Part 3

The second Reason, which, if alone, would have been a sufficient one, is, that it is impossible to subject the Treatment of chronical Distempers to the Capacity and Conduct of Persons, who are not Physicians. Each acute Distemper generally arises from one Cause; and the Treatment of it is simple and uniform; since those Symptoms, which manifest the Malady, point out its Cause and Treatment. But the Case is very differently circumstanced in tedious and languid Diseases; each of which may depend on so many and various Causes (and it is only the real, the true Cause, which ought to determine us in selecting its proper Remedies) that though the Distemper and its Appellation are evidently known, a meer By-stander may be very remote from penetrating into its true Cause; and consequently be incapable of chusing the best Medicines for it. It is this precise and distinguishing Discernment of the real particular Cause *[or of the contingent Concurrence of more than one]* that necessarily requires the Presence of Persons conversant in the Study and the Practice of all the Parts of Physick; and which Knowledge it is impossible for People, who are Strangers to such Studies, to arrive at. Moreover, their frequent Complexness; the Variety of their Symptoms; the different Stages of these tedious Diseases [not exactly attended to even by many competent Physicians] the Difficulty of ascertaining the different Doses of Medicines, whose Activity may make the smallest Error highly dangerous, &c. &c. are really such trying Circumstances, as render the fittest Treatment of these Diseases sufficiently difficult and embarrassing to the most experienced Physicians, and unattainable by those who are not Physicians.

A third Reason is, that, even supposing all these Circumstances might be made so plain and easy, as to be comprehended by every Reader, they would require a Work of an excessive Length; and thence be disproportioned to the Faculties of those, for whom it was intended. One single chronical Disease might require as large a Volume as the present one.

But finally, were I to acknowledge, that this Compliance was both necessary and practicable, I declare I find it exceeds my Abilities; and that I am also far from having sufficient Leisure for the Execution of it. It is my Wish that others would attempt it, and may succeed in accomplishing it; but I hope these truly worthy Persons, who have honoured me by proposing the Achievement of it to myself, will perceive the Reasons for my not complying with it, in all their Force; and not ascribe a Refusal, which arises from the very Nature of the thing, either to Obstinacy, or to any Want of an Inclination to oblige them.

I have been informed my Citations, or rather References, have puzzled some Readers. It was difficult to foresee this, but is easy to prevent it for the future. The Work contains Citations only of two Sorts; one, that points to the Remedies prescribed; and the other, which refers to some Passage in the Book itself, that serves to illustrate those Passages in which I cite. Neither of these References could have been omitted. The first is marked thus, *No.* with the proper Figure to it, as 1, 2, &c. This signifies, that the Medicine I direct is described in the Table of Remedies, according to the Number annexed to that Character. Thus when we find directed, in any Page of the Book, the warm Infusion *No. 1*; in some other, the Ptisan *No. 2*; or in a third, the Almond Milk, or Emulsion *No. 4*, it signifies, that such Prescriptions will be found at the Numbers 1, 2, and 4; and this Table is printed at the End of the Book.

If, instead of forming this Table, and thus referring to the Prescriptions by their Numbers, I had repeated each Prescription as often as I directed it, this Treatise must have been doubled in Bulk, and insufferably tiresome to peruse. I must repeat here, what I have already said in the former Edition, that the Prices of the Medicines, or of a great Number of them, are those at which the Apothecaries may afford them, without any Loss, to a Peasant in humble Circumstances. But it should be remembered, they are not set down at the full Prices which they may handily demand; since that would be unjust for some to insist on them at. Besides, there is no Kind of Tax in *Swisserland*, and I have no Right to impose one.

The Reasons for omitting the Prices here, may be seen Page 23 of this Translation.

The Citations of the second Kind are very plain and simple. The whole Work is divided into numbered Paragraphs distinguished by the Mark Sec.. And not to swell it with needless Repetitions, when in one Place I might have even pertinently repeated something already observed, instead of such Repetition at Length, I have only referred to the Paragraph, where it had been observed. Thus, for Example when we read Page 81, Sec. 50 --*When the Disease is so circumstanced as we have described*, Sec. 46,-- this imports that, not to repeat the Description already given, I refer the Reader to that last Sec. for it.

