The Account of Disease in A Survey of the Wisdom of
THE ACCOUNT OF DISEASE
IN A SURVEY OF THE WISDOM OF GOD
IN CREA TION
(1763) An Introductory Comment In 1747, in §8 of his preface to Primitive Physic, Wesley complained about 'men of a philosophical turn' who were not satisfied with traditional medical treatments founded merely upon common experience. These men desired to account for the success or failure of medicines, so they began to examine 'the human body and all its parts', and to 'form theories of diseases and their cure' which they substituted in place of common experience.
This complaint might suggest that Wesley was opposed to the modern focus on natural science—or what was called 'natural philosophy' in the eighteenth century. Such was hardly the case.1 Wesley stayed abreast of publications in natural philosophy, including the Philosophical Transactions of the Royal Society for the Improvement of Natural Knowledge. And he judged their findings about the natural world of sufficient importance to provide a distillation
(with theological reflections) for his Methodist people, published in 1763 as A Survey of the Wisdom of God in Creation; or, A Compendium of Natural Philosophy. Initially a two-volume work, Wesley's
Survey grew to five volumes by its third edition in 1777.2
Wesley's Survey opens with an account of the human body. This is followed by descriptions of other animals; then plants, fossils, and the physical elements of earth, fire, and water; and concludes with consideration of the heavens—including air, meteors, and cosmology. Survey will be considered as a whole elsewhere in this edition of Wesley's Works. But one excerpt sheds light on his assumptions about illness and health. Chapter Three of Part I summarizes the causes of disorder in the human body, including the ultimate disorder
' See Randy L. Maddox, 'John Wesley's Precedent for Theological Engagement with the Natural Sciences', Wesleyan Theological Journal 44.1 (2009): 23-54.
2 See Bibliography, No. 259.
Medical and Health Writings of death.3 While Wesley stressed that this summary was conjectural
(see §7), it is noteworthy that it contains no mention of the traditional humours. Rather, Wesley embraced Buddeus's mechanical description of the causes of disease as the most credible conjecture.
This is consistent with what is found elsewhere. Wesley readily described our bodies as 'exquisitely wrought machines' created by God.4 And he had long been drawn to an explanation of mortality as a clogging of the arteries due to foreign material in the blood.5
Wesley's foundational source for the first edition of Survey was a textbook in Latin by Johann Franz Buddeus (1667-1729), a professor at the universities of Halle and Jena.6 Most chapters in this initial edition are based on abridged translations of the Buddeus text, with excerpts from other works in natural philosophy or natural theology sprinkled throughout, and the occasional insertion of Wesley's own voice. Chapter Three of Part I is representative. Six of the first seven sections in the chapter trace back to Buddeus.
It includes as well an extended footnote from Ephraim Chambers's Cyclopaedia, a report drawn from The Universal Magazine of Knowledge and Pleasure, and excerpts from books by William
Derham (1615-1735) and John Ray (1627-1705). Wesley's voice emerges most clearly in three sections: §6 distills his advice related to the six 'non-naturals', echoing the closing section of the Preface to Primitive Physic:; §8 reiterates his insistence that attention should be directed less toward accounting for diseases than toward proven practices for avoiding them; and §9 draws on several sources in rehearsing his long-held conviction about the biological processes involved in mortality and death.
Wesley inserted additional excerpts in this chapter, from various sources, in subsequent editions of Survey of the Wisdom of God in Creation. These insertions, and the editions in which they are contained, will be documented elsewhere in this edition.
3Survey of the Wisdom of God {1763), 1:83-89.
+JW, Sermon 51, The Good Steward, 1.4, 2:285 in this edn.
'See JW, Sermon 141 (1730), 'The Image of God', §11.1-5, 4:29h-99 in this edn.
"Johann Franz Buddeus, Elementa Philosophiae Theoretica (Halle: GlaucheHallensis, 1706).
