240 On Chronic Debilitij *^ 



fickleness ; fretfulness ; taciturnity ; sadness ; imperfect 

 memory ; strange whims ; proneness to reverie ; a fixed 

 persuasion that the disease is incurable, and that it is of a 

 totally dift'erent nature from what it really is ; great im- 

 patience at being thought less sick than the patient had 

 thought himself; frequent and strange dreams ; night- 

 mare ; and sometimes settled melancholy. 



These are all the symptoms which I recolleet to have 

 seen. That others may have occurred, I have no doubt ; 

 but I believe none of much importance have been omit- 

 ted. It is by no means to be supposed that all of these 

 ever occur in one case, for no two cases are exactly or 

 even very nearh^ alike. A general similarity runs through 

 the whole, and so many of the symptoms are present in 

 everv severe case, as to leave no doubt about the nature 

 of the disease. On several of these it will be necessary 

 to enlarge, with some particularity. Previously to doing 

 this, I shall point out the differences between the disease 

 under consideration, and certain others, ha"\'ing symptoms 

 in some degree similar. 



These diseases are, 



1. A schirrous or other tumor of the stomach. Of 

 this it may be observed, that it is very rare ; that when- 

 ever it is so far advanced as to excite serious trouble, it 

 occasions, according to accounts given of it, continual, 

 severe, fixed pains ; that the usual remedies for dyspep- 

 sia afford no relief ; and that a tolerably correct opinion 

 may be formed from the manner of its commencement 

 and progress. 



2. An arthritic humor in the blood. With respect to 

 the existence of such a humor, although much has been 

 written by ingenious men on the subject, not a shadow of 

 proof has been exhibited, so far as my knowledge extends. 

 When it shall be exhibited it will be time enough to con- 

 sider it ; till then it may be fairly ranked with other in- 

 genious whims, which have served to amuse their au- 

 thors and mislead mankind. That there is in some in- 

 stances what is usually termed a retrocedent gouty there 

 can be no question ; or, in other words, there is a trans- 

 lation of the morbid action ; or, in other words still, the 

 several morbid actions which constitute a regular case of 