The Use of these Citations is not the least Innovation, and extremely commodious and easy: but were there only a single Reader likely to be puzzled by them, I ought not to omit this Explanation of them, as I can expect to be generally useful, only in Proportion as I am clear: and it must be obvious, that a Desire of being extensively useful is the sole Motive of this Work. I have long since had the Happiness of knowing, that some charitable and intelligent Persons have applied the Directions it contains, with extraordinary Success, even in violent Diseases: And I shall arrive at the Height of my Wishes, if I continue to be informed, that it contributes to alleviate the Sufferings, and to prolong the Days, of my rational Fellow Creatures.

N. B. A Small Blank occurring conveniently here in the Impression, the Translator of this Work has employed it to insert the following proper Remark, viz.

Whenever the Tea or Infusion of the Lime-tree is directed in the Body of the Book, which it often is, the Flowers are always meant, and not the Leaves; though by an Error of the Press, or perhaps rather by an Oversight of the Transcribers of this Version, it is printed Leaves instead of Flowers P. 392, as noted and corrected in the Errata. These Flowers are easily procurable here, meerly for gathering, in most Country Places in July, as few Walks, Vistas, &c. are without these Trees, planted for the pleasant Shade they afford, and to keep off the Dust in Summer, though the Leaf drops rather too early for this Purpose. Their Flowers have an agreeable Flavour, which is communicated to Water by Infusion, and rises with it in Distillation. They were, to the best of my Recollection, an Ingredient in the antiepileptic Water of Langius, omitted in our late Dispensatories of the College. They are an Ingredient in the antiepileptic Powder, in the List of Medicines in the present Practice of the Hotel Dieu at Paris: and we think were in a former Prescription of our Pulvis de Gutteta, or Powder against Convulsions. Indeed they are considered, by many medical Writers, as a Specific in all Kinds of Spasms and Pains; and _Hoffman_ affirms, he knew a very tedious Epilepsy cured by the Use of an Infusion of these Flowers.

I also take this Opportunity of adding, that as this Translation is intended for the Attention and the Benefit of the Bulk of the Inhabitants of the British Empire, I have been careful not to admit any Gallicisms into it; as such might render it either less intelligible, or less agreeable to its Readers. If but a single one occurs, I either have printed it, or did intend it should be printed, distinguishably in Italics. K.

_Introduction._

The Decrease of the Number of Inhabitants, in most of the States of Europe, is a Fact, which impresses every reflecting Person, and is become such a general Complaint, as is but too well established on plain Calculations. This Decrease is most remarkable in Country Places. It is owing to many Causes; and I shall think myself happy, if I can contribute to remove one of the greatest of them, which is the pernicious Manner of treating sick People in Country Places. This is my sole Object, tho' I may be excused perhaps for pointing out the other concurring Causes, which may be all included within these two general Affirmations; That greater Numbers than usual emigrate from the Country; and that the People increase less every where.

There are many Sorts of Emigration. Some leave their Country to enlist in the Service of different States by Sea and Land; or to be differently employ'd abroad, some as Traders, others as Domestics, &c.

Military Service, by Land or Sea, prevents Population in various Respects. In the first Place, the Numbers going abroad are always less, often much less, than those who return. General Battles, with all the Hazards and Fatigues of War; detached Encounters, bad Provisions, Excess in drinking and eating, Diseases that are the Consequences of Debauches, the Disorders that are peculiar to the Country; epidemical, pestilential or contagious Distempers, caused by the unwholsome Air of Flanders, Holland, Italy and Hungary; long Cruises, Voyages to the East or West Indies, to Guinea, &c. destroy a great Number of Men. The Article of Desertion also, the Consequences of which they dread on returning home, disposes many to abandon their Country for ever. Others, on quitting the Service, take up with such Establishments, as it has occasionally thrown in their Way; and which necessarily prevent their Return. But in the second Place, supposing they were all to come back, their Country suffers equally from their Absence; as this very generally happens during that Period of Life, when they are best adapted for Propagation; since that Qualification on their Return is impaired by Age, by Infirmities and Debauches: and even when they do marry, the Children often perish as Victims to the Excesses and Irregularities of their Fathers: they are weak, languishing, distempered, and either die young, or live incapable of being useful to Society. Besides, that the prevailing Habit of Libertinage, which many have contracted, prevents several of them from marrying at all. But notwithstanding all these inconvenient Consequences are real and notorious; yet as the Number of those, who leave their Country on these Accounts, is limited, and indeed rather inconsiderable, if compared with the Number of Inhabitants which must remain at home: as it may be affirmed too, that this relinquishing of their Country, may have been even necessary at some Times, and may become so again, if the Causes of Depopulation should cease, this kind of Emigration is doubtless the least grievous of any, and the last which may require a strict Consideration.

