sick People to eat, to be stifled, or to drink such heating things as heighten their Fever? What Advantage can accrue to us from opposing the fatal Torrent, which sweeps them off? What Arguments can persuade People, that some thousand Men of Genius, of Knowledge, and of Experience, who pass their Lives among a Croud and Succession of Patients; who are entirely employed to take Care of them, and to observe all that passes, have been only amusing and deceiving themselves, on the Effects of Food, ofRegimen and of Remedies? Can it enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or a Biscuit,deserves a Patient's Confidence, better than a Physician who forbids them? Nothing can be more disagreeable to the latter, than his being obliged to dispute continually in Behalf of the poor Patients; and to be in constant Terror, lest this mortally officious Attendance, by giving such Food as augments all the Causes of the Disease, should defeat the Efficacy of all the Remedies he administers to remove it; and should fester and aggravate the Wound, in Proportion to the Pains he takes to dress it. The more such absurd People love a Patient, the more they urge him to eat, which, in Effect, verifies the Proverb ofkilling one with Kindness.