The Account of Disease
Of the Preternatural State of the Human Body1 1. When the structure or disposition of the parts of the body is so disturbed and disordered that the natural operations are no longer performed, or not in the manner they ought, this is a 'preternatural state of the body', otherwise termed a 'disease'.2
2. There cannot but be a great variety of diseases, whether we consider the manner wherein that structure or disposition is disturbed, the part wherein each disease has its seat, or the various effects and circumstances of them. Some diseases only hurt the use of the parts. Some wholly destroy it. Some affect this or that part, others the whole body. Some disorder the body, some the mind, and others both mind and body.3
3. But they are all reducible to three classes, those of the solids, of the fluids, and of both. The solid parts may be bruised, wounded, swelled, or removed out of their natural place.4
4. The diseases of the fluids lie chiefly in the blood—when it is either too thick and sizy,5 whereby its motion becomes too languid and slow, whence spring the diseases owing to obstruction; or too thin. From the former cause arise leprosies, scirrhuses, lethargies, melancholy, hysteric affections. And if at the same time it abounds in acid salts, the sharp points of these tear the tender fibres and occasion the scurvy, king's evil, consumption, with a whole train of painful distempers.
Fevers frequently arise from the too great thinness in the blood.6
5. As to the diseases ascribed to the animal spirits,7 some are thought to proceed from the suppression or diminution of their
1Survey of the Wisdom of God (1763), 1:83-89; drawing on Buddeus, Elementa, Bk. I, Chap. IV (pp. 91-101).
2 Buddeus, Elementa, §1 (p. 92).
3 Ibid, §2 (pp. 92-93).
4 Ibid, §3 (p. 93). The 1763 edn. of Survey included a footnote here that was incorporated into the text in subsequent editions. This note departed from Buddeus's description of disease to offer an account of calluses as a providential way of protecting bones and skin. The note was an adaptation of the articles on 'Callus' and 'Callus microscopically examined' in A Supplement to Mr. Chambers's Cyclopaedia: or, Universal
EEctionary of Arts and Sciences (London: W. Innys et al, 1753), vol. 1, unnumbered.
5I.e, viscous.
This section distills Buddeus, Elementa, §§4-8 (pp. 93-95).
7 'Animal spirits' were assumed in the 18th century to be very subtle or ethereal fluids that moved through the nerves like blood did through the arteries and veins. The flow of the animal spirits was used to account for sensation, dispositions, moods, and voluntary action. See OED. JW elsewhere equated 'animal spirits' with the 'ethereal fire' of electricity that flows through the nerves; see below,
'Thoughts on Nervous Disorders', §5.
Medical and Health Writings motion, as apoplexies and palsies; some from their excessive or irregular motion, as madness, convulsions, epilepsies.
6. Such are the proximate causes ot diseases. As to the remote, the chief are these: 1) intemperance in meat or drink, either with regaid to the quantity or quality; 2) want of exercise, or excess therein,
3) immoderate sleep or watching; 4) unwholesome air, 5) the diminution of some natural evacuation; [and] 6) irregular passions. All or any of these affect the temperature and motion of the blood and spirits.8 9
7. But it can scarcely be conceived, after all that has been said and wrote on almost every subject, how very little is known to this day concerning the causes of diseases. In most cases the skilful physicians acknowledge they have nothing but conjectures to offer. We may give a specimen with regard to fevers, the most common of all distempers. These are of various kinds—at present we will speak of intermitting fevers only. Most of these agree in the following symptoms. During the approach of the fit, cold and shivering seize the body, with a small and slow pulse. Heat succeeds, with a quick, strong, hard pulse; followed by sweat and a softer pulse. 1 hese fits return at stated times.
It is supposed that these changes in the blood arise from some foreign matter mixed with it, which it cannot readily assimilate, and which therefore must in some measure hinder its motion—perhaps because the particles of it are too large, too long, or branching out.