But that abandoning of their Country, or Expatriation, as it may be termed, the Object of which is a Change of the Emigrants Condition, is more to be considered, being more numerous. It is attended with many and peculiar Inconveniencies, and is unhappily become an epidemical Evil, the Ravages of which are still increasing; and that from one simple ridiculous Source, which is this; that the Success of one Individual determines a hundred to run the same Risque, ninety and nine of whom may probably be disappointed. They are struck with the apparent Success of one, and are ignorant of the Miscarriage of others. Suppose a hundred Persons might have set out ten Years ago, to seek their Fortune, as the saying is, at the End of six Months they are all forgotten, except by their Relations; but if one should return the same Year, with more Money than his own Fortune, more than he set out with; or if one of them has got a moderate Place with little Work, the whole Country rings with it, as a Subject of general Entertainment. A Croud of young People are seduced by this and sally forth, because not one reflects, that of the ninety nine, who set out with the hundredth Person, one half has perished, many are miserable, and the Remainder come back, without having gained any thing, but an Incapacity to employ themselves usefully at home, and in their former Occupations: and having deprived their Country of a great many Cultivaters, who, from the Produce of the Lands, would have attracted considerable Sums of Money, and many comfortable Advantages to it. In short, the very small Proportion who succeed, are continually talked of; the Croud that sink are perpetually forgot. This is a very great and real Evil, and how shall it be prevented? It would be sufficient perhaps to publish the extraordinary Risque, which may be easily demonstrated: It would require nothing more than to keep an exact yearly Register of all these Adventurers, and, at the Expiration of six, eight, or ten Years, to publish the List, with the Fate, of every Emigrant. I am greatly deceived, or at the End of a certain Number of Years, we should not see such Multitudes forsake their native Soil, in which they might live comfortably by working, to go in Search of Establishments in others; the Uncertainty of which, such Lists would demonstrate to them; and also prove, how preferable their Condition in their own Country would have been, to that they have been reduced to. People would no longer set out, but on almost certain Advantages: fewer would undoubtedly emigrate, more of whom, from that very Circumstance, must succeed. Meeting with fewer of their Country-men abroad, these fortunate few would oftner return. By this Means more Inhabitants would remain in the Country, more would return again, and bring with them more Money to it. The State would be more populous, more rich and happy; as the Happiness of a People, who live on a fruitful Soil, depends essentially on a great Number of Inhabitants, with a moderate Quantity of pecuniary Riches.

But the Population of the Country is not only necessarily lessened, in Consequence of the Numbers that leave it; but even those who remain increase less, than an equal Number formerly did. Or, which amounts to the same Thing, among the same Number of Persons, there are fewer Marriages than formerly; and the same Number of Marriages produce fewer Christenings. I do not enter upon a Detail of the Proofs, since merely looking about us must furnish a sufficient Conviction of the Truth of them. What then are the Causes of this? There are two capital ones, Luxury and Debauchery, which are Enemies to Population on many Accounts.

Luxury compells the wealthy Man, who would make a Figure; and the Man of a moderate Income, but who is his equal in every other Respect, and who will imitate him, to be afraid of a numerous Family; the Education of which must greatly contract that Expence he had devoted to Parade and Ostentation: And besides, if he must divide his Estate among a great many Children, each of them would have but a little, and be unable to keep up the State and the Train of the Father's. Since Merit is unjustly estimated by exterior Shew and Expence, one must of Course endeavour to attain for himself, and to leave his Children in, a Situation capable of supporting that Expence. Hence the fewer Marriages of People who are not opulent, and the fewer Children among People who marry.

Luxury is further prejudicial to the Increase of the People, in another Respect. The irregular Manner of Life which it introduces, depresses Health; it ruins the Constitutions, and thus sensibly affects Procreation. The preceding Generation counted some Families with more than twenty Children: the living one less than twenty Cousins. Very unfortunately this Way of thinking and acting, so preventive of Increase, has extended itself even into Villages: and they are no longer convinced there, that the Number of Children makes the Riches of the Countryman. Perhaps the next Generation will scarcely be acquainted with the Relation of Brotherhood.

