n
some of the unnatural stimuli, such as wine and spirits; and
particularly if we previously to the present time perceived the
functions to go on with more vigour, our spirits and strength
greater, before we experienced the slight disturbance of which we
complain, we are verging towards sthenic or inflammatory disease, and
therefore to prevent the disease we ought immediately to diminish the
action of the exciting powers; the quantity of food ought to be
diminished, wine and other liquors abstained from, heat carefully
avoided; and even the quantity of blood in the circulating system
diminished, if the habit is full and the pulse strong.

On the contrary, if the exciting powers have acted more feebly than
is natural; that is, if we have lived on a less nourishing diet, or
have taken it in less quantity; if we have been long exposed to cold,
without alternating with heat, and other debilitating causes; and if
at the same time we find the vigour of the functions diminished,
though they are not yet become much disturbed, we are verging towards
asthenic disease. To prevent which, we must take a more nutritious
diet, and join a portion of wine, and perhaps take some tonic
medicines. This however ought to be done gradually, for fear of
exhausting the excitability, which in these cases is morbidly
accumulated.

It must be evident that the great difficulty here is to determine the
nature of the predisposition; for if we make a mistake, instead of
preventing, we shall accelerate the disease. For instance, the first
slight disturbance of the functions which rises from a sthenic state,
often resembles those verging towards a state of debility or
asthenia. I have seen various instances arising from plethora, or a
sthenic state, where the patient complained of depression of spirits,
and inability to move; and, in short, from his own account was
labouring under asthenic diathesis: but by inquiring carefully into
the action of the exciting causes, examining minutely the state of
the pulse and of the functions, I have been convinced that the
depression of spirits which he felt, and other symptoms of weakness,
depended on fullness, and they have been quickly removed by lowering
the diet, administering a laxative, or taking a little blood: whereas
if, apprehending from the symptoms that he had laboured under
debility, I had ordered him a more generous diet and tonic remedies,
an inflammatory disease would have been the consequence, wh