When the circulation is hindered or retarded, chillness naturally follows. And if these particles, sticking in the finer passages, are pressed on by the affluent blood, this will occasion both a shock and tremor of the muscles and make the pulse more weak and slow. But when they are at length broken and comminuted by the continued efflux of the blood, it will flow more violently and, of course, occasion heat—which driving the blood to the surface of the body, many of its thinner particles will burst through the pores in the form of sweat. As to the fevers returning at stated times, it is supposed the peccant matter is generated from time to time and mingled with the blood afresh. Whence the same symptoms of course return, and that with more or less violence, as more or less of that matter is generated. And as this is done more swiftly or slowly, the fever returns
8Buddeus, Elementa, §9 (p. 95).
'This is JW's briefest account of the six 'non-naturals'. See his longer discussion in §16 of his Preface to Primitive Physic, taken from George Chevne, An Essay on Health and Long Life (London: George Strahan, 1724). There is no parallel material in Buddeus at this juncture.
The Account of Disease
in one, two, or three days. But all this is mere conjecture. It may be so, and it may not. So that though we may guess much, we know nothing about it.10
8. It is sufficient for us to know how we may avoid diseases, whether we can account for them or not. To this end, we should avoid whatever in meat, drink, motion, or rest is likely to produce any considerable change in the blood. The body likewise should be as far as possible accustomed to bear some change of food, air, and other externals, that if we should at any time be constrained to make such a change, no ill consequence may ensue. But no precise rule can be laid down which will suit all constitutions. Every man must consult his own reason and experience, and carefully follow them.11
9. As long as the soul and body are united, a man is said to be alive. But it is extremely difficult to determine the precise time at which life ceases, or what that is which is absolutely necessary to the continuance of it. Is respiration? But when this is entirely ceased, as is the case in a person strangled, blow strongly into the lungs, and they play again—which shows he was not dead before. Is the beating of the heart? But when this also is ceased, in the forementioned case, take the same method, and when the lungs begin to play, the heart begins to beat anew. Is the circulation of the blood?
But persons drowned, who have been so long under water as to have no pulse remaining in any artery, and consequently no circulation, have recovered by the use of proper means and lived many years after. Is the fluidity of the blood? Nay, but it is a common thing in Sweden to recover to life one who has been twenty-four hours under water, and who not only has no pulse but is as stiff all over as any dead corpse can be.12 What then is death? Undoubtedly it is the separation of the soul and body. But there are many cases wherein none but God can tell the moment wherein they separate.
But what is properly a natural death? From the very birth, every vessel in the human body grows stiffer and stiffer by the adhesion of more and more earthy particles to its inner surface. Not only solid food supplies it with these, but every fluid that circulates through it. Hereby more and more of the small vessels grow harder, and their cavities narrower. Hence the dryness and stiffness of all
l0This section distills Buddeus, Elementa, §§11-18 (pp. 96-100).
"There is no parallel material in Buddeus at this juncture; or for the rest of this chapter.
12 See the report in 'Some Remarkable Instances of Different Persons that remained a Considerable Time under Water, without being Suffocated', Universal
Magazine of Knowledge and Pleasure, 31 (Aug. 1762): 88-91.
Medical and Health Writings the parts which are observable in old age. By this means, more and more of the vessels are destroyed, the finer fluids secerned in less quantity, the concoctions weakened, and the reparation of the decayed and injured parts prevented. So that the coarser juices continue to run slowly through the larger vessels. Soon these also not only become narrow, but stiff, bony, and inelastic; till even the great artery, having lost its spring, can propel the blood no longer. And then follows death by old age, which is a purely natural death. But this is a very rare case. It is seldom life is so long protracted, the lamp of life being easily blown out when it burns with so feeble a flame. So that the age of man seldom exceeds threescore years and ten before dust returns to dust.13
Indeed, soon after the creation, when the earth was to be peopled by one man and one woman, the wise providence of God prolonged the life of man to above 900 years. After the flood, when there was three men to people the earth, their age was cut shorter. And none of these patriarchs, except Shem, attained to five hundred years.