A third Inconvenience of Luxury is, that the Rich retreat from the Country to live in Cities; and by multiplying their Domestics there, they drain the former. This augmented Train is prejudicial to the Country, by depriving it of Cultivaters, and by diminishing Population. These Domestics, being seldom sufficiently employed, contract the Habit of Laziness; and they prove incapable of returning to that Country Labour, for which Nature intended them. Being deprived of this Resource they scarcely ever marry, either from apprehending the Charge of Children, or from their becoming Libertines; and sometimes, because many Masters will not employ married Servants. Or should any of them marry, it is often in the Decline of Life, whence the State must have the fewer Citizens.

Idleness of itself weakens them, and disposes them to those Debauches, which enfeeble them still more. They never have more than a few Children, and these sickly; such as have not Strength to cultivate the Ground; or who, being brought up in Cities, have an Aversion to the Country.

Even those among them who are more prudent, who preserve their Morals, and make some Savings, being accustomed to a City Life, and dreading the Labour of a Country one (of the Regulation of which they are also ignorant) chuse to become little Merchants, or Tradesmen; and this must be a Drawback from Population, as any Number of Labourers beget more Children than an equal Number of Citizens; and also by Reason, that out of any given Number, more Children die in Cities, than in the Country.

The same Evils also prevail, with Regard to female Servants. After ten or twelve Years Servitude, the Maid-Servants in Cities cannot acquit themselves as good Country Servants: and such of them as chuse this Condition, quickly fail under that Kind or Quantity of Work, for which they are no longer constituted. Should we see a Woman married in the Country, a Year after leaving Town, it is easy to observe, how much that Way of living in the Country has broke her. Frequently their first Child-bed, in which Term they have not all the Attendance their Delicacy demands, proves the Loss of their Health; they remain in a State of Languor, of Feebleness, and of Decay: they have no more Children; and this renders their Husbands unuseful towards the Population of the State.

Abortions, Infants carried out of their Country after a concealed Pregnancy, and the Impossibility of their getting Husbands afterwards, are frequently the Effects of their Libertinage.

It is to be apprehended too these bad Effects are rather increasing with us; since, either for want of sufficient Numbers, or from oeconomical Views, it has become a Custom, instead of Women Servants, to employ Children, whose Manners and whole Constitutions are not yet formed; and who are ruined in the same Manner, by their Residence in Town, by their Laziness, by bad Examples, and bad Company.

Doubtless much remains still unsaid on these important Heads; but besides my Intention not to swell this Treatise immoderately, and the many Avocations, which prevent me from launching too far into what may be less within the Bounds of Medicine, I should be fearful of digressing too far from my Subject. What I have hitherto said however, I think cannot be impertinent to it; since in giving Advice to the People, with Regard to their Health, it was necessary to display to them the Causes that impaired it: though what I might be able to add further on this Head, would probably be thought more remote from the Subject.

I shall add then but a single Hint on the Occasion. Is it not practicable, in Order to remedy those Evils which we cannot prevent, to select some particular Part or Canton of the Country, wherein we should endeavour by Rewards, 1st. Irremoveably to fix all the Inhabitants. 2dly. To encourage them by other Rewards to a plentiful and legitimate Increase. They should not be permitted to go out of it, which must prevent them from being exposed to the Evils I have mentioned. They should by no means intermarry with any Strangers, who might introduce such Disorders among them. Thus very probably this Canton, after a certain Time, would become even over-peopled, and might send out Colonies to the others.

One Cause, still more considerable than those we have already mention'd, has, to this very Moment, prevented the Increase of the People in France. This is the Decay of Agriculture. The Inhabitants of the Country, to avoid serving in the Militia; to elude the Days-Service impos'd by their Lords, and the Taxes; and being attracted to the City by the Hopes of Interest, by Laziness and Libertinage, have left the Country nearly deserted. Those who remain behind, either not being encouraged to work, or not being sufficient for what there is to do, content themselves with cultivating just as much as is absolutely necessary for their Subsistence. They have either lived single, or married but late; or perhaps, after the Example of the Inhabitants of the Cities, they have refused to fulfil their Duty to Nature, to the State, and to a Wife. The Country deprived of Tillers, by this Expatriation and Inactivity, has yielded nothing; and the Depopulation of the State has daily increased, from the reciprocal and necessary Proportion between Subsistence and Population, and because Agriculture alone can increase Subsistence. A single Comparison will sufficiently evince the Truth and the Importance of these Principles, to those who have not seen them already divulged and demonstrated in the Works of the Friend of Man.