In the next century, none reached 240. In the third, none but Terah lived 200—men being then so increased that they built cities and divided into different nations. As their number increased, the length of their lives diminished, till about the time of Moses it was reduced to 70 or 80 years, where it stands at this day. This is a good medium, so that the earth is neither overstocked nor kept too thin of inhabitants. If men were now to live to Methuselah's age of 969 years, or only to Abraham's of 175, the earth would be overpeopled. If on the contrary, the age of man was limited (like that of divers other animals) to 10, 20, or 30 years, it would not be peopled enough. But at the present rate, the balance is nearly even, and life and death keep on an equal pace.14
This is highly remarkable, that wherever any account has been taken there is a certain rate and proportion in the propagation of mankind. Such a number marry, and so many are born, in proportion to the number of persons in every town or nation. And as to births, two things are very observable. One is the proportion of males and females: fourteen males to thirteen females, which is exactly agreeable to all the bills of mortality. And this surplusage of males allows one man to one woman, notwithstanding the casualties
13 CfJW's suggestion about how mortality spread through the bodies of Adam and Eve after they sinned in Sermon 141, The Image of God', §11.1-5, 4:296-99 in this edn.
14 This paragraph taken from William Derham, Physico-Theology, 4th edn.
(London: William Innys, 1716), 172-75.
The Account of Disease
to which men are exposed above women. The other is that a few more are born than appear to die in any place. This is an admirable provision for extraordinary emergencies, to supply unhealthy places, to make up the ravages of epidemic distempers and the depredations of war, and to afford a sufficient number for colonies in the yet unpeopled parts of the earth. On the other hand, those extraordinary expenses are not only a just punishment of sin but also a wise means to keep the balance of mankind even. So one would be ready to conclude, by considering the Asiatic and other more fertile countries, where prodigious multitudes are swept away by wars and plagues and still they remain full of people.15
As to the length of life, it has been an ancient opinion that men lived longer in cold countries than in hot. But the reverse is true.
The inhabitants of the Caribbee islands usually live a hundred and fifty years. In the Molucca islands, this ordinary life of the natives is a hundred and thirty years. In Sumatra, Java, and the neighbouring islands, the life of the inhabitants commonly extends to a hundred and forty years. In the realm of Cassuby, to 150. The Brazilians frequently live 160 years, and many in Florida and Jucatan still longer.16
Nor is this at all improbable. For there being no such inequality of weather in those climates as in ours, the body is not shocked by sudden changes, but kept in a more equal temper. And sickly persons with us, when fixed to their beds, and kept in an equal degree of heat, are often found to hold out many years, who would otherwise scarce have survived one.
Before concluding this head, we may observe one more eminent instance of the divine wisdom in the great variety throughout the world of men's faces, voices, and handwriting. Flad men's faces been cast in the same mould, their organs of speech given the same sound, and had the same structure of muscles and nerves given the hand the same direction in writing, what confusion, what numberless inconveniencies must we have been exposed to? No security could have been to our persons, no certainty of our possessions.
Our courts of justice abundantly testify the effects of mistaking men's faces or handwriting. But this, the wise Creator has taken care to prevent from being a general case. A man's face distinguishes him in the light, as his voice does in the dark. And his
15 Ibid., 175-77.
16 This paragraph is distilled from John Ray, The Wisdom of God Manifested in the Works of Creation, 3rd edn. (London: Samuel Smith & Benjamin Walford,
1701), 205-6 [this section of Ray was first included in the 3rd edition].
Medical and Health Writings handwriting can speak for him when absent, and secure his contracts to future generations.1'
Lastly, how admirably has God secured the execution of his original sentence, upon every child of man, 'Dust thou art, and unto
5 dust shalt thou return'?18 From the moment we live, we prepare for death, by the adhesion of dust, mixed with all our aliments, to our native dust; so that whatever we eat or drink, to prolong life, must sap the foundation of it. Thus, in spite of all the wisdom of man and all the precautions which can be used, every morsel we take
10 poisons while it feeds, and brings us nearer to the dust from whence we came.19
See JW s elaboration of this point in Sermon 57,'On the Fall of Man' SII 1-5 2:405-8 in this edn. '
17 Derham, Physico-Theology, 309-11.
18Gen. 3